Early detection and integrated care for adolescents and young adults with severe psychotic disorders: rationales and design of the Integrated Care in Early Psychosis Study (ACCESS III)

Abstract

To the authors' knowledge, this is the first study assessing the efficacy and cost-effectiveness of a combined intervention consisting of early detection strategies and strategies to improve quality of care in both adolescents and young adults with early-phase psychosis. The results will be published in 2016.

Early detection and integrated care for adolescents and young adults with psychotic disorders: the ACCESS III study

“…The ACCESS III study evaluates the extension of the original ACCESS integrated care model by implementation of a broad early detection initiative and in collaboration with child‐ and youth psychiatry expansion of the model to severely ill adolescents and young adult patients with early psychosis in the age range of 12–29 years .…”

“…Early detection with shorter duration of untreated psychosis (DUP) and integrated care have both been found of relevance for good outcomes in the early phase of psychotic disorders.…”

“…Besides EPPIC, TIPS and OPUS, the ACCESS early detection and integrated care model for adolescents and young adults under study was based on the original ACCESS integrated care model for multiple‐episode patients . In the previous ACCESS I (1‐year follow‐up compared to standard care) and II studies (4‐year follow‐up with continuous integrated care , it was shown that ACCESS significantly reduced service disengagement, medication non‐adherence, and involuntary admissions, and improved psychopathology, functioning, quality of life, and satisfaction with care.…”

Implications of Psychotherapy and Low-Dose Medication Following First-Episode Psychosis

“…While males and females present symptoms at different ages, the peak age of early onset of psychosis symptoms is between ages 12 and 29 years-old (Lambert, et al, 2016), but typically before the age of 18 (Kumperscak, 2013). Younger patients diagnosed with schizophrenia, or early onset schizophrenia (EOS) experience fewer unfavorable repercussions of the illness.…”

“…Combined intervention strategies are being used to improve early detection and quality of care in adolescents and young adults in the early phases of psychotic disorders (Lambert, et al, 2016) and there are various studies being conducted to examine the intervention's' cost-effectiveness. Psychotic episodes of schizophrenia usually first occur in adolescence and early adulthood, an important time when developing a sense of self, independence, relationships, and life plans.…”