scholarly journals Research and practice for ultra-high risk for psychosis: A national survey of early intervention in psychosis services in England

2017 ◽  
Vol 13 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Helen J. Stain ◽  
Lauren Mawn ◽  
Stephanie Common ◽  
Marie Pilton ◽  
Andrew Thompson
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
National Survey ◽  
Research And Practice ◽  
Ultra High Risk ◽  
Early Intervention In Psychosis

scholarly journals Research and practice for ultra-high risk for psychosis: A national survey of early intervention in psychosis services in England

2017 ◽  
Vol 41 (S1) ◽  
pp. S191-S192
Author(s):  
H. Stain ◽  
L. Mawn ◽  
S. Common ◽  
M. Pilton ◽  
T. Andrew
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Clinical Guidelines ◽  
Online Survey ◽  
Family Intervention ◽  
Behavioural Therapy ◽  
Self Report ◽  
Family Work ◽  
Ultra High Risk ◽  
Early Intervention In Psychosis

ObjectivesEvidence from meta-analyses of randomised clinical trials shows interventions for young people at ultra-high risk (UHR) of developing psychosis are effective both clinically and economically. While research evidence has begun to be integrated into clinical guidelines, there is a lack of research on the implementation of these guidelines. This paper examines service provision for UHR individuals in accordance with current clinical guidelines within the National Health Service (NHS) in England.MethodA self-report online survey was completed by clinical leaders of Early Intervention in Psychosis (EIP) teams (n = 50) within the NHS across the UK.ResultsOf the 50 EIP teams responding (from 30 NHS Trusts), 53% reported inclusion of the UHR group in their service mandate, with age range predominantly 14–5 years (81%) and service provided for at least 12 months (53%). Provision of services according to NICE clinical guidelines showed 50% of services offered cognitive behavioural therapy (CBT) for psychosis, and 42% offered family intervention. Contrary to guidelines, 50% of services offered antipsychotic medication. Around half of services provided training in assessment by CAARMS, psycho-education, CBT for psychosis, family work and treatment for anxiety and depression.ConclusionsDespite clear evidence for the benefit of early intervention in this population, current provision for UHR within EIP services in England does not match clinical guidelines. While some argue this is due to a lack of allocated funding, it is important to note the similar variable adherence to clinical guidelines in the treatment of people with established schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Programma 2000: Celebrating 10 Years of Activity of an Italian Pilot Programme on Early Intervention in Psychosis

2008 ◽  
Vol 42 (12) ◽  
pp. 1003-1012 ◽  
Author(s):  
Angelo Cocchi ◽  
Anna Meneghelli ◽  
Antonio Preti
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Rating Scale ◽  
Young Patients ◽  
Skills Training ◽  
First Episode ◽  
Global Functioning ◽  
Adult Intelligence Scale ◽  
Cognitive Behavioural ◽  
Early Intervention In Psychosis

Objective: This paper describes the structure and the organization of the single Italian programme specifically targeted at the early detection of and interventions for subjects at onset of or at high risk of psychosis, Programma 2000. Methods: Programma 2000 is a comprehensive multi-modal protocol of early intervention in psychosis, set up in Milan in 1999. The service has been very active since its opening, and at the time of writing (spring (April) 2008), more than 300 young patients have been evaluated through a detailed protocol that embraces Health of the Nation Outcome Scale (HoNOS), Brief Psychiatric Rating Scale (BPRS), Cognitive Behavioural Assessment 2.0, Disability Assessment Schedule, Camberwell Family Interview, Wechsler Adult Intelligence Scale and the Early Recognition Inventory Retrospective Assessment of Symptoms. The treatment includes psychoeducation, cognitive behavioural therapy (CBT), both structured and unstructured psychosocial interventions and pharmacotherapy, when necessary. Results: The programme focuses on young people aged 17–30 years: to date, a total of 132 subjects with definite psychosis or within the high-risk category have been enrolled in treatment after assessment. Patients with first-episode psychosis were, on average and expectedly, more severe than those in the at-risk group, and were more likely to be prescribed antipsychotic drugs. A large majority of patients in both groups received tailored CBT; individual sessions of skills training were provided to two-thirds of patients. In both groups, improvement was found in both the BPRS and HoNOS, and in the level of global functioning as assessed on Global Assessment of Functioning at 6 month and 1 year follow up. Global functioning was more sensitive to change than symptom severity, reflecting the intensive and personalized efforts to improve social and role functioning in patients. Conclusions: Programma 2000 is still in development but it has already gained the support of therapists and other relevant people involved in the life of subjects at onset, or at high risk of psychosis.

Evaluating an early intervention in psychosis service for ‘high-risk’ adolescents: symptomatic and social recovery outcomes

2014 ◽  
Vol 9 (3) ◽  
pp. 260-267 ◽  
Author(s):  
Rebecca Lower ◽  
Jonathan Wilson ◽  
Evelina Medin ◽  
Emma Corlett ◽  
Ruth Turner ◽  
...  
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Social Recovery ◽  
Early Intervention In Psychosis

Prospective outcome of early intervention for individuals at ultra-high-risk for psychosis

2008 ◽  
Vol 2 (4) ◽  
pp. 277-284 ◽  
Author(s):  
GeumSook Shim ◽  
Do-Hyung Kang ◽  
Jung-Seok Choi ◽  
Myung Hun Jung ◽  
Soo Jin Kwon ◽  
...  
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Ultra High Risk

scholarly journals Early intervention in patients at ultra high risk of psychosis: benefits and risks

2009 ◽  
Vol 119 (6) ◽  
pp. 426-442 ◽  
Author(s):  
M. B. de Koning ◽  
O. J. N. Bloemen ◽  
T. A. M. J. van Amelsvoort ◽  
H. E. Becker ◽  
D. H. Nieman ◽  
...  
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Ultra High Risk

Patterns of referral in first-episode schizophrenia and ultra high-risk individuals: results from an early intervention program in Italy

2013 ◽  
Vol 48 (12) ◽  
pp. 1905-1916 ◽  
Author(s):  
Angelo Cocchi ◽  
Anna Meneghelli ◽  
Arcadio Erlicher ◽  
Alessia Pisano ◽  
Maria Teresa Cascio ◽  
...  
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Intervention Program ◽  
First Episode ◽  
Early Intervention Program ◽  
Ultra High Risk ◽  
First Episode Schizophrenia

Implementation and development of early intervention in psychosis services in Italy: a national survey promoted by the Associazione Italiana Interventi Precoci nelle Psicosi

2015 ◽  
Vol 12 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Angelo Cocchi ◽  
Anna Cavicchini ◽  
Marzia Collavo ◽  
Lucio Ghio ◽  
Sara Macchi ◽  
...  
Keyword(s):  
Early Intervention ◽  
National Survey ◽  
Early Intervention In Psychosis

scholarly journals Ultra high risk of psychosis on committal to a young offender prison: an unrecognised opportunity for early intervention

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Darran Flynn ◽  
Damian Smith ◽  
Luke Quirke ◽  
Stephen Monks ◽  
Harry G Kennedy
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Young Offender ◽  
Ultra High Risk

First Psychotic Episode and Early Intervention: An Opportunity to Change the Course of the Illness

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
R. Coentre ◽  
D. Barrocas ◽  
I. Chendo ◽  
P. Levy
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Clinical Effectiveness ◽  
Psychotic Episode ◽  
List Type ◽  
First Psychotic Episode ◽  
Effective Care ◽  
Two Stages ◽  
Early Intervention In Psychosis ◽  
Prevention Of Relapse

Aims:Early intervention in psychosis constitutes an important opportunity to change the classic limited outcome associated with the patients who suffer of psychotic disease.Methods:Based on literature review the authors analyse the evidence for early intervention in first psychotic episode.Results:The evidence for the effectiveness of interventions in early psychosis can be considered in two stages:1.first stage before the onset of full symptoms of psychosis, in people with high risk of developing psychosis or in the prodrome phase of the illness;2.second stage includes the therapeutic focus on the period after the first psychotic episode, reducing the duration of untreated psychosis (DUP) and ameliorate the recovery.Preventing psychosis by intervene in the prodrome or in people with high risk of developing psychosis remains ethically contentious because of the non-specificity of the symptoms. by the contrary there is evidence that early and specialised intervention in first psychotic episode improves outcome. Besides the controversy of the relation between long DUP and poor outcome, there is agreement that clinicians should identify and treat psychosis early with a great impact in patients and their family's life. Effective care during first psychotic episode includes proactive engagement and initiation of low doses of antipsychotics and psychosocial treatments, aiming for maximal symptomatic and functional recovery and the prevention of relapse.Conclusion:There is evidence that early intervention in first psychotic episode improve clinical effectiveness over standard care. Further studies are important to make evidence more robust.

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