Systematic review of the evidence for service models delivering early intervention in psychosis outside the stand‐alone centre

Behan, Caragh; Masterson, Sarah; Clarke, Mary

doi:10.1111/eip.12334

Cited by 16 publications

(12 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interventions supporting social recovery and employment should be offered to patients with schizophrenia, as stated in different national clinical guidelines (Gaebel, Riesbeck, & Wobrock, ). Especially early intervention services, focusing usually on younger patients, are becoming more widely offered and there has been an upsurge in research on such services (Behan, Masterson, & Clarke, ). In studies focusing on interventions, a younger age of onset has been associated with poorer pre‐morbid functioning and more severe baseline illness in schizophrenia: a lower onset age is related to having more negative symptoms (Ballageer et al, ; Pencer, Addington, & Addington, ), impaired social functioning (Hui et al, ; Vourdas et al, ) and poorer work history (Hui et al, ; Mueser, Salyers, & Mueser, ) at baseline as well as poorer pre‐morbid functioning in the form of, for example, education (Ballageer et al, ; Hui et al, ).…”

Section: Discussionmentioning

confidence: 99%

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

Immonen

Jääskeläinen

Korpela

et al. 2017

Early Intervention Psych

216

116

View full text Add to dashboard Cite

The aim of this study was to analyse the effect of age at onset on the long‐term clinical, social and global outcomes of schizophrenia through a systematic review and a meta‐analysis. Original studies were searched from Web of Science, PsycINFO, Pubmed and Scopus, as well as manually. Naturalistic studies with at least a 2‐year follow‐up were included. Of the 3509 search results, 81 articles fulfilled the inclusion criteria. The meta‐analysis was performed in Stata as a random‐effect analysis with correlation coefficients between age at onset and the outcomes (categorized into remission, relapse, hospitalization, positive symptoms, negative symptoms, total symptoms, general clinical outcome, employment, social/occupational functioning and global outcome). There was a statistically significant (P < .05) correlation between younger age at onset and more hospitalizations (number of studies, n = 9; correlation, r = 0.17; 95% confidence interval, CI 0.09–0.25), more negative symptoms (n = 7; r = 0.14; 95% CI 0.01–0.27), more relapses (n = 3; r = 0.11; 95% CI 0.02–0.20), poorer social/occupational functioning (n = 12; r = 0.15; 95% CI 0.05–0.25) and poorer global outcome (n = 13; r = 0.14; 95% CI 0.07–0.22). Other relationships were not significant. This was the first systematic review of the effects of age at onset on the long‐term outcomes of schizophrenia. The results show that age at onset has a small, but significant impact on some of the outcomes of schizophrenia.

show abstract

Section: Discussionmentioning

confidence: 99%

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

Immonen

Jääskeläinen

Korpela

et al. 2017

Early Intervention Psych

216

116

View full text Add to dashboard Cite

show abstract

“…In LMICs, for example, it remains unknown whether specialist EIP would be practicable and similarly cost‐effective. There are also unanswered questions regarding service duration, delivery, and other parameters of this complex intervention that could have clinical and cost implications.…”

Section: Current Economic Evidence and Key Events In Mental Health Carementioning

confidence: 99%

Economics and mental health: the current scenario

2020

View full text Add to dashboard Cite

Economics and mental health are intertwined. Apart from the accumulating evidence of the huge economic impacts of mental ill‐health, and the growing recognition of the effects that economic circumstances can exert on mental health, governments and other budget‐holders are putting increasing emphasis on economic data to support their decisions. Here we consider how economic evaluation (including cost‐effectiveness analysis, cost‐utility analysis and related techniques) can contribute evidence to inform the development of mental health policy strategies, and to identify some consequences at the treatment or care level that are of relevance to service providers and funding bodies. We provide an update and reflection on economic evidence relating to mental health using a lifespan perspective, analyzing costs and outcomes to shed light on a range of pressing issues. The past 30 years have witnessed a rapid growth in mental health economics, but major knowledge gaps remain. Across the lifespan, clearer evidence exists in the areas of perinatal depression identification‐plus‐treatment; risk‐reduction of mental health problems in childhood and adolescence; scaling up treatment, particularly psychotherapy, for depression; community‐based early intervention and employment support for psychosis; and cognitive stimulation and multicomponent carer interventions for dementia. From this discussion, we pull out the main challenges that are faced when trying to take evidence from research and translating it into policy or practice recommendations, and from there to actual implementation in terms of better treatment and care.

show abstract

“…The literature documents disagreements on the type of early intervention model that is most appropriate for patients and applicable and feasible in real-world mental healthcare structures (61) and debates on obstacles when early intervention centers are established within the public Department of Mental Healthcare (62). In Latvia, healthcare expenditures are among the lowest compared to other countries; nevertheless, the situation in similar to other Eastern Europe countries with similar policy makers’ attitudes toward mental healthcare (28).…”

Section: Discussionmentioning

confidence: 99%

Implementing the Latvian Early Intervention Program (LAT-EIP) for Patients With Schizophrenia Spectrum First-Episode Psychosis: Study Protocol

Berze

Civcisa²,

Krone³

et al. 2019

Front. Psychiatry

View full text Add to dashboard Cite

Background: Patients with first-episode psychosis are mainly young people in the active phase of their social and professional lives, and psychosis is a serious disruption of normal life with high risk of disability. Integrated biopsychosocial early intervention treatment is crucial for patients with first-time psychosis episode. The purpose of this trial is to adapt the first early intervention program for patients with first-time non-affective psychosis in Latvia, and to investigate whether it is possible to integrate this kind of treatment approach in the frame of existing services and whether it provides better outcomes for patients than existing services. Design/Methods: The study has a nonrandomized controlled design in a real-life environment. Participants are all consecutive patients presenting in the psychiatric emergency room with first-time non-affective schizophrenia spectrum psychosis episode (ICD criteria F23, F20) from a catchment area of 262,541 inhabitants, with urban and rural regions. The Latvian Early Intervention Program is a 6-month program developed from existing treatment guidelines and recommendations and adapted to a low-resource environment, integrated in an existing outpatient unit. This study aimed to test the hypothesis that the patients who received intervention have milder symptoms, higher functioning, and better adherence to outpatient treatment. The study primary aims are: 1) to establish and examine in practice the adapted early intervention for patients with first schizophrenia spectrum psychosis; 2) compare clinical and functional outcomes (including occupation, housing, and social relationships) between intervention treatment and standard treatment; and 3) compare the number of rehospitalizations, adherence to outpatient treatment, and assigned disability. Secondary aims are: 1) to compare full recovery status in both treatment groups at 12 months follow-up and 2) to develop recommendations for establishing early intervention programs in limited resource settings. Discussion/Conclusions: Across the world, there is wide inequality in the availably and accessibility to early intervention treatment. This study will increase our knowledge in early intervention treatment approach and outcomes for patients with schizophrenia spectrum first psychosis episode in real-life working clinical practices. We hope to provide theoretical and practical aspects to develop strategies for early intervention service implementation in limited resource mental healthcare settings.

show abstract

Systematic review of the evidence for service models delivering early intervention in psychosis outside the stand‐alone centre

Cited by 16 publications

References 44 publications

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

Economics and mental health: the current scenario

Implementing the Latvian Early Intervention Program (LAT-EIP) for Patients With Schizophrenia Spectrum First-Episode Psychosis: Study Protocol

Contact Info

Product

Resources

About