scholarly journals Improving 1-year outcome in first-episode psychosis

2005 ◽  
Vol 187 (S48) ◽  
pp. s98-s103 ◽  
Author(s):  
Lone Petersen ◽  
Merete Nordentoft ◽  
Pia Jeppesen ◽  
Johan ⊘hlenschlæger ◽  
Anne Thorup ◽  
...  
Keyword(s):  
Standard Treatment ◽  
First Episode Psychosis ◽  
Integrated Treatment ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Social Outcome ◽  
Long Term Outcome ◽  
Poor Outcome ◽  
Episode Psychosis

BackgroundBecause early illness course and outcome may affect the long-term outcome of schizophrenia-spectrum disorders, it is especially important to address poor outcome in this early critical period.AimsTo evaluate whether integrated treatment compared with standard treatment reduced the proportion of patients with poor clinical and social outcome after 1 year.MethodA total of 547 patients with first-episode psychosis were included in the study, 275 randomly assigned to integrated treatment and 272 to standard treatment. Measures assessed psychotic symptoms and social functioning.ResultsThere was a significant beneficial effect of integrated treatment v. standard treatment on ‘any poor outcome’. Integrated treatment had a significantly better effect on ‘any poor outcome’ in patients with schizophrenia compared with patients in standard treatment.ConclusionsThe integrated treatment significantly reduced the proportion of patients with poor clinical and social outcome compared with standard treatment.

scholarly journals Integrated treatment of first-episode psychosis: effect of treatment on family burden

2005 ◽  
Vol 187 (S48) ◽  
pp. s85-s90 ◽  
Author(s):  
Pia Jeppesen ◽  
Lone Petersen ◽  
Anne Thorup ◽  
Maj-Britt Abel ◽  
Johan ⊘ehlenschlæger ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Burden Of Illness ◽  
Skills Training ◽  
First Episode Psychosis ◽  
Integrated Treatment ◽  
Family Burden ◽  
First Episode ◽  
Schizophrenia Spectrum ◽  
Episode Psychosis ◽  
Satisfaction With Treatment

BackgroundThe families of patients with first-episode psychosis often play a major role in care and often experience lack of support.AimsTo determine the effect of integrated treatment v. standard treatment on subjective burden of illness, expressed emotion (EE), knowledge of illness and satisfaction with treatment in key relatives of patients with a first episode of schizophrenia-spectrum disorder.MethodPatients with ICD-10 schizophrenia-spectrum disorders (first episode) were randomly assigned to integrated treatment or to standard treatment. Integrated treatment consisted of assertive community treatment, psychoeducational multi-family groups and social skills training. Key relatives were assessed with the Social Behaviour Assessment Schedule (SBAS, burden of illness), the 5-min speech sample (EE), and a multiple choice questionnaire at entry and after 1 year.ResultsRelatives in integrated treatment felt less burdened and were significantly more satisfied with treatment than relatives in standard treatment. There were no significant effects of intervention groups on knowledge of illness and EE.ConclusionsThe integrated treatment reduced family burden of illness and improved satisfaction with treatment.

The Danish OPUS-trial: RCT of standard treatment versus integrated treatment in first episode psychosis. 5 years follow-up

2007 ◽  
Vol 22 ◽  
pp. S84 ◽  
Author(s):  
M. Nordentoft ◽  
M. Bertelsen ◽  
A. Thorup ◽  
L. Petersen ◽  
J. Ahlenschleger ◽  
...  
Keyword(s):  
Standard Treatment ◽  
First Episode Psychosis ◽  
Integrated Treatment ◽  
First Episode ◽  
Episode Psychosis

Association between Financial Strain, Social Network and Five-year Recovery from First Episode Psychosis

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Mattsson
Keyword(s):  
Social Network ◽  
Linear Regression Analysis ◽  
First Episode Psychosis ◽  
Financial Strain ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Unique Contribution ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Episode Psychosis

Despite much effort to positively affect long-term outcome in psychosis and schizophrenia many patients are still facing a poor outcome with persistent psychotic symptoms and decline in social functioning. the aim of this study was to examine the relationship between financial strain and social network and five-year outcome of first episode psychosis (FEP). FEP patients were divided into recovered (n = 52) and non-recovered (n = 19). Each personwas matched according to age and gender with fourpersons (n = 284) from a longitudinal populationbasedstudy. All persons had answered an extensivequestionnaire including social network, quantitative and qualitative, financial strain and mental health. Linear regression analysis showed that both financial strain and social network were associated, and had a unique contribution, to outcome. the results indicate that FEP patients might benefit from interventions that reduce financial strain thus facilitating daily life and cultural and social activities.

scholarly journals Aggressive incidents in first-episode psychosis

2001 ◽  
Vol 178 (5) ◽  
pp. 433-440 ◽  
Author(s):  
John Milton ◽  
Shazad Amin ◽  
Swaran P. Singh ◽  
Glynn Harrison ◽  
Peter Jones ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Increased Risk ◽  
Episode Psychosis ◽  
Clinical Associations ◽  
Independent Effects ◽  
One Act ◽  
Service Contact

BackgroundRecent research has reported increased risk of aggressive incidents by individuals with psychotic illness.AimsTo examine acts of aggression in first-episode psychosis.MethodSubjects with a first-episode psychosis were ascertained from a defined catchment area (Nottingham, UK) and reassessed at 3 years (n=166) using clinical interview, informants, health care and forensic records.ResultsOf the subjects, 9.6% demonstrated at least one act of serious aggression (defined as weapon use, sexual assault or victim injury) during at least one psychotic episode and 23.5% demonstrated lesser acts of aggression (defined as all other acts of aggression). For all aggressive subjects (33.1%), unemployment (OR=3.6, 95%CI 1.6–8.0), comorbid substance misuse (OR=3.1, CI 1.1–8.8) and symptoms of overactivity at service contact (OR=6.9, CI 2.7–17.8) had independent effects on risk of aggression.ConclusionsWe confirmed some previously reported demographic and clinical associations with aggression in first-episode psychosis but no relationship with specific psychotic symptoms or diagnostic groups was observed.

Antipsychotic medication and remission of psychotic symptoms 10 years after a first-episode psychosis

2017 ◽  
Vol 182 ◽  
pp. 42-48 ◽  
Author(s):  
Regitze Sølling Wils ◽  
Ditte Resendal Gotfredsen ◽  
Carsten Hjorthøj ◽  
Stephen F. Austin ◽  
Nikolai Albert ◽  
...  
Keyword(s):  
Antipsychotic Medication ◽  
First Episode Psychosis ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Episode Psychosis

iMAgery focused psychological therapy for persecutory delusions in PSychosis (iMAPS): a multiple baseline experimental case series

2020 ◽  
Vol 48 (5) ◽  
pp. 530-545
Author(s):  
Christopher D.J. Taylor ◽  
Penny E. Bee ◽  
James Kelly ◽  
Richard Emsley ◽  
Gillian Haddock
Keyword(s):  
Case Series ◽  
First Episode Psychosis ◽  
Psychological Therapy ◽  
Multiple Baseline ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Multiple Baseline Design ◽  
Persecutory Delusions ◽  
Baseline Design ◽  
Episode Psychosis

AbstractBackground:Many people with psychosis experience persecutory delusions and report negative schematic beliefs and intrusive mental images which may be maintaining factors for psychotic symptoms.Aims:This study examined the feasibility and acceptability of a new psychological therapy targeting schemas and images (iMAPS therapy).Method:The study used a randomised multiple baseline design. Participants with first episode psychosis were randomised using a multiple baseline design with 2–5 assessments. Six sessions of therapy, consisting of a combination of imagery techniques and imagery rescripting techniques, was used. In each session, participants completed a Mental Imagery in Psychosis Questionnaire (MIPQ) and imagery interview. Mood and delusional beliefs (PSYRATS) were also measured at each session.Results:Five participants with first episode psychosis completed the baseline visits and attended all therapy sessions. One participant declined the final assessment. Results demonstrated significant reductions in negative schematic beliefs, delusions, imagery distress and other measures of schema (YSQ, SMI). Although multiple baseline randomisation strengthens the study, it lacked a control arm and blind assessments.Conclusions:iMAPS appears a feasible and acceptable treatment for psychosis, and further evaluation is indicated.

Integrated treatment ameliorates negative symptoms in first episode psychosis—results from the Danish OPUS trial

2005 ◽  
Vol 79 (1) ◽  
pp. 95-105 ◽  
Author(s):  
A. Thorup ◽  
L. Petersen ◽  
P. Jeppesen ◽  
J. Øhlenschlæger ◽  
T. Christensen ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Integrated Treatment ◽  
First Episode ◽  
Episode Psychosis

scholarly journals Cannabis use and first-episode psychosis: relationship with manic and psychotic symptoms, and with age at presentation

2013 ◽  
Vol 44 (3) ◽  
pp. 499-506 ◽  
Author(s):  
J. M. Stone ◽  
H. L. Fisher ◽  
B. Major ◽  
B. Chisholm ◽  
J. Woolley ◽  
...  
Keyword(s):  
Longitudinal Design ◽  
First Episode Psychosis ◽  
Cannabis Use ◽  
Daily Functioning ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Time Points ◽  
Manic Symptoms ◽  
Episode Psychosis ◽  
Early Intervention In Psychosis

BackgroundCannabis use has been reported to be associated with an earlier onset of symptoms in patients with first-episode psychosis, and a worse outcome in those who continue to take cannabis. In general, studies have concentrated on symptoms of psychosis rather than mania. In this study, using a longitudinal design in a large naturalistic cohort of patients with first-episode psychosis, we investigated the relationship between cannabis use, age of presentation to services, daily functioning, and positive, negative and manic symptoms.MethodClinical data on 502 patients with first-episode psychosis were collected using the MiData audit database from seven London-based Early Intervention in psychosis teams. Individuals were assessed at two time points – at entry to the service and after 1 year. On each occasion, the Positive and Negative Syndrome Scale, Young Mania Rating Scale and Global Assessment of Functioning Scale disability subscale were rated. At both time points, the use of cannabis and other drugs of abuse in the 6 months preceding each assessment was recorded.ResultsLevel of cannabis use was associated with a younger age at presentation, and manic symptoms and conceptual disorganization, but not with delusions, hallucinations, negative symptoms or daily functioning. Cannabis users who reduced or stopped their use following contact with services had the greatest improvement in symptoms at 1 year compared with continued users and non-users. Continued users remained more symptomatic than non-users at follow-up.ConclusionsEffective interventions for reducing cannabis use may yield significant health benefits for patients with first-episode psychosis.

Pathways to Care, Duration of Untreated Psychosis and Treatments Received by Patients with First-Episode Psychosis

2011 ◽  
Vol 26 (S2) ◽  
pp. 1394-1394
Author(s):  
D. Giacco ◽  
A. Fiorillo ◽  
V. Del Vecchio ◽  
M. Luciano ◽  
G. Sampogna ◽  
...  
Keyword(s):  
Health Professionals ◽  
Suicide Attempts ◽  
Hospital Admissions ◽  
Psychiatric Treatment ◽  
First Episode Psychosis ◽  
Pathways To Care ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Long Term Outcome ◽  
Episode Psychosis

IntroductionPathways to care and duration of untreated psychosis (DUP) strongly influence the long-term outcome of schizophrenia.AimsTo investigate pathways to care, duration of untreated psychosis (DUP) and treatments received by a sample of individuals aged between 18 and 35 years meeting diagnostic criteria for psychosis.MethodsPathways to care and DUP were explored by an “ad-hoc” schedule administered to patients and caregivers.ResultsThe sample consists of 30 patients. The first episode of psychosis, which occurred at 19.7 (± 4.7) years, was characterized by negative symptoms and disorganized behaviours in more than half of the sample, suicide attempts (28%) and hospital admissions (26%). DUP was 41.6 ± 60.4 weeks, being longer than that reported in international literature. In 76% of cases patients’ relatives asked for a first contact with health professionals, referring the patients to psychiatrists (34% of cases), general practitioners (31%), neurologists (21%) or psychologists (13%). When professionals other than psychiatrists were contacted, the interval between the contact and receipt of appropriate psychiatric treatment (according to the current guidelines) was particularly long (15.2 ± 32.1 weeks). 34% of patients were treated with a monotherapy of psychotropic drugs: 24% with antipsychotics, 7% with anxiolytics and 3% with antidepressants; 48% received a poly-pharmacotherapy. 35% were treated with psychotherapy (in most of the cases cognitive-behavioural therapy), which was the only treatment for 18% of patients.ConclusionsThese results emphasize the need to train health professionals on diagnosis and treatment of first episode psychosis. DUP may be reduced by anti-stigma campaigns among general population.

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