Cognitive remediation combined with an early intervention service in first episode psychosis

IntroductionThe UK NICE technology guidance “Structural Neuroimaging in First-Episode Psychosis” concludes that CT/MRI is not routinely recommended as an initial investigation for first-episode psychosis.ObjectivesTo evaluate the use of CT/MRI in a group of Early Intervention Service (EIS) patients with a first-episode psychosis aged 18–35 years at presentation.AimsTo develop practice guidelines for use of neuroimaging in first-episode psychosis.MethodsAll 107 patients registered with the EIS in Hounslow, London, UK, were eligible for inclusion in this review. Data was collected from the medical records and the Picture Archiving and Communications System. Data was analysed using a microsoft excel data analysis tool. Additionally, comparisons were made between the group of patients with normal scans and that with abnormal scans. Statistical significance was determined using the chi-squared method with a significance of P < 0.05.Results17 patients had documented neuroimaging results. 4 scans were abnormal. There was no significant difference between the group with normal and abnormal scans in terms of gender, abnormalities of physical/neurological health, blood tests and whether the patient had any additional medical conditions. Abnormal scan results did not influence treatment or outcome for any patient.ConclusionsThe abnormal scans were not correlated to clinical indices of history, examination and laboratory tests. Abnormal scans appear to have a low yield in terms of clinical effectiveness. The findings support selective use of neuroimaging in this cohort of patients. The indications for it usage would appear to rely on clinical judgement as well clinical findings.

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Understanding Pathways to Care of Individuals Entering a Specialized Early Intervention Service for First-Episode Psychosis

Psychiatric Services ◽

10.1176/appi.ps.201700018 ◽

2018 ◽

Vol 69 (6) ◽

pp. 648-656 ◽

Cited By ~ 8

Author(s):

Leopoldo J. Cabassa ◽

Sarah Piscitelli ◽

Morgan Haselden ◽

Rufina J. Lee ◽

Susan M. Essock ◽

...

Keyword(s):

Early Intervention ◽

First Episode Psychosis ◽

Pathways To Care ◽

First Episode ◽

Early Intervention Service ◽

Intervention Service ◽

Episode Psychosis

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What are the benefits of evidence-based supported employment for patients with first-episode psychosis?

Psychiatric Bulletin ◽

10.1192/pb.28.8.281 ◽

2004 ◽

Vol 28 (8) ◽

pp. 281-284 ◽

Cited By ~ 62

Author(s):

Miles Rinaldi ◽

Karen Mcneil ◽

Mike Firn ◽

Marsha Koletsi ◽

Rachel Perkins ◽

...

Keyword(s):

Early Intervention ◽

Supported Employment ◽

First Episode Psychosis ◽

Educational Activity ◽

First Episode ◽

Evidence Based ◽

Early Intervention Service ◽

Model Fidelity ◽

Intervention Service ◽

Episode Psychosis

Aims and MethodTo examine the effectiveness of integrating evidence-based supported employment into an early intervention service for young people with first-episode psychosis. Demographic, clinical and vocational data were collected over a 12-month period to evaluate the effect on vocational outcomes at 6 months and 12 months of the employment of a vocational specialist, and to assess model fidelity.ResultsFollowing vocational profiling and input from the vocational specialist and the team, there were significant increases in the proportion of clients engaged in work or educational activity over the first 6 months of the intervention, and in a subsample over a second 6-month period. The evidence-based Supported Employment Fidelity Scale was used to measure the degree of implementation, which scored 71, signifying ‘good implementation’.Clinical ImplicationsThe results suggest that implementing evidence-based supported employment within an early intervention service increases employment and education opportunities for patients within the service.

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Rates and predictors of disengagement of patients with first‐episode psychosis from the early intervention service for sychosis service (EASY) covering 15 to 64 years of age in Hong Kong

Early Intervention in Psychiatry ◽

10.1111/eip.12491 ◽

2017 ◽

Vol 13 (3) ◽

pp. 398-404 ◽

Cited By ~ 8

Author(s):

Ka Wa Lau ◽

Sherry K.W. Chan ◽

Christy L.M. Hui ◽

Edwin H.M. Lee ◽

Wing Chung Chang ◽

...

Keyword(s):

Hong Kong ◽

Early Intervention ◽

First Episode Psychosis ◽

First Episode ◽

Early Intervention Service ◽

Intervention Service ◽

Episode Psychosis

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Engagement at entry to an early intervention service for first episode psychosis: an exploratory study of young people and caregivers

Psychosis ◽

10.1080/17522439.2018.1502341 ◽

2018 ◽

Vol 10 (3) ◽

pp. 175-186 ◽

Cited By ~ 6

Author(s):

Rachel M Tindall ◽

Kelly Allott ◽

Magenta Simmons ◽

Winsome Roberts ◽

Bridget E Hamilton

Keyword(s):

Early Intervention ◽

Young People ◽

Exploratory Study ◽

First Episode Psychosis ◽

First Episode ◽

Early Intervention Service ◽

Intervention Service ◽

Episode Psychosis

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Disengagement Processes Within an Early Intervention Service for First-Episode Psychosis: A Longitudinal, Qualitative, Multi-Perspective Study

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.00565 ◽

2020 ◽

Vol 11 ◽

Author(s):

Rachel Tindall ◽

Magenta Simmons ◽

Kelly Allott ◽

Bridget Hamilton

Keyword(s):

Early Intervention ◽

First Episode Psychosis ◽

First Episode ◽

Early Intervention Service ◽

Intervention Service ◽

Episode Psychosis

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The missing voice of engagement: an exploratory study from the perspectives of case-managers at an early intervention service for first-episode psychosis

BMC Psychiatry ◽

10.1186/s12888-019-2315-0 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Rachel M. Tindall ◽

Kelly Allott ◽

Magenta Simmons ◽

Winsome Roberts ◽

Bridget E. Hamilton

Keyword(s):

Early Intervention ◽

Young People ◽

Case Manager ◽

Young Person ◽

First Episode Psychosis ◽

Case Managers ◽

First Episode ◽

Early Intervention Service ◽

Intervention Service ◽

Episode Psychosis

Abstract Background A key component of case-management in early intervention services for first-episode psychosis is engaging a person with the service and building a relationship from which therapy and treatment can be facilitated. The aim of this study was to understand how case-managers at an early intervention service experience the process of engagement and working with varying levels of attendance and participation. Methods Qualitative interviews were conducted with the case-managers of nine young people treated at an early intervention service for first-episode psychosis within 6 months of treatment entry. Interviews discussed the process of working with the young person and factors that influenced service engagement. Interviews were analyzed using thematic analysis. Results Case-managers described a range of influences on engagement which were grouped under the themes: young person and caregiver influences on engagement, case-manager influences on engagement, and influences of the early intervention service system on engagement. The experience of engagement was described as relational, however it occurred in the context of broader influences, some of which were unable to be changed or challenged by the case-manager (e.g., resource allocation, models of treatment, young person demographics). Conclusion This study illustrates the challenges that case-managers face when working with young people with first-episode psychosis, and the direct influence this has on engagement with treatment. Understanding these challenges and addressing them in policy and service design may lead to improvements in young peoples’ recovery from first-episode psychosis and increase case-manager job satisfaction.

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