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Early intervention psychosis

Nikolai Albert, Louise Birkedal Glenthøj, Marianne Melau, Heidi Jensen, Carsten Hjorthøj, Merete Nordentoft
BACKGROUND: Previous studies report that 20% to 30% of those initially diagnosed with schizotypal disorder go on to develop a psychotic disorder (predominantly schizophrenia). Schizotypal disorder share some traits of those used to identify patients at ultra-high risk for psychosis. METHOD: As part of a randomized clinical trial testing the effect of prolonged specialized early intervention, we recruited 83 participants diagnosed with a schizotypal disorder. Participants were recruited 18 months into their two-year treatment program, and follow-up interviews were conducted three and a half year later...
October 16, 2016: Schizophrenia Research
Julia M Lappin, Margaret Heslin, Peter B Jones, Gillian A Doody, Ulrich A Reininghaus, Arsime Demjaha, Timothy Croudace, Thomas Jamieson-Craig, Kim Donoghue, Ben Lomas, Paul Fearon, Robin M Murray, Paola Dazzan, Craig Morgan
OBJECTIVE: To compare baseline demographics and 10-year outcomes of a first-episode psychosis patient incidence cohort in order to establish whether current youth-focussed age-based criteria for early intervention services are justified by patient needs. The patients in this cohort were treated prior to the establishment of early intervention services. The study aimed to test the hypothesis that those who develop psychosis at a younger age have worse outcomes than those who develop psychosis at an older age...
October 18, 2016: Australian and New Zealand Journal of Psychiatry
M Lambert, V Niehaus, C Correll
This review aims to describe the importance of i) detecting individuals at clinical high-risk for psychosis (schizophrenia) or bipolar disorder, especially in children and adolescents, in order to enable early intervention, and ii) evaluating different intervention strategies, especially pharmacotherapy, during the subsyndromal or "prodromal" stages of these severe and often debilitating disorders. The different approaches regarding the psychotic and bipolar clinical high-risk state are discussed, including reasons and evidence for early (pharmacological) intervention and risks of treatment vs...
October 13, 2016: Pharmacopsychiatry
Charmaine Tang, Mythily Subramaniam, Boon Tat Ng, Edimansyah Abdin, Lye Yin Poon, Swapna K Verma
OBJECTIVE: Early symptomatic response is pertinent in improving outcomes in first-episode psychosis. One of the ways in which this may be achieved is by reducing inappropriate delays in clozapine initiation. This study aimed to examine clozapine prescribing practices among clinicians by establishing the prevalence of clozapine use, identifying baseline clinical and demographic factors that were associated with clozapine use, examining outcomes in clozapine users versus nonusers, and identifying inappropriate antipsychotic prescription patterns prior to clozapine initiation...
October 11, 2016: Journal of Clinical Psychiatry
Suzanne Di Capite, Rachel Upthegrove, Pavan Mallikarjun
BACKGROUND: To determine the "real world" relapse rate in patients with first-episode psychosis (FEP) who had discontinued antipsychotic medication and identify socio-demographic and clinical factors associated with the risk of relapse. METHODS: Quantitative data were obtained via case-note review on 63 patients with FEP who had discontinued antipsychotic medication from Birmingham Early Intervention Service between 2012 and 2015. The follow-up period was until either: an occurrence of a relapse; end of 12-month study period; end of patient's case-note record...
October 13, 2016: Early Intervention in Psychiatry
Catherine Shiu-Yin Chong, Man-Wah Siu, Condy Hoi-Shuen Kwan, Wing-Chung Chang, Edwin Ho-Ming Lee, Sherry Kit-Wa Chan, Christy Lai-Ming Hui, Fiona Yee-Ki Tam, Eric Yu-Hai Chen, William Tak-Lam Lo
AIM: To explore the changes of functioning in people suffering from first-episode psychosis throughout their first year into an early intervention service, and the baseline predictors of their functioning levels at baseline, 6 and 12 months METHOD: Consecutive subjects presenting to an early intervention service were recruited from 1 February 2013 to 31 May 2015. Information on their socio-demographic status was collected. Structured instruments were used to assess their premorbid functioning, duration of untreated psychosis, psychopathology and insight at baseline...
October 12, 2016: Early Intervention in Psychiatry
Robin E Gearing, Kathryne B Brewer, Irfan Mian, Kiara Moore, Prudence Fisher, Jane Hamilton, James Mandiberg
AIM: The timely identification and treatment of psychosis are increasingly the focus of early interventions, with research targeting the initial high-risk period in the months following first-episode hospitalization. Ongoing treatment after stabilization is also essential in the years following a first-episode psychosis (FEP), but has received less research attention. In this study, variables that could impact continued psychiatric service utilization by adolescents following their FEP and temporal patterns in service utilization are examined...
October 11, 2016: Early Intervention in Psychiatry
Sibylle Metzler, Diane Dvorsky, Christine Wyss, Carlos Nordt, Susanne Walitza, Karsten Heekeren, Wulf Rössler, Anastasia Theodoridou
An important aim in schizophrenia research is to optimize the prediction of psychosis and to improve strategies for early intervention. The objectives of this study were to explore neurocognitive performance in individuals at risk for psychosis and to optimize predictions through a combination of neurocognitive and psychopathological variables. Information on clinical outcomes after 24 months was available from 118 subjects who had completed an extensive assessment at baseline. Subjects who had converted to psychosis were compared with subjects who had not...
September 30, 2016: Psychiatry Research
Andrea Murru, Bernardo Carpiniello
The first psychotic episode is classically viewed as a critical period which management is important in determining the long-term outcome of the schizophrenia (SCZ). For this reason, the duration of untreated illness (DUI), defined as the interval between the onset of the psychiatric disorder and the administration of the first pharmacological treatment, is a clinical variable that has been increasingly investigated due to its potentially modifiable nature and its value as a predictor of outcome. DUI is poorly applicable and highly unreliable in psychosis...
October 4, 2016: Neuroscience Letters
Jacqueline Sin, Claire Henderson, Debbie Spain, Catherine Gamble, Ian Norman
BACKGROUND: Recruitment to clinical research studies can prove complex. This is particularly true of mental health research, given factors such as confidentiality, capacity and consent, or when attempting to recruit family members as opposed to service users themselves. AIM: This study investigated the challenges experienced and strategies employed in the recruitment of siblings of people with first episode psychosis using Early Intervention in Psychosis Services (EIPS) in England...
October 6, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Kristen A Woodberry, Larry J Seidman, Caitlin Bryant, Jean Addington, Carrie E Bearden, Kristin S Cadenhead, Tyrone D Cannon, Barbara A Cornblatt, Thomas H McGlashan, Daniel H Mathalon, Diana O Perkins, Ming T Tsuang, Elaine F Walker, Scott W Woods
Early intervention for psychotic disorders, a growing international priority, typically targets help-seeking populations with emerging psychotic ("positive") symptoms. We assessed the nature of and degree to which treatment of individuals at high risk for psychosis preceded or followed the onset of positive symptoms. The North American Prodrome Longitudinal Study-2 collected psychosocial treatment histories for 745 (98%) of 764 high-risk participants (M age = 18.9, 57% male, 57.5% Caucasian, 19.1% Hispanic) recruited from 8 North American communities...
October 5, 2016: Journal of Clinical Child and Adolescent Psychology
Emily Liffick, Nicole F Mehdiyoun, Jenifer L Vohs, Michael M Francis, Alan Breier
OBJECTIVE: Because of the chronicity, severity, and marked psychosocial impairment that may characterize the illness, schizophrenia is an incredibly costly disease. Recent data indicate that intervention earlier in the course of schizophrenia produces cost savings. This study compared health service utilization and associated costs for patients receiving treatment for first-episode psychosis (FEP) delivered within the early-intervention (EI) model at the Prevention and Recovery Center for Early Psychosis (PARC) and for a matched sample of FEP patients receiving treatment as usual at a geographically similar mental health clinic...
October 3, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Anders L Dannevang, Lasse Randers, Matthias Gondan, Kristine Krakauer, Dorte Nordholm, Merete Nordentoft
AIM: Deterioration in premorbid adjustment is related to ultra-high risk (UHR) individuals developing psychosis, but it has not been examined how UHR individuals' development differs compared to healthy controls. This study investigates differences in premorbid adjustment between UHR individuals and a healthy control group. METHOD: A total of 48 UHR individuals and 50 healthy controls matched on group level for age, gender and parents' socio-economic status were included in the study...
September 29, 2016: Early Intervention in Psychiatry
Tarek Okasha, Nivert Zaki, Marwa Abd El Meguid, Marwa El-Missiry, Walaa Sabry, Mostafa Kamel Ismaeil, Samar M Fouad
BACKGROUND: Duration of untreated psychosis (DUP) has been considered as a poor prognostic factor for psychotic disorder. Several studies have been investigating different predictors of DUP in Western countries, while in Egypt only a few studies have examined various predictors of DUP. AIMS: To study DUP in Egyptian patients with psychotic disorders and to investigate how certain illnesses, patient, socio-cultural risk factors and help-seeking behaviour are correlated with prolonged DUP...
September 28, 2016: International Journal of Social Psychiatry
Alice Oppetit, Julie Bourgin, Gilles Martinez, Mathilde Kazes, Célia Mam-Lam-Fook, Raphael Gaillard, Jean-Pierre Olié, Marie-Odile Krebs
AIM: The aim is to describe a centre operating in Paris that pioneers the early intervention for young people at the onset and at high risk of psychosis in France. METHODS: Comprehensive descriptive analysis of different clinical and service measures is used in describing the implementation of the C'JAAD (Evaluation Centre for Young Adults and Adolescents) using data from an ongoing prospective non-interventional research programme. RESULTS: Over a 2-year period, 151 patients were referred to the C'JAAD and included in the ICAAR research programme...
September 28, 2016: Early Intervention in Psychiatry
Charlotte A Labys, Ezra Susser, Jonathan K Burns
BACKGROUND: Growing interest in strategies regarding early intervention for psychosis has led to a parallel interest in understanding help-seeking behavior, especially in low- and middle-income countries (LMICs). Nevertheless, few LMIC studies have examined individuals with psychosis in non-urban, non-hospital settings. Using the perspective of formal and informal community service providers, we aimed to uncover descriptions of people with psychosis in a rural South African community and illuminate the potential complexities of their help-seeking journeys...
2016: International Journal of Mental Health Systems
Eric Roche, John Lyne, Brian O'Donoghue, Ricardo Segurado, Caragh Behan, Laoise Renwick, Felicity Fanning, Kevin Madigan, Mary Clarke
BACKGROUND: Formal thought disorder (FTD) is associated with poor outcome in established psychotic illnesses and it can be assessed as a categorical or dimensional variable. However, its influence on functional outcome and hospitalisation patterns in early psychosis has not been investigated. We evaluated the relationship between FTD and these outcomes in a first episode psychosis (FEP) sample. MATERIALS AND METHODS: A mixed diagnostic FEP cohort was recruited through an Early Intervention in Psychosis Service in Ireland...
September 14, 2016: Schizophrenia Research
Margaret A Mariano, Kerri Tang, Matthew Kurtz, Wendy R Kates
AIM: Schizophrenia and 22q11.2 deletion syndrome (22q11DS) share similar patterns of cognitive deficits. Up to 30% of those with 22q11DS develop schizophrenia during early adulthood. As cognitive decline has recently been found to predict onset of psychosis in adolescents with 22q11DS, early interventions such as cognitive remediation (CR) during adolescence are warranted. This paper investigates the durability of a remote, computerized, CR programme for youth with 22q11DS. Our aim was to determine if the positive effects of CR persisted 6 months beyond intervention completion...
September 15, 2016: Early Intervention in Psychiatry
Niklas Granö, Jorma Oksanen, Santeri Kallionpää, Mikko Roine
Previous studies have shown an association between hopelessness and suicidal behaviour in clinical populations. The aim of the study was to investigate sensitivity, specificity, and predictive validity of the Beck Hopelessness Scale (BHS) for suicidal ideation in adolescents who show early risk signs on the psychiatric disorder continuum. Three-hundred and two help-seeking adolescents (mean age = 15.5 years) who were entering an early intervention team at Helsinki University Central Hospital, Finland, completed questionnaires of BHS and suicidal ideation, derived from Beck Depression Inventory (BDI-II)...
September 14, 2016: Nordic Journal of Psychiatry
D Leguay
This article attempts to identify and put into perspective the different approaches that could globally prevent the suffering induced by schizophrenia, from the detection of early psychosis to the impact on individual and family functioning and emotional health. Schizophrenia causes, at the community level, a number of difficult consequences and associated costs, which likely could be reduced if specific strategies, already known and documented internationally, were applied. Two areas not explored in this article: the role of medication and the issue of suicide prevention...
September 9, 2016: L'Encéphale
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