Understanding inequalities in outcomes between demographic groups is a necessary step in addressing them in clinical care. Inequalities in treatment uptake between demographic groups may explain disparities in outcomes in people with first-episode psychosis (FEP).

To investigate disparities between broad demographic groups in symptomatic improvement in patients with FEP and their relationship to treatment uptake.

We used data from 6813 patients from the 2021–2022 National Clinical Audit of Psychosis data-set. Data were grouped by category type to obtain mean outcomes before adjustment to see whether disparities in outcomes remained after differences in treatment uptake had been accounted for. After matching, the average effect of each demographic variable in terms of outcome change was calculated. Moderator effects on specific treatments were investigated using interaction terms in a regression model.

Observational results showed that patients aged 18–24 years were less likely to improve in outcome, unless adjusted for intervention uptake. Patients classified as Black and Black British were less likely to improve in outcome (moderation effect 0.04, 95% CI 0–0.07) after adjusting for treatment take-up and demographic factors. Regression analysis showed the general positive effect of supported employment interventions in improving outcomes (coefficient −0.13, 95% CI −0.07 to −0.18, P < 0.001), and moderator analysis suggested targeting particular groups for interventions.

Inequalities in treatment uptake and psychotic symptom outcome of FEP by social and demographic factors require monitoring over time. Our analysis provides a framework for monitoring health inequalities across national clinical audits in the UK.

了解人口群体之间结果的不平等是在临床护理中解决这些问题的必要步骤。人口群体之间接受治疗的不平等可以解释首发精神病 （FEP） 患者结局的差异。

探讨广泛人口群体之间 FEP 患者症状改善的差异及其与治疗接受的关系。

我们使用了来自 6813-2021 年全国精神病临床审计数据集的 2022 名患者的数据。数据按类别类型分组，以获得调整前的平均结局，以查看在考虑了治疗接受的差异后，结局的差异是否仍然存在。匹配后，计算每个人口统计变量在结果变化方面的平均影响。使用回归模型中的交互项研究调节因子对特定治疗的影响。

观察结果表明，除非根据干预接受进行调整，否则 18-24 岁患者不太可能改善结局。在调整治疗接受和人口统计学因素后，被归类为黑人和英国黑人的患者不太可能改善结局 （调节效应 0.04,95% CI 0-0.07）。回归分析显示，支持性就业干预对改善结局具有普遍的积极影响（系数 -0.13,95% CI -0.07 至 -0.18，P < 0.001），调节者分析建议针对特定群体进行干预。

社会和人口因素对 FEP 的治疗接受和精神病症状结果的不平等需要随着时间的推移进行监测。我们的分析为监测英国国家临床审计中的健康不平等提供了一个框架。