Incidence of First-Episode Psychosis Among Privately Insured Individuals

OBJECTIVE: Accurate estimates of incidence rates of first-episode psychosis (FEP) are needed to support coordinated specialty care (CSC) programs in determining the staffing and resources needed to meet the local demand for care. The goal of this study was to examine incidence rates of FEP among privately insured individuals. METHODS: The authors examined data from IBM MarketScan to identify individuals with a FEP diagnosis between 2013 and 2021 (N=86,695). RESULTS: Between 2013 and 2021, the median annual incidence rate of FEP was 80.54 per 100,000 individuals ages 15-40, with a higher incidence rate among men than women. However, incidence rates for women increased significantly between 2013 and 2021, whereas rates for men did not. CONCLUSIONS: Despite the finding of a lower incidence rate of FEP than previously reported, when compared with national enrollment data for CSC teams, these data suggest that >90% of Americans with FEP do not access CSC.