Relapse Risk Assessment in Early Phase Psychosis: The Search for a Reliable and Valid Tool

Tibbo, Philip G.; Malla, Ashok; Manchanda, Rahul; Williams, Richard L.; Joober, Ridha

doi:10.1177/070674371405901207

Cited by 18 publications

(8 citation statements)

References 40 publications

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“…The resulted proportion is similar to the identified risk reported from the international literature for individuals with ARMS (Fusar‐Poli et al, ). Likewise the relapse rate of the FEP patients was within the expected range given by other EIP services (Addington, Addington, & Patten, ; Tibbo, Malla, Manchanda, Williams, & Joober, ). However, our sample is relatively small and the referred subjects might not represent the population of people with UHR and FEP as a whole.…”

Section: Discussionsupporting

confidence: 72%

Early psychosis intervention outpatient service of the 1st Psychiatric University Clinic in Athens: 3 Years of experience

Kollias

Xenaki

Dimitrakopoulos

et al. 2016

Early Intervention Psych

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To present the 3-year experience of the early intervention in psychosis (EIP) service implementation of the 1st Psychiatric University Clinic in Athens. An overview of: (1) the purpose of our service, (2) the referral network, (3) the selection criteria, (4) the diagnostic procedures, (5) the therapeutic interventions and (6) the research activities. The service was established in 2012 and developed gradually aiming to provide information, early detection, treatment and support to people aged 15 to 40 years with psychotic manifestations, who are either at increased risk of developing psychosis (at-risk mental state [ARMS]) or with first episode psychosis (FEP). In order to assess individuals with ARMS, we used the comprehensive assessment of at-risk mental states interview and the Social and Occupational Functioning Assessment Scale The duration of untreated psychosis was estimated by using the Nottingham Onset Schedule. So far we have had 65 referrals, of which 26 were ARMS and 17 FEP. Based on the individual needs, they were offered psychotherapeutic and/or pharmacological treatment. After 3 years, the rate of transition to psychosis was 19.2% and the rate of psychosis relapse was 11.7%. The implementation of our service has had positive results, enabling young people with early psychosis to receive prompt and effective care. The rates of transition to psychosis are the first to be published from a Greek EIP service. Further development of our referral network and inter-hospital collaboration will allow us to address the needs of a wider part of the population.

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Section: Discussionsupporting

confidence: 72%

Early psychosis intervention outpatient service of the 1st Psychiatric University Clinic in Athens: 3 Years of experience

Kollias

Xenaki

Dimitrakopoulos

et al. 2016

Early Intervention Psych

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“…Relapse is associated with higher risks of self-harm, loss of employment, and strain on personal relationships, as well as biological risk of cognitive decline [2]. Predicting relapse remains challenging given the complexity of schizophrenia and the heterogeneity of presentations [3,4], as well as the fundamental difficulty of observing patient behavior and symptoms outside of the clinic.…”

Section: Introductionmentioning

confidence: 99%

Relapse prediction in schizophrenia through digital phenotyping: a pilot study

Barnett

Torous

Staples

et al. 2018

Neuropsychopharmacol

302

237

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Among individuals diagnosed, hospitalized, and treated for schizophrenia, up to 40% of those discharged may relapse within 1 year even with appropriate treatment. Passively collected smartphone behavioral data present a scalable and at present underutilized opportunity to monitor patients in order to identify possible warning signs of relapse. Seventeen patients with schizophrenia in active treatment at a state mental health clinic in Boston used the Beiwe app on their personal smartphone for up to 3 months. By testing for changes in mobility patterns and social behavior over time as measured through smartphone use, we were able to identify statistically significant anomalies in patient behavior in the days prior to relapse. We found that the rate of behavioral anomalies detected in the 2 weeks prior to relapse was 71% higher than the rate of anomalies during other time periods. Our findings show how passive smartphone data, data collected in the background during regular phone use without active input from the subjects, can provide an unprecedented and detailed view into patient behavior outside the clinic. Real-time detection of behavioral anomalies could signal the need for an intervention before an escalation of symptoms and relapse occur, therefore reducing patient suffering and reducing the cost of care.

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“…Individuals that have recurrent episodes of relapse are at high risk for developing a chronic form of the illness, with important functional implications and increased risk for suicide (Crumlish et al, 2009;Dodgson, Ross, Tiffin, Mitford, & Brabban, 2012;Dutta, Murray, Allardyce, Jones, & Boydell, 2011). Relapses often result in psychiatric hospitalizations (Addington, Patten, McKenzie, Addington, 2013), and can significantly undermine young people's sense of hope and optimism for the future (Tibbo, Malla, Manchanda, Williams, & Joober, 2014). Evidently, it is important to minimize relapses in the early phases of psychosis through both pharmacological and psychosocial interventions ( Alvarez-Jiménez, Parker, Hetrick, McGorry, & Gleeson, 2011).…”

Section: Introductionmentioning

confidence: 99%

“Worried about relapse”: Family members’ experiences and perspectives of relapse in first‐episode psychosis

Lal

Malla

Marandola

et al. 2017

Early Intervention Psych

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Family members' unmet needs for relapse-focused education, support and communication with service providers and peers, can have a negative impact on relapse prevention. Addressing family members' education and support needs in a tailored manner (including preferences for types of peer support) can contribute positively to their confidence and ability to recognize and respond to relapse. This can help reduce fear and anxieties about relapse, and positively influence the ability to function as caregivers. Future research should focus on best approaches for providing education, sustained contact with the clinical team and family peer support.

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Relapse Risk Assessment in Early Phase Psychosis: The Search for a Reliable and Valid Tool

Cited by 18 publications

References 40 publications

Early psychosis intervention outpatient service of the 1st Psychiatric University Clinic in Athens: 3 Years of experience

Early psychosis intervention outpatient service of the 1st Psychiatric University Clinic in Athens: 3 Years of experience

Relapse prediction in schizophrenia through digital phenotyping: a pilot study

“Worried about relapse”: Family members’ experiences and perspectives of relapse in first‐episode psychosis

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