scholarly journals Initial treatment phase in early psychosis: can intensive home treatment prevent admission?

2006 ◽  
Vol 30 (7) ◽  
pp. 243-246 ◽  
Author(s):  
Matthew Gould ◽  
Kate Theodore ◽  
Stephen Pilling ◽  
Paul Bebbington ◽  
Mark Hinton ◽  
...  
Keyword(s):  
Initial Treatment ◽  
Catchment Area ◽  
Admission Rate ◽  
Treatment Phase ◽  
First Episode Psychosis ◽  
First Episode ◽  
Clinical Implications ◽  
Crisis Resolution ◽  
Crisis Resolution Teams ◽  
Episode Psychosis

Aims and MethodThe aim of this study was to describe the early treatment phase in first-episode psychosis in an area with well-established crisis resolution teams. Socio-demographic characteristics and patterns of initial treatment were investigated for all individuals with first-episode psychosis identified prospectively over a 1-year period in two London boroughs.ResultsOver a year, 111 people presented with first-episode psychosis. Fifty-one people (46%) were initially managed in the community, with the remaining 60 (54%) admitted to in-patient units immediately. By 3 months after presentation, a total of 80 people (72%) had been admitted and 54 (49%) had been compulsorily detained under the Mental Health Act 1983. Thirty-three people were initially managed by the crisis resolution teams and 15 of these were eventually admitted.Clinical ImplicationsIn a catchment area in which alternatives to admission are well developed, the admission rate for first-episode psychosis was still high.

Estimating the incidence of first-episode psychosis using population-based health administrative data to inform early psychosis intervention services

2018 ◽  
Vol 49 (12) ◽  
pp. 2091-2099 ◽  
Author(s):  
Kelly K. Anderson ◽  
Ross Norman ◽  
Arlene G. MacDougall ◽  
Jordan Edwards ◽  
Lena Palaniyappan ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Administrative Data ◽  
Catchment Area ◽  
Population Based ◽  
First Episode Psychosis ◽  
Case Definition ◽  
First Episode ◽  
Affective Psychosis ◽  
Health Administrative Data ◽  
Episode Psychosis

AbstractBackgroundDiscrepancies between population-based estimates of the incidence of psychotic disorder and the treated incidence reported by early psychosis intervention (EPI) programs suggest additional cases may be receiving services elsewhere in the health system. Our objective was to estimate the incidence of non-affective psychotic disorder in the catchment area of an EPI program, and compare this to EPI-treated incidence estimates.MethodsWe constructed a retrospective cohort (1997–2015) of incident cases of non-affective psychosis aged 16–50 years in an EPI program catchment using population-based linked health administrative data. Cases were identified by either one hospitalization or two outpatient physician billings within a 12-month period with a diagnosis of non-affective psychosis. We estimated the cumulative incidence and EPI-treated incidence of non-affective psychosis using denominator data from the census. We also estimated the incidence of first-episode psychosis (people who would meet the case definition for an EPI program) using a novel approach.ResultsOur case definition identified 3245 cases of incident non-affective psychosis over the 17-year period. We estimate that the incidence of first-episode non-affective psychosis in the program catchment area is 33.3 per 100 000 per year (95% CI 31.4–35.1), which is more than twice as high as the EPI-treated incidence of 18.8 per 100 000 per year (95% CI 17.4–20.3).ConclusionsCase ascertainment strategies limited to specialized psychiatric services may substantially underestimate the incidence of non-affective psychotic disorders, relative to population-based estimates. Accurate information on the epidemiology of first-episode psychosis will enable us to more effectively resource EPI services and evaluate their coverage.

scholarly journals T131. INCIDENCE OF FIRST-EPISODE PSYCHOSIS IN THE CATCHMENT AREA OF RIBEIRÃO PRETO, BRAZIL

2018 ◽  
Vol 44 (suppl_1) ◽  
pp. S166-S166
Author(s):  
Cristina Del-Ben ◽  
Shuhama Rosana ◽  
Camila Loureiro ◽  
Taciana Ragazzi ◽  
Daniela Zanatta ◽  
...  
Keyword(s):  
Catchment Area ◽  
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 Randomized Controlled Trial of Clozapine and CBT for First-Episode Psychosis with Enduring Positive Symptoms: A Pilot Study

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
J. Edwards ◽  
J. Cocks ◽  
P. Burnett ◽  
D. Maud ◽  
L. Wong ◽  
...  
Keyword(s):  
Pilot Study ◽  
Negative Symptoms ◽  
Controlled Trial ◽  
Treatment Phase ◽  
First Episode Psychosis ◽  
First Episode ◽  
Positive Symptoms ◽  
Treatment Groups ◽  
Episode Psychosis ◽  
Symptomatic Remission

Here we report the results of a pilot study investigating the relative and combined effects of a 12 week course of clozapine and CBT in first-episode psychosis patients with prominent ongoing positive symptoms following their initial treatment. Patients from our early psychosis service who met the inclusion criteria () were randomized to one of four treatment groups: clozapine, clozapine plus CBT, thioridazine, or thioridazine plus CBT. The degree of psychopathology and functionality of all participants was measured at baseline then again at 6, 12 and 24 weeks, and the treatment outcomes for each group determined by statistical analysis. A substantial proportion (52%) of those treated with clozapine achieved symptomatic remission, as compared to 35% of those who were treated with thioridazine. Overall, those who received clozapine responded more rapidly to treatment than those receiving the alternative treatments. Interestingly, during the early treatment phase CBT appeared to reduce the intensity of both positive and negative symptoms and thus the time taken to respond to treatment, as well having as a stabilizing effect over time.

scholarly journals The impact of peri-natal stress on psychosis risk: results from the Bo-FEP incidence study

2020 ◽  
Author(s):  
Tiziano De Matteis ◽  
Giuseppe D'Andrea ◽  
Jatin Lal ◽  
Domenico Berardi ◽  
Ilaria Tarricone
Keyword(s):  
Incidence Study ◽  
Catchment Area ◽  
Maternal Education ◽  
Health Centre ◽  
First Episode Psychosis ◽  
First Episode ◽  
Environment Interaction ◽  
Episode Psychosis ◽  
Study Results ◽  
The Impact

Abstract Objective: According to the gene-environment interaction model the pathogenesis of psychosis relies on an adverse neuro-socio-developmental pathway. Perinatal stress represents an important risk factor for the development of psychosis because of the increasingly evident interference with socio-neuro-development in the earlier phases of life. We aim to investigate the correlation of perinatal risk factors with the onset of psychosis with a case-control – incidence study. Results: Patients (and their mothers) were eligible if they presented with first-episode psychosis at the Bologna West Community Mental Health Centre (Bo-West CMHC) between 2002 and 2012. The Bo-West CMHC serves a catchment area of about 200,000 people. The controls were recruited in the same catchment area and study period. 42 patients, 26 controls and their mothers were included. We collected the history of peri-natal stress and calculated crude and adjusted Odds Ratios for onset of first-episode psychosis. Adjusted logistic regression showed that psychosis onset was significantly associated with stressful situations during pregnancy, lower level of maternal physical health before or during pregnancy, use of anti-inflammatory drugs during pregnancy, and low level of maternal education. The results of our study suggest that stress during perinatal period increases the risk of developing psychosis.

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.

Early intervention in psychosis in emerging countries: Findings from a first‐episode psychosis programme in the Ribeirão Preto catchment area, southeastern Brazil

2021 ◽  
Author(s):  
Gabriel Elias Corrêa‐Oliveira ◽  
Luis Felipe Scarabelot ◽  
Jéssica Morais Araújo ◽  
André Campiolo Boin ◽  
Rebeca Mendes de Paula Pessoa ◽  
...  
Keyword(s):  
Early Intervention ◽  
Catchment Area ◽  
First Episode Psychosis ◽  
Emerging Countries ◽  
Southeastern Brazil ◽  
First Episode ◽  
Episode Psychosis ◽  
Early Intervention In Psychosis

Clinical Correlates of Initial Treatment Disengagement in First-Episode Psychosis

2017 ◽  
Vol 11 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Neely Myers ◽  
Sanaa Bhatty ◽  
Beth Broussard ◽  
Michael T. Compton
Keyword(s):  
Initial Treatment ◽  
First Episode Psychosis ◽  
First Episode ◽  
Clinical Correlates ◽  
Episode Psychosis

scholarly journals Self-harm in first-episode psychosis

2008 ◽  
Vol 192 (3) ◽  
pp. 178-184 ◽  
Author(s):  
Samuel B. Harvey ◽  
Kimberlie Dean ◽  
Craig Morgan ◽  
Elizabeth Walsh ◽  
Arsime Demjaha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Phase ◽  
First Episode Psychosis ◽  
Male Gender ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Episode Psychosis ◽  
Self Harm ◽  
Pre Treatment ◽  
Incident Cases

BackgroundLittle is known about self-harm occurring during the period of untreated first-episode psychosis.AimsTo establish the prevalence, nature, motivation and risk factors for self-harm occurring during the untreated phase of first-episode psychosis.MethodAs part of the æSOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study, episodes of self-harm were identified among all incident cases of psychosis presenting to services in south-east London and Nottingham over a 2-year period.ResultsOf the 496 participants, 56 (11.3%) had engaged in self-harm between the onset of psychotic symptoms and first presentation to services. The independent correlates of self-harm were: male gender, belonging to social class I/II, depression and a prolonged period of untreated psychosis. Increased insight was also associated with risk of self-harm.ConclusionsSelf-harm is common during the pre-treatment phase of first-episode psychosis. A unique set of fixed and malleable risk factors appear to operate in those with first-episode psychosis. Reducing treatment delay and modifying disease attitudes may be key targets for suicide prevention.

Poster #T217 PRELIMINARY SAMPLE DESCRIPTION OF FIRST EPISODE PSYCHOSIS IN A BRAZILIAN LARGE CATCHMENT AREA

2014 ◽  
Vol 153 ◽  
pp. S366
Author(s):  
Rosana Shuhama ◽  
Silvia Tenan ◽  
Juliana Souza ◽  
Maristela S. Schaufelberger ◽  
Paulo Louzada-Junior ◽  
...  
Keyword(s):  
Catchment Area ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Large Catchment
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