Early Intervention in Psychosis

Abstract

Early intervention for potentially serious disorder is a fundamental feature of healthcare across the spectrum of physical illness. It has been a major factor in the reductions in morbidity and mortality that have been achieved in some of the non-communicable diseases, notably cancer and cardiovascular disease. Over the past two decades, an international collaborative effort has been mounted to build the evidence and the capacity for early intervention in the psychotic disorders, notably schizophrenia, where for so long deep pessimism had reigned. The origins and rapid development of early intervention in psychosis are described from a personal and Australian perspective. This uniquely evidence-informed, evidence-building and cost-effective reform provides a blueprint and launch pad to radically change the wider landscape of mental health care and dissolve many of the barriers that have constrained progress for so long.

Mapping the Consequences of Impaired Synaptic Plasticity in Schizophrenia through Development: An Integrative Model for Diverse Clinical Features

“…However, benefits have generally not extended to broader aspects of cognition [212,215]. If impaired synaptic plasticity disrupts the optimal tuning of local and long-range circuits, targeting plasticity deficits with pharmacological interventions and/or behavioral interventions intended to strengthen adaptive synapses earlier in development (e.g., support for school/extracurricular involvement, cognitive enhancement training, cognitive behavioral therapy) may provide more effective options for ameliorating the emergence of subsequent cognitive and/or psychotic symptoms [216–219]. Indeed, meta-analyses suggest that behavioral interventions can delay or prevent conversion to psychosis among some clinical high risk individuals [220,221], although sample sizes have been modest, effects on cognitive and neural functioning have been rarely investigated, and the neural mechanisms of treatment efficacy are unclear.…”

Psychiatrists' opinion towards medication discontinuation in remitted first‐episode psychosis: A multi‐site study of the Asian Network for Early Psychosis

“…Guiding clinical practice in Asian mental health care delivery is one of the main aims of the ANEP (McGorry, ). The network hopes to achieve this by developing a set of Asian‐specific clinical guidelines for the management of psychosis, by consolidating an Asian‐specific evidence base, and by facilitating collaboration within Asia.…”

A structured review of psychiatric rehabilitation for individuals living with severe mental illness within three regions of the Asia‐Pacific: Implications for practice and policy

“…Whether one believes the early psychosis movement has “overreached” and overshadowed the provision of better care for all (Bosanac, Patton, & Castle, ), it nonetheless shed light on the power that strong advocates, collaboration, media, and political influence can have on influencing care (McGorry, ). Positively for psychiatric rehabilitation, while the evidence behind the benefit of early psychosis services to overall psychiatric care is contentious (Bosanac et al, ; Castle, ), there is little controversy, despite little implementation, for psychiatric rehabilitation.…”