Article

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: 7.34). 02/2006; 188(1):37-45. DOI: 10.1192/bjp.bp.104.007286
Source: PubMed

ABSTRACT 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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    • "However, there is less evidence regarding the long-run outcomes for FEP programs versus usual care. After 18 months, the LEO (Lambeth Early Onset team) study did not find [21] a significant difference between clients in specialize programs versus those who were not. After 5 years, the OPUS trial did not find significant differences in employment between clients who were in FEP versus usual care [23] "
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    • "Participants in the LEO study were aged 16–40 years, and had presented to mental health services for the first or second time (the latter having disengaged without treatment after presenting once) with ICD-10 non-affective psychoses and the absence of organic psychosis or primarily substance addiction. Beneficial 12-and 18-month outcomes were found for the specialist intervention in global functioning, hospitalization rates, and vocational and social parameters (Garety et al. 2006). However, controlling for differences in baseline parameters such as previous psychotic episodes and ethnicity obviated the advantage in terms of relapse rates (Patton et al. 2007). "
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    • "The early phase of psychotic disorders has received increasing attention over the last 20 years, and the efficacy of specialised early intervention programs has now been established through randomised controlled trials (Garety et al., 2006; Petersen et al., 2005). One of the main aims of such programs has been to reduce the duration of untreated psychosis (DUP) (Melle et al., 2004; Marshall et al., 2005; Schimmelmann et al., 2008; Polari et al., 2009) in order to provide treatment at an earlier stage of the illness, considering findings of a link between longer DUP and poorer outcome (Marshall et al., 2005). "
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