Early intervention in psychosis: a new evidence based paradigm

@article{McGorry2002EarlyII,
  title={Early intervention in psychosis: a new evidence based paradigm},
  author={Patrick D. McGorry and E{\'o}in Killackey},
  journal={Epidemiology and Psychiatric Sciences},
  year={2002},
  volume={11},
  pages={237 - 247}
}
SUMMARY Objective – Even in countries whose mental health services are comparatively well resourced, the care offered to those in the early stages of psychotic illnesses is not what it could be. Patients often have to progress to chronicity before receiving adequate interventions, by which stage there has been great potential for harm, not only through the psychosis, but also to the quality of life of the individual who has often missed or not completed adequately, several important… 
Effectiveness of early intervention in psychosis
TLDR
Evidence shows that early intervention reduces the duration of untreated psychosis, produces better outcomes in terms of symptomatic and functional domains, and is cheaper than standard models of care.
Early intervention in psychosis: concepts, evidence and future directions
TLDR
A broader focus for early intervention would solve many of the second order issues raised by the early psychosis reform process, such as diagnostic uncertainty despite a clear-cut need for care, stigma and engagement, and should be more effective in mobilizing community support.
FORUM: EaRly INTERVENTION IN psychOsIs: clINIcal aNd EThIcal challENgEs
TLDR
A broader focus for early intervention would solve many of the second order issues raised by the early psychosis reform process, such as diagnostic uncertainty despite a clear-cut need for care, stigma and engagement, and should be more effective in mobilizing community support.
Early Psychosis: Where we've been, where we still have to go
TLDR
Some issues that have created controversy are examined here including pre-onset intervention and identification, the relationship of duration of untreated psychosis (DUP) to outcome and whether or not early intervention is an effective and economically viable model.
First episode psychosis and treatment delay--causes and consequences.
TLDR
Efforts at thelevel of Communities as well as efforts at the level of psychiatry specialists could help individuals and their families to overcome the illness situation and improve their quality of life.
Key Worker–Mediated Enhancement of Physical Health in First Episode Psychosis: Protocol For a Feasibility Study in Primary Care
TLDR
The protocol for a feasibility study examining how key workers may enhance physical health by supporting integration between primary and secondary care is outlined, identifying issues involved in enhancing recruitment and retention, as well as the likely effect size.
Prediction of psychosis in adolescents and young adults at high risk: results from the prospective European prediction of psychosis study.
TLDR
A differential predictive clinical model of transition to first-episode psychosis is developed that identified an increased risk of psychosis with appropriate prognostic accuracy in a sample of help-seeking patients.
Emerging psychosis in young people - Part 2
TLDR
Key issues for the optimal management of emerging psychotic disorders, with a particular focus on the role of the GP are summarized, including the engagement of the young person into therapy.
A Naturalistic Study of Treatment Outcomes with Aripiprazole in Young People with First Episode Psychosis
TLDR
Aripiprazole was one of many medications used in this study and may have been useful for the treatment of some individuals with first episode psychosis.
A prospective study of the relationship between stress, coping and the onset of psychosis in a high risk group
TLDR
It was concluded that the appraisals made about stressors differentiated the groups and led to differences in coping and distress levels.
...
...

References

SHOWING 1-10 OF 65 REFERENCES
Have the times come for early intervention in psychosis?
  • H. Verdoux
  • Psychology, Medicine
    Acta psychiatrica Scandinavica
  • 2001
TLDR
After having carefully reviewed the literature on past and ongoing studies on early intervention programmes in first-episode schizophrenia, Larsen et al. conclude that a large number of questions remained unanswered with regard to the efficacy such programmes.
Early intervention in schizophrenia and related disorders: advantages and pitfalls
TLDR
Clinicians should concentrate on providing phase specific treatment early following the onset of psychosis and wait for more definitive evidence regarding the application of interventions in the pre-psychotic phase of the illness.
EPPIC: an evolving system of early detection and optimal management.
TLDR
A framework for preventive intervention in early psychosis is outlined, based on more than a decade of experience initially gained within a first-generation model, a comprehensive "real-world" model of care targeting the multiple clinical foci underpinning the preventive task.
Cognitively oriented psychotherapy for early psychosis (COPE): a 1-year follow-up.
TLDR
Post-treatment assessment results from a non-randomized controlled trial of Cognitively oriented psychotherapy for early psychosis suggest that the present formulation of COPE does not confer any advantage to those patients receiving the therapy over those not receiving the Therapy.
Duration of untreated psychosis: a critical examination of the concept and its importance
TLDR
Evidence thus far suggests that DUP may be related to ease of reducing psychotic symptoms once treatment begins for first episode patients, but there is no evidence of a relationship to likelihood of relapse.
Early psychosis in the inner city: a survey to inform service planning
TLDR
This survey confirmed existing knowledge on the social and service needs of this population, in finding high rates of unemployment and homelessness, poor engagement with services and frequent involuntary pathways to mental healthcare.
Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms.
TLDR
More specific pharmacotherapy and psychotherapy reduces the risk of early transition to psychosis in young people at ultra-high risk, although their relative contributions could not be determined.
Prediction of psychosis
TLDR
It is demonstrated that it is possible to identify individuals with a high likelihood of onset of psychosis within a brief follow-up period, which lays the foundation for early treatment in an attempt to prevent, delay or minimise the severity of first onset of schizophrenia.
Duration of untreated psychosis in first-episode schizophrenia: marker or determinant of course?
...
...