Specialized inpatient treatment for young people with early psychosis: acute-treatment and 12-month results

Abstract

The objective of the study was to investigate the development of clinical outcomes of young people with early psychosis in a specialized inpatient treatment and assess the feasibility of such an intervention in an inpatient setting. The study was a prospective cohort study of patients with early psychosis treated at the specialized inpatient treatment “Fühinterventions-und Therapiezentrum, FRITZ” (early intervention and therapy center) in Berlin, Germany. The primary outcomes were attitudes towards psychiatric medication and patient satisfaction with treatment after 6 weeks. Secondary outcomes were clinical symptoms, functioning, remission, recovery, all-cause treatment discontinuation, and rehospitalisation at 6 and 12 months after inpatient treatment. We recruited 95 inpatients with early psychosis. Attitudes towards psychiatric medication (Δ6weeks = 3.00, d6weeks = 0.55; Δ6mo = 2.15, d6mo = 0.35; Δ12mo = 3.03, d12mo = 0.52) and patient satisfaction (Δ6weeks = 0.21, d6weeks = 0.40; Δ6mo = 0.32, d6mo = 0.43; Δ12mo = 0.13, d12mo = 0.17) changed with medium effect sizes at six weeks up to a 6- and 12-month follow-up. Clinical outcomes changed significantly with medium-to-large-effect sizes over 12 months CGIΔ12mo = 1.64, d12mo = −1.12; PANSS totalΔ12mo = 20.10, d12mo = −0.76; GAFΔ12mo = 19.58, d12mo = 1.25). The all-cause treatment discontinuation rate was 13.69% (n = 13) at a 6-month and 35.79% (n = 34) at a 12-month follow-up. The rehospitalization rate was 30.53% (n = 29) at a 6-month and 43.16% (n = 41) at a 12-month follow-up. Patients with specialized inpatient treatment for early psychosis showed improvements in attitude towards psychiatric medication, patient satisfaction, symptoms, and functioning for up to 12 months.Trial registration: DRKS00024351, 2021/02/11 retrospectively registered.

Alternative approaches to standard inpatient mental health care: development of a typology of service models

“…Specialist eating disorder wards focus on medical stabilisation, nutritional rehabilitation, psychotherapy and developing effective coping skills (36,98). Early psychosis wards aim to provide timely intervention and comprehensive treatment (99,100).…”

soulspace: Integrated youth mental health care in Berlin, Germany—An introduction to the program and a description of its users

“…The catchment area comprises 280.000 inhabitants, with a high proportion of young people (45.1%), and high proportions of individuals with migration backgrounds. Additionally, poverty, and alcohol and substance use are rather frequent in that district (Jacobi et al, 2014;Senatsverwaltung für Gesundheit und Soziales, 2014;Siebert et al, 2022). (early intervention initiative) (FIT).…”

“…Continuity of care is performed when diagnoses or patient needs change or when patients turn 18, allowing the complete treatment to be performed by the same, multidisciplinary team of professionals and with different fields of expertise. Moreover, close relationships and personal continuity with the AMHS and CAHMS staff at Frühinterventions‐ und Therapiezentrum (early intervention and therapy center) ( FRITZ ); Bechdolf et al, 2021; Siebert et al, 2022) at the nearby hospital ensures that service users can receive specialized assertive outreach treatment, day clinic and inpatient care if needed. Awareness , engagement and integration : The early intervention initiative FIT is integrated in a community counselling service for young people ( transit ) in order to foster engagement of users and integration in the community by incorporating the expertise of other groups and organizations in the community. Awareness campaigns and workshops are performed in school classes, with liason teachers, in employment offices and in job centres (for awareness activities refer to section 8). Early intervention : Self‐referrals and referrals by others get first assessed by the social workers and psychologists of the low threshold counselling service transit .…”

Die besondere Rolle des Modellvorhabens nach § 64b SGB V für die psychiatrische Adoleszentenstation in Riedstadt

“…Die Zusammensetzung des Teams richtet sich nach der Annahme einer durchschnittlichen Patientenverteilung von KJP und EP der Personalausstattung Psychiatrie und Psychosomatik Richtlinie (PPP-RL). In einer Online-Recherche der Autoren konnten weitere AS in Wasserburg am Inn, Nürnberg, Münster, Königslutter, Bremen-Ost, Kutzenberg (Obermain), Dinslaken (Niederrhein), Winterthur sowie Duisburg 1 ausfindiggemachtwerden.Darüberhinaus bietet das Klinikum am Urban in Berlin spezielle Angebote für junge Erwachsene, zwischen 16 und 29 Jahren, mit psychischen Krisen in Form eines Frühinterventions-und Therapiezentrums (FRITZ am Urban) an [13,14].…”