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.

Evaluating Psychosocial Interventions in First-Episode Psychosis

2008 ◽  
Vol 71 (4) ◽  
pp. 155-160
Author(s):  
Niall Turner ◽  
Peter Whitty ◽  
Caroline Lydon ◽  
Mary Clarke ◽  
Stephen Browne ◽  
...  
Keyword(s):  
Psychosocial Interventions ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis

Psychosocial interventions for people with a first episode psychosis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Swaran P. Singh ◽  
Mohapradeep Mohan ◽  
Domenico Giacco
Keyword(s):  
Psychosocial Interventions ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis

Incidence of Tardive Dyskinesia in First-Episode Psychosis Patients Treated With Low-Dose Haloperidol

2003 ◽  
Vol 64 (9) ◽  
pp. 1075-1080 ◽  
Author(s):  
Piet P. Oosthuizen ◽  
Robin A. Emsley ◽  
J. Stephanus Maritz ◽  
Jadri A. Turner ◽  
N. Keyter
Keyword(s):  
Tardive Dyskinesia ◽  
Low Dose ◽  
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.

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

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 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 Challenging the Minimum Effective Antipsychotic Dose During Maintenance: Implications From 10-Year Follow-Up of First Episode Psychosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Chen-Chung Liu ◽  
Chih-Min Liu ◽  
Yi-Ling Chien ◽  
Yi-Ting Lin ◽  
Ming H. Hsieh ◽  
...  
Keyword(s):  
Low Dose ◽  
First Episode Psychosis ◽  
Fine Tuning ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Full Time ◽  
Episode Psychosis ◽  
Employment Education

Background: Contradictory messages regarding the necessity of long-term antipsychotic treatment after first episode psychosis arouse deliberations in clinical practice. We explored if there is an alternative beyond the dichotomy of maintenance treatment and discontinuation of medications.Methods: We conducted a retrospective observational study by reviewing medical records at the study hospital of a cohort of patients since their participation in an early psychosis study starting from 2006, with special interests in patients able to maintain good functioning under treatment with a low antipsychotic dose.Results: Of the 81 patients with first-episode psychosis, 55 patients (67.9%) had follow-up information for longer than 5 years. The majority (n = 46, 83.6%) had non-affective psychosis, 20 patients (36.4%) had full-time employment/education by the time of their latest visit; among them, 15 patients received dosage of antipsychotics no more than the minimum effective dose [chlorpromazine equivalent (CPZE) dose, 200 mg/day]. Besides, 10 of 55 patients (18.2%) only received very low dose antipsychotics (CPZE < 50 mg/day) during maintenance, which was significantly correlated to good functioning. Being male, having a history of hospitalization, and being on clozapine therapy were correlated to poorer functioning. Antipsychotic-free status was achieved only in two non-psychotic patients.Conclusions: A substantial proportion of patients could achieve good functioning under low-dose antipsychotic maintenance after first-episode psychosis, even if they could not completely withdraw antipsychotics in the long term. Optimizing the balance between preventing relapse and preserving functioning by fine-tuning antipsychotic dosage during maintenance is a challenge warranting more clinical attention.

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.

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