Specialised care for early psychosis: Symptoms, social functioning and patient satisfaction - Randomised controlled trial

The University of Manchester, Manchester, England, United Kingdom
The British Journal of Psychiatry (Impact Factor: 7.99). 02/2006; 188(1):37-45. DOI: 10.1192/bjp.bp.104.007286
Source: PubMed


The provision of early intervention services for people with psychosis is UK government policy, although evidence for benefit of such services is sparse.
To evaluate the effects of a service providing specialised care for early psychosis (the Lambeth Early Onset Team) on clinical and social outcomes, and on service user satisfaction.
One hundred and forty-four people with psychosis, presenting to mental health services for the first or second time (if previously failed to engage in treatment), were randomly allocated to care by the early onset team or to standard care. Information was obtained on symptoms, treatment adherence, social and vocational functioning, satisfaction and quality of life. Relapse and rehospitalisation data have been reported separately.
Outcomes for the participants treated by the early onset team were significantly better at 18 months for aspects of social and vocational functioning, satisfaction, quality of life and medication adherence. Symptom improvement did not significantly differ between the groups.
The provision of specialised care for early psychosis can achieve better outcomes. The study therefore provides support for current policy.

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    • "Research findings support a number of key elements of early intervention programs, yet there is variability in their implementation (Catts et al., 2010; Ghio et al., 2012; McGorry et al., 2008; Srihari et al., 2012). Some programs stress the importance of case management, while others focus on medication or social and functional recovery (Garety et al., 2006; Spencer et al., 2001). Although variation exists, most studies indicate key components such as: pharmacological interventions , cognitive-behavioral treatment, family interventions, and vocational services (Allott et al., 2011; De Masi et al., 2008; Hill et al., 2012; Spencer et al., 2001). "
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    ABSTRACT: Programs providing interventions for early psychosis are becoming commonplace in the United States (U.S.); however, the characteristics of existing services remain undocumented. We examined program characteristics, clinical services, and program eligibility criteria for outpatient early intervention programs across the U.S. using a semi-structured telephone interview. Content analysis was used to identify the presence or absence of program components, based in part on a recent list of essential evidence-based components recommended for early intervention programs (Addington, MacKenzie, Norman, Wang and Bond, 2013) as well as program characteristics, including eligibility criteria. A total of 34 eligible programs were identified; 31 (91.2%) program representatives agreed to be interviewed. Of the examined components, the most prevalent were individual psychoeducation and outcomes tracking; the least prevalent were outreach services and communication with inpatient units. The populations served by US programs were most frequently defined by restrictions on the duration of psychosis and age. This study provides critical feedback on services for the early psychosis population and identifies research to practice gaps and areas for future improvement. Copyright © 2015 Elsevier B.V. All rights reserved.
    Schizophrenia Research 08/2015; 168(1). DOI:10.1016/j.schres.2015.08.020 · 3.92 Impact Factor
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    • "The outcomes were also better in satisfaction (Verona Service Satisfaction Scale), quality of life (MANSA), and pharmacological adherence. In addition, the patients maintained educational or work activities for a longer period of time than the control group (6.9 vs. 4.2 months) (11). Patients receiving specialized care reported a greater average number of significant others in their social network (2.40 ± 1.20 vs. 1.71 ± 1.06), which linear regression analysis correlated with significant improvement in total PANNS and GAF (β = 2.95, SE = 1.04), showing the importance of social network in clinical improvement (12). "
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    Frontiers in Psychiatry 10/2013; 4:116. DOI:10.3389/fpsyt.2013.00116
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    • "However, it is interesting to note at this point that, in both countries, there is a gap between the mental health needs of adolescents and the services available to them. Some researchers in the United Kingdom have claimed that help for adolescents is often not available or effective (Garety et al., 2006). Others have pointed out that many of the major mental health disorders begin in adolescence, but that this is where service provision is weakest (Gunn, 2004). "
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