Predicting 5-year outcome in first episode psychosis-construction of a prognostic rating scale

2008 ◽  
Vol 23 ◽  
pp. S115
Author(s):  
L. Flyckt ◽  
M. Mattsson ◽  
G. Edman ◽  
R. Carlsson ◽  
J. Cullberg
Keyword(s):  
Rating Scale ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis

Service innovations

2003 ◽  
Vol 27 (4) ◽  
pp. 148-151 ◽  
Author(s):  
Rahul Tomar ◽  
Neil Brimblecombe ◽  
Geraldine O'Sullivan
Keyword(s):  
Rating Scale ◽  
Diagnostic Category ◽  
First Episode Psychosis ◽  
Community Services ◽  
Home Treatment ◽  
First Episode ◽  
Crisis Resolution ◽  
Episode Psychosis ◽  
Significant Difference ◽  
At Home

Aims and MethodDemographic and clinical details were recorded for individuals with first-episode psychosis, potentially requiring hospital admission, who were assessed by two home treatment/crisis resolution teams over an 18-month period. The aims were to identify the proportion of such individuals that can be treated at home, factors associated with successful home treatment and reasons for hospitalisation when this took place.ResultsSuccessful home management was achieved in 20 (54%) of cases. No significant difference was found in any demographic variable, diagnostic category and initial Brief Psychiatric Rating Scale (BPRS) ratings between those who were hospitalised and those who were not. The most common reason recorded for admission was that of risk to self.Clinical ImplicationsMany patients with first-episode psychosis otherwise requiring hospitalisation can be managed successfully at home by an intensive home-treatment team. These findings have significant implications for both in-patient and community services, in view of the planned increases in home treatment/crisis resolution services proposed in the NHS Plan.

scholarly journals Service innovations

2003 ◽  
Vol 27 (04) ◽  
pp. 148-151
Author(s):  
Rahul Tomar ◽  
Neil Brimblecombe ◽  
Geraldine O'Sullivan
Keyword(s):  
Rating Scale ◽  
Diagnostic Category ◽  
First Episode Psychosis ◽  
Community Services ◽  
Home Treatment ◽  
First Episode ◽  
Crisis Resolution ◽  
Episode Psychosis ◽  
Significant Difference ◽  
At Home

Aims and MethodDemographic and clinical details were recorded for individuals with first-episode psychosis, potentially requiring hospital admission, who were assessed by two home treatment/crisis resolution teams over an 18-month period. The aims were to identify the proportion of such individuals that can be treated at home, factors associated with successful home treatment and reasons for hospitalisation when this took place.ResultsSuccessful home management was achieved in 20 (54%) of cases. No significant difference was found in any demographic variable, diagnostic category and initial Brief Psychiatric Rating Scale (BPRS) ratings between those who were hospitalised and those who were not. The most common reason recorded for admission was that of risk to self.Clinical ImplicationsMany patients with first-episode psychosis otherwise requiring hospitalisation can be managed successfully at home by an intensive home-treatment team. These findings have significant implications for both in-patient and community services, in view of the planned increases in home treatment/crisis resolution services proposed in the NHS Plan.

scholarly journals Patients With First-Episode Psychosis are Not a Homogeneous Population: Implications for Treatment

2014 ◽  
Vol 10 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Angelo Cocchi ◽  
Giorgio Cerati ◽  
Antonio Lora ◽  
Anna Meneghelli ◽  
Emiliano Monzani ◽  
...  
Keyword(s):  
Rating Scale ◽  
Severe Depression ◽  
Public Mental Health ◽  
First Episode Psychosis ◽  
First Episode ◽  
Homogeneous Population ◽  
Symptom Profile ◽  
Episode Psychosis ◽  
Early Intervention In Psychosis ◽  
Cluster 2

Objective:This study aimed at defining the characteristics of a population of patients diagnosed with first-episode psychosis (FEP), and accessing for the first time a center for early intervention in psychosis in the health district of Milan and its surroundings.Methods:Patients were included in the study from January 2007 to December 2008; criteria: first contact with any public mental health service of the catchment area for a first episode of schizophrenia or related syndromes according to the ICD-10 criteria. Cluster analysis was used to divide patients into groups based on the main socio-demographic and clinical characteristics at presentation.Results:Overall, 91 FEP patients were enrolled in the study. Two clusters were identified, which differed principally by symptom profile. Patients in cluster 1 (n=36) had severe agitation, and a history of alcohol and/or substance abuse at presentation more often than those in cluster 2 (n=55), who were more likely to suffer at presentation from severe depression or apathy, anxiety, poor self-care, functional or work impairment and severe social withdrawal. After six months of treatment patients improved on almost all symptomatic dimensions on the Health of the Nation Outcome Scale and the Brief Psychiatric Rating Scale, with greater improvement in cluster 1 than in cluster 2.Conclusions:The findings of this study need replication in larger samples and on a wider severity scale. Nevertheless, the heterogeneity of patients with FEP might impact on treatment. Policymakers should recognize the importance of the diagnostic and outcome assessment in the treatment of severe mental disorders.

Self-Administered Instrument to Measure the Patient's Experience of Recovery After First-Episode Psychosis: Development and Validation of the Psychosis Recovery Inventory

2005 ◽  
Vol 39 (6) ◽  
pp. 493-499 ◽  
Author(s):  
Eric Y.H. Chen ◽  
Dennise K.P. Tam ◽  
Josephine W.S. Wong ◽  
C.W Law ◽  
Cindy P.Y. Chiu
Keyword(s):  
Internal Consistency ◽  
Validation Study ◽  
Convergent Validity ◽  
Rating Scale ◽  
First Episode Psychosis ◽  
First Episode ◽  
Recovery Stage ◽  
Retest Reliability ◽  
Episode Psychosis ◽  
Test Retest Reliability

Objective: Patients who are recovering from a first-episode psychosis face specific and complex issues that are related to their illness and treatment experiences, such as the appraisal of the extent of their recoveryand the risk ofrelapse. Currently, no instrument provides a comprehensive assessment of these related attitudes. A novel self-administered rating scale for the measurement of key perceptions during the recovery stage after a firstepisode psychosis is presented. The Psychosis Recovery Inventory (PRI) is designed to specifically address a number of closely related issues that are faced by patients who are recovering from a first-episode psychosis. Method: The process of development of the PRI involved the generation of items from qualitative interviews, the construction and refinement of these items and a validation study. The longitudinal stability of the PRI items was assessed in a test–retest reliability study in which 20 patients completed the retest within 4 weeks. The internal consistency and convergent validity of the PRI were evaluated by a comparison of the PRI subscale scores and the Scale to Assess Unawareness of Mental Disorder and Drug Attitude Inventory scores in a sample of 48 first-episode psychosis patients. Results: The validation study shows that the PRI is an instrument with a good test–retest reliability, internal consistency and convergent validity. Conclusions: This pragmatic, low burden, self-administered scale can be applied in clinical and research settings to obtain reliable information on the attitudes of patients on a range of interrelated issues in the recovery stage that follows a first-episode psychosis.

Prolonged recovery in first-episode psychosis

1998 ◽  
Vol 172 (S33) ◽  
pp. 107-116 ◽  
Author(s):  
Jane Edwards ◽  
Dana Maude ◽  
Patrick D. McGorry ◽  
Susan M. Harrigan ◽  
John T. Cocks
Keyword(s):  
Early Intervention ◽  
Psychosocial Functioning ◽  
Rating Scale ◽  
Clinical Care ◽  
First Episode Psychosis ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Positive Symptoms ◽  
Course Of Illness ◽  
Episode Psychosis

Background Early identification and specialised treatment of individuals with enduring positive symptoms may assist in alleviating symptoms and has the potential to change the course of illness.Method Prevalence and descriptive data on enduring positive symptoms in two first-episode samples are outlined. Attempts to incorporate the focus of early intervention for persisting psychosis into routine clinical care of individuals with first-episode psychosis are described.Results Of the 227 individuals with first-episode psychosis who were assessed using the Brief Psychiatric Rating Scale at 3/6 months and 12 months following initial stabilisation (from a total sample of 347), 6.6% experienced enduring positive symptoms at all three time points. When the analysis was restricted to schizophrenia, schizophreniform and schizoaffective disorders (n=158) the percentage increased to 8.9%. These patients had significantly longer mean duration of untreated psychosis prior to initiation of treatment and, at 12-month follow-up, significantly higher depression and poorer psychosocial functioning.Conclusions The association of untreated psychosis with treatment resistance supports the argument for early intervention as soon as possible following the onset of psychotic symptoms.

Analysis of the initial treatment phase in first-episode psychosis

1998 ◽  
Vol 172 (S33) ◽  
pp. 71-76 ◽  
Author(s):  
Paddy Power ◽  
Kathryn Elkins ◽  
Steven Adlard ◽  
Christina Curry ◽  
Patrick McGorry ◽  
...  
Keyword(s):  
Low Dose ◽  
Rating Scale ◽  
Treatment Phase ◽  
Psychosocial Interventions ◽  
First Episode Psychosis ◽  
First Episode ◽  
The People ◽  
Episode Psychosis ◽  
Scale Scores ◽  
Psychiatric Rating Scale

Background The Early Psychosis Prevention and Intervention Centre (EPPIC) commenced operation in Melbourne, Australia, in 1992. It offers a model for management of first-episode psychosis, utilising principles of early detection, low-dose medication and comprehensive psychosocial interventions within the least restrictive setting.Method Data were examined from the first three months of treatment for all consecutive people with first-episode psychosis (n=231) accepted in the programme in 1995–1996. A subsample of patients (n=120) was assessed comparing clinical ratings with variables of gender, diagnosis, hospitalisation, and medication.Results Hospitalisations were brief, and avoided for a third of the people. Low-dose antipsychotic medication was maintained in both in-patient and community settings. Those people with manic psychosis were more likely to be hospitalised. Hospitalised people received higher antipsychotic dosages, and had a greater rate of reduction in Brief Psychiatric Rating Scale psychotic sub-scale scores at three months follow-up. Eighty per cent of a representative subsample had responded to treatment and 63% were in remission by the end of the three months.Conclusion This naturalistic study suggests that the feasibility of implementing the EPPIC model in a range of clinical settings is promising and applicable in practice.

scholarly journals Spontaneous Parkinsonism in Antipsychotic-Naive Patients with First-Episode Psychosis

2005 ◽  
Vol 50 (7) ◽  
pp. 429-431 ◽  
Author(s):  
Siow Ann Chong ◽  
Mythily Subramaniam ◽  
Swapna Verma
Keyword(s):  
Intervention Program ◽  
Rating Scale ◽  
Chinese Women ◽  
First Episode Psychosis ◽  
First Episode ◽  
Affective Psychosis ◽  
Asian Patients ◽  
Affective Symptoms ◽  
Episode Psychosis ◽  
Significant Difference

Objective: The purpose of this study was to establish rates of spontaneous parkinsonism (SP) among the different types of psychosis. We hypothesized that the rate would be higher among persons with affective symptoms. Methods: We included in the study consecutive patients admitted to a first-episode psychosis intervention program. We recorded sociodemographic data from interviews with patients and caregivers and from medical records. We used the Simpson–Angus Rating Scale at baseline to assess parkinsonism and a diagnosis of SP was established if the Simpson–Angus score was ≥ 0.3. Results: A total of 174 patients were examined; of these, only 4 (2.3%; 2 Chinese women, 1 Chinese man, and 1 Malay man) had SP. There was a significant difference in the rates of SP in patients with affective psychosis and schizoaffective disorder, compared with those with nonaffective psychoses (15.4% vs 1.2%; χ2 = 10.7, P = 0.001). The 2 groups did not differ significantly in age, duration of untreated psychosis, or sex distribution. Conclusions: The rate of SP in Asian patients with first-episode psychosis was low, and it was significantly higher in those with affective symptoms.

scholarly journals T72. COGNITIVE CLUSTERS IN FIRST-EPISODE PSYCHOSIS AND THEIR RELATIONSHIP TO SYMPTOMATOLOGY AND DEVELOPMENTAL SCHOLASTIC PERFORMANCE

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S259-S259
Author(s):  
Eric Tan ◽  
Susan Rossell ◽  
Kenneth Subotnik ◽  
Joseph Ventura ◽  
Keith H Nuechterlein
Keyword(s):  
Rating Scale ◽  
Developmental Stages ◽  
Function Analysis ◽  
Analytical Techniques ◽  
Hierarchical Cluster ◽  
First Episode Psychosis ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Episode Psychosis ◽  
Scholastic Performance

Abstract Background Groups with differential levels of cognitive impairment are increasingly recognized among patients with schizophrenia spectrum disorders. Using cluster analytical techniques, this study sought to explore cognitive clusters in a sample of first-episode psychosis patients and compare levels of symptomatology as well as childhood and adolescent scholastic performance between the resultant groups. Methods Data from 105 first-episode psychosis patients (n=56 with schizophrenia, n=13 with schizoaffective disorder, depressed type, n=36 with schizophreniform disorder) (mean age=22.06, SD=3.79) in the UCLA Aftercare Research Program were used for this analysis. Cognition was assessed using a modified beta version of the MATRICS Consensus Cognitive Battery which consisted of 16 tasks across seven cognitive domains. Symptomatology and developmental scholastic performance were assessed using the Brief Psychiatric Rating Scale and the Cannon-Spoor Premorbid Adjustment Scale respectively. Hierarchical cluster analysis with Ward’s method and squared Euclidean distance was conducted, confirmed by discriminant function analysis and optimized with k-means clustering. Stability of the solution was evaluated through split-sample (random 80% and 70% samples) and alternate method (average linkage method) replication via Cohen’s κ analysis. Results Three clusters were identified: most impaired (n=27), moderately impaired (n=41) and good (n=37). Controlling for multiple comparisons, one-way ANOVAs revealed no significant differences in symptomatology between the groups (p>.008). Significant differences were observed for scholastic performance at three different developmental stages: childhood (p<.0001), early adolescence (p<.0001) and late adolescence (p<.0001), with the good group demonstrating significantly better scholastic performance than both the moderately impaired and most impaired groups (who did not significantly differ from each other) at all three stages. Discussion The findings add to growing evidence that cognitive clusters in FEP mirror that of later-stage schizophrenia. Cognitive clusters were not associated with differences in symptom severity, but reflected differing levels of premorbid scholastic performance during the developmental years. This suggests that performance at school may not just be a risk factor for developing schizophrenia, but also related to the severity of impairment and potentially prognosis.

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