Specialised early intervention teams for recent-onset psychosis

Puntis, Stephen; Minichino, Amedeo; Crescenzo, Franco De; Cipriani, Andrea; Lennox, Belinda; Harrison, Rosamund

doi:10.1002/14651858.cd013288.pub2

Cited by 17 publications

(11 citation statements)

References 178 publications

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“…Across three studies, 24 out of 344 (7%) patients disengaged from the specialised services; 43 of 286 (15%) disengaged from treatment as usual. The Cochrane Collaboration team considered this to be their most confident and most important finding (Puntis et al, 2020b).…”

Section: Specialised Early Intervention V Treatment As Usualmentioning

confidence: 99%

“…Their vaunted success has influenced policymakers around the world, leading to widespread roll-out of this model of care (Asian Network of Early Psychosis Writing Group, 2012; Cocchi et al, 2018; Csillag et al, 2016; Roe et al, 2021; Stefanis, 2022). These teams provide ‘the gold standard treatment for first-episode psychosis’ and are considered the ‘Jewel in the Crown’ of English psychiatry (French, 2018; Puntis et al, 2020a, 2020b). Their main role has been to treat promptly teenagers and young adults who have newly developed any of the overlapping conditions of schizophrenia, schizoaffective disorder, delusional disorder, affective psychosis, or other non-specified psychotic illness.…”

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confidence: 99%

“…There have been concerns that improved outcomes may not be maintained following discharge or transfer of care (Allison, Bastiampillai, Malhi, & Castle, 2019; Bosanac, Patton, & Castle, 2010; Gafoor et al, 2010; Gallagher et al, 2022; Hyatt, Hasler, & Wilner, 2022; Jones et al, 2020; McGorry, Ratheesh, & O'Donoghue, 2018; Pelosi & Birchwood, 2003; Puntis et al, 2020a) and that ‘the duration of treatment that [specialised early intervention] teams offer to patients is not sufficiently long enough to consolidate the therapeutic gains made during treatment…’ (Puntis et al, 2020a). These issues have been examined in recently published Cochrane reviews of international randomised controlled trials (RCTs) and in an important observational study of psychiatric services in Oxfordshire, England (Puntis et al, 2020a, 2020b; Puntis, Oke, & Lennox, 2018).…”

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confidence: 99%

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Neglecting the care of people with schizophrenia: here we go again

Pelosi

Arulnathan

2023

Psychol. Med.

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Specialist early intervention teams consider clinician–patient engagement and continuity of care to be a driving philosophy behind the treatment they provide to people who have developed schizophrenia or a related psychotic illness. In almost all countries where this service model has been implemented there is a dearth of available data about what is happening to patients following time-limited treatment. Information on discharge pathways in England indicates that some early intervention specialists are discharging most of their patients from all psychiatric services after only 2 or 3 years of input. Some ex-patients will be living in a state of torment and neglect due to an untreated psychosis. In the UK, general practitioners should refuse to accept these discharge pathways for patients with insight-impairing mental illnesses.

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Section: Specialised Early Intervention V Treatment As Usualmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Neglecting the care of people with schizophrenia: here we go again

Pelosi

Arulnathan

2023

Psychol. Med.

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“…The authors of the paper in this month's Cochrane Corner (Puntis 2020a) conducted a systematic review and meta-analysis of randomised control trials (RCTs) comparing SEI with standard psychiatric care for individuals in the early stages of psychosis. Four RCTs, published between 2004 and 2016, were included in the meta-analysis, involving a total of 1145 participants.…”

Section: The Cochrane Reviewmentioning

confidence: 99%

Specialised early intervention for recent-onset psychosis

Butt

2022

BJPsych advances

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SUMMARY Specialised early intervention (SEI) services have seen significant investment and expansion in the UK, aiming to improve long-term outcomes for psychotic disorders. This commentary discusses a recent Cochrane review that examines the evidence for SEI services delivered within the first 3 years of onset of psychotic illness. From a small number of studies conducted in high-income countries, the review draws the conclusion that there is low- to moderate-certainty evidence that SEI services improve recovery and reduce disengagement.

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“…High quality randomised controlled trials in several countries have provided evidence to support new service models such as employment support (Modini et al, 2016) and an assertive and local approach to people experiencing mental health crises. However, as outlined by Puntis, there are significant gaps in evidence for cornerstones of practice such as EIP (early intervention in psychosis) services (Puntis et al, 2020). Approaches such as Open Dialogue (OD) are often talked about as the epitome of ‘modern’ social psychiatry.…”

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confidence: 99%