A community intervention for early identification of First Episode Psychosis

Malla, Ashok; Norman, Ross; Scholten, Derek; Manchanda, Rahul; McLean, Terry

doi:10.1007/s00127-005-0901-6

Cited by 64 publications

(19 citation statements)

References 29 publications

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“…The timeline is presented to the research team, including one senior psychiatrist, and consensus is reached on several key measures such as DUP, defined as the time between onset of psychotic symptoms and commencement of one month of continuous antipsychotic treatment. In addition to furthering research (Bechard‐Evans et al, ; Cassidy, Schmitz, Norman, Manchanda, & Malla, ; Malla et al, ; Malla, Norman, Scholten, Manchanda, & Mclean, ), these indices continuously inform outreach targets and activities.…”

Section: Resultsmentioning

confidence: 99%

“…Over time, PEPP's intake clinician has fostered relationships with numerous catchment-area healthcare and community (Bechard-Evans et al, 2007;Cassidy, Schmitz, Norman, Manchanda, & Malla, 2008;Malla et al, 2014;Malla, Norman, Scholten, Manchanda, & Mclean, 2005), these indices continuously inform outreach targets and activities.…”

Section: Early Identification and Outreachmentioning

confidence: 99%

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Description, evaluation and scale‐up potential of a model for rapid access to early intervention for psychosis

MacDonald

Malla

Joober

et al. 2018

Early Intervention Psych

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Section: Resultsmentioning

confidence: 99%

Section: Early Identification and Outreachmentioning

confidence: 99%

Description, evaluation and scale‐up potential of a model for rapid access to early intervention for psychosis

MacDonald

Malla

Joober

et al. 2018

Early Intervention Psych

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“…18 Some EI programs, but not all, offer early detection strategies to reduce the duration of untreated psychosis. 19,20 The EI services in this study were located at 4 academic centers in Ontario, Canada: Toronto, London, Hamilton, and Ottawa. The First Episode Psychosis Program at the Centre for Addiction and Mental Health in Toronto is affiliated with the University of Toronto and consists of an outpatient clinic, an inpatient unit, and a Home Intervention Program.…”

Section: Programsmentioning

confidence: 99%

“…The Prevention and Early Intervention Psychosis Program (PEPP) in London is affiliated with the University of Western Ontario and consists of an outpatient and inpatient unit 21 and an active community early detection initiative. 20 The PEPP serves a population of approximately 400 000 people. When the study began, the Psychotic Disorders Clinic (PDC) at McMaster Hospital, Hamilton Health Sciences, was affiliated with McMaster University in Hamilton and consisted of an outpatient clinic.…”

Section: Programsmentioning

confidence: 99%

0223 Substance Use and Abuse in First Episode Psychosis: Prevalence Before and After Early Intervention

Archie¹,

Akhtar–Danesh²,

Rush³

et al. 2006

Schizophrenia Research

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Despite the high prevalence of substance abuse among firstepisode psychosis (FEP) populations, few studies examine whether early intervention (EI) improves substance abuse. Objective: To examine the prevalence and pattern of substance use and abuse among an FEP sample over 12 months. Methods: All the participants were diagnosed with a first episode of a schizophrenia spectrum disorder. The participants were followed prospectively. The prevalence rates of substance use and abuse from this sample were compared before and after 12 months of EI services and were compared with rates observed in a sample from the general population. Results: A total of 200 participants (80.0% males; mean age 24 years) entered the study: 183 participants completed all the assessments at baseline, 131 participants completed all the assessments at 12 months. At baseline, the findings showed similar prevalence rates between the FEP sample and the general sample for lifetime cannabis use (60% vs 55%, respectively) and hazardous alcohol use (26% vs 21%) but significantly different prevalence rates for lifetime hallucinogen (29% vs 15%; P < .001) and cocaine use (20% vs 14%; P < .001). At 12 months, the prevalence rates for drug abuse (P < .01), hazardous alcohol use (P < .01), and concurrent drug abuse and hazardous alcohol use (P < .05) were significantly lower than at baseline. Conclusion: Substance use and abuse decreased significantly after 12 months of EI services; EI services may be able to detect and to reduce substance use among FEP patients before it becomes a more serious disorder.

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“…DUP was significantly shorter and associated with better clinical status and reduced suicide risk at baseline and negative symptoms at 12 months, with positive effects on clinical and functional status maintained at 5 year follow-up [10]. However, similar public health initiatives in Australia [11] and Canada [12] have failed to demonstrate any impact on DUP.…”

Section: Introductionmentioning

confidence: 99%

Don’t turn your back on the symptoms of psychosis: a proof-of-principle, quasi-experimental public health trial to reduce the duration of untreated psychosis in Birmingham, UK

et al. 2013

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BackgroundReducing the duration of untreated psychosis (DUP) is an aspiration of international guidelines for first episode psychosis; however, public health initiatives have met with mixed results. Systematic reviews suggest that greater focus on the sources of delay within care pathways, (which will vary between healthcare settings) is needed to achieve sustainable reductions in DUP (BJP 198: 256-263; 2011).Methods/DesignA quasi-experimental trial, comparing a targeted intervention area with a ‘detection as usual’ area in the same city. A proof-of–principle trial, no a priori assumptions are made regarding effect size; key outcome will be an estimate of the potential effect size for a definitive trial. DUP and number of new cases will be collected over an 18-month period in target and control areas and compared; historical data on DUP collected in both areas over the previous three years, will serve as a benchmark. The intervention will focus on reducing two significant DUP component delays within the overall care pathway: delays within the mental health service and help-seeking delay.DiscussionThis pragmatic trial will be the first to target known delays within the care pathway for those with a first episode of psychosis. If successful, this will provide a generalizable methodology that can be implemented in a variety of healthcare contexts with differing sources of delay.Trial registrationhttp://www.controlled-trials.com/ISRCTN45058713

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A community intervention for early identification of First Episode Psychosis

Cited by 64 publications

References 29 publications

Description, evaluation and scale‐up potential of a model for rapid access to early intervention for psychosis

Description, evaluation and scale‐up potential of a model for rapid access to early intervention for psychosis

0223 Substance Use and Abuse in First Episode Psychosis: Prevalence Before and After Early Intervention

Don’t turn your back on the symptoms of psychosis: a proof-of-principle, quasi-experimental public health trial to reduce the duration of untreated psychosis in Birmingham, UK

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