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Early intervention in psychosis: service models worldwide and the Irish experience

Published online by Cambridge University Press:  13 June 2014

Sami Omer*
Affiliation:
Department of Old Age Psychiatry, Sligo, Co Sligo, Ireland.
Caragh Behan
Affiliation:
St. Ita's Hospital, Co. Dublin, Ireland.
John L Waddington
Affiliation:
Molecular & Cellular Therapeutics andRCSI Research Institute, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland.
Eadbhard O'Callaghan
Affiliation:
Department of Psychiatry, University College Dublin, Dublin 4, and DELTA/DETECT Early Intervention in Psychosis Services, Dun Laoghaire Co. Dublin, Ireland
*
*Correspondence E-mail: Omersami@hotmail.com

Abstract

This paper examines the concept of early intervention in psychosis at primary and secondary prevention levels. Examples of early intervention service models from different countries are presented and we discuss current evidence for efficacy. We highlight the Irish experience of early intervention to date, and discuss future implementation of early intervention services in Ireland.

Type
Perspective
Copyright
Copyright © Cambridge University Press 2010

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References

1.Department of Health. The NHS Plan: a plan for investment, a plan for reform. Department of Health. London, 2000. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4002960 (accessed Feb 2009).Google Scholar
2.Department of Health. The Mental Health Policy Implementation Guide. Department of Health. London, 2001. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4009350 (accessed Jul 2009).Google Scholar
3.Yung, AR, McGorry, PD.The prodromal phase of first-episode psychosis: past and current conceptualizations. Schiz Bull 1996; 22(2): 353–70.CrossRefGoogle ScholarPubMed
4.Marshall, M, Rathbone, J.Early intervention for psychosis. Cochrane Database Syst Rev. 2006;(4):CD004718.Google ScholarPubMed
5.Klosterkötter, J, Ruhrmann, S, Schultze-Lutter, Fet al.The European Prediction of Psychosis Study (EPOS): integrating early recognition and intervention in Europe. World Psychiatry 2005; 4(3): 161–7.Google ScholarPubMed
6.Edwards, J, McGorry, PD.Implementing Early Intervention in Psychosis: A Guide to Establishing Early Psychosis Services. London; Dunitz Ltd, 2002.CrossRefGoogle Scholar
7.Perkins, DO, Gu, H, Boteva, K, Lieberman, JA.Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. Am J Psychiatry 2005; 162(10): 1785–804.CrossRefGoogle ScholarPubMed
8.Wyatt, RJ.Neuroleptics and the natural course of schizophrenia. Schiz Bull 1991; 17(2): 325–51.CrossRefGoogle ScholarPubMed
9.McGorry, PD, Warner, R.Consensus on early intervention in schizophrenia Schiz Bull 2002; 28(3): 543–4.Google Scholar
10.Clarke, M, Whitty, P, Browne, Set al. Suicidally in first episode psychosis. Schiz Res 2006; 86(1-3): 221–5.CrossRefGoogle ScholarPubMed
11.Norman, RM, Malla, AK.Duration of untreated psychosis: a critical examination of the concept and its importance. Psychol Med 2001; 31(3): 381400.CrossRefGoogle ScholarPubMed
12.Marshall, M, Lewis, S, Lockwood, A, Drake, R, Jones, P, Croudace, T.Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Arch Gen Psychiatry 2005; 62(9): 975–83.CrossRefGoogle ScholarPubMed
13.Norman, RM, Lewis, SW, Marshall, M.Duration of untreated psychosis and its relationship to clinical outcome. Br J Psychiatry Suppl. 2005; 48: s1923.CrossRefGoogle ScholarPubMed
14.Whitty, P, Clarke, M, McTigue, Oet al.Diagnostic stability four years after a first episode of psychosis. Psychiatr Serv 2005; 56(9):1084–8.CrossRefGoogle ScholarPubMed
15.Crumlish, N, Whitty, P, Clarke, Met al.Beyond the critical period: longitudinal study of 8-year outcome in first-episode non-affective psychosis. Br J Psychiatry 2009; 194(1): 1824.CrossRefGoogle ScholarPubMed
16.Birchwood, M, Todd, P, Jackson, C.Early intervention in psychosis. The critical period hypothesis. Br J Psychiatr Suppl. 1998; 172(33): 5359CrossRefGoogle ScholarPubMed
17.Singh, SP, Fisher, HL.Early intervention in psychosis: obstacles and opportunities. Adv Psychiat Treat 2005; 11:71–8.CrossRefGoogle Scholar
18.Singh, PS, Fisher, HLEarly intervention services. Psychiatry 2004; 3: 1721.CrossRefGoogle Scholar
19.Pinfold, V, Smith, J, Shiers, D.Audit of early intervention in psychosis service development in England in 2005. Psychiat Bull 2007; 31: 710.CrossRefGoogle Scholar
20.Yung, AR, Organ, BA, Harris, MG.Management of early psychosis in a generic adult mental health service. Aust NZ J Psychiatry 2003; 37: 429436.CrossRefGoogle Scholar
21.McGorry, PD, Edwards, J, Mihalopoulos, C, Harrigan, SM, Jackson, HJ.EPPIC: an evolving system of early detection and optimal management. Schiz Bull 1996; 22(2): 305–26.CrossRefGoogle ScholarPubMed
22.Amminger, GP, Harris, MG, Conus, Pet al. Treated incidence of first-episode psychosis in the catchment area of EPPIC between 1997 and 2000. Acta Psychiat Scand 2006; 114: 337345.CrossRefGoogle ScholarPubMed
23.Melle, I, Larsen, TK, Haahr, Uet al.Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. Arch Gen Psychiatry 2004; 61(2): 143–50.CrossRefGoogle ScholarPubMed
24.Malla, A, Norman, R, McLean, T, Scholten, D, Townsend, L.A Canadian programme for early intervention in non-affective psychotic disorders. Aust NZ J Psychiatry 2003; 37(4): 407–13.CrossRefGoogle ScholarPubMed
25.Craig, TK, Garety, P, Power, Pet al.The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 2004; 329(7474): 1067.CrossRefGoogle ScholarPubMed
26.Garety, PA, Craid, TKJ, Dunn, Get al.Specialised care for early psychosis: symptoms, social functioning and patient satisfaction. Br J Psych 2006; 188(1): 3745.CrossRefGoogle ScholarPubMed
27.Agius, M, Shah, S, Ramkisson, R, Murphy, S, Zaman, R.Three year outcomes of an early intervention for psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team-fiinal results. Psychiatr Danub 2007; 19(3): 130–8.Google Scholar
28.Cullberg, J, Mattsson, M, Levander, S, Holmqvist, R, Tomsmark, L, Elingfors, C, Wieseigren, IM.Treatment costs and clinical outcome for first episode schizophrenia patients: a 3-year follow-up of the Swedish ‘Parachute Project’ and two comparison groups. Acta Psychiat Scand 2006; 114(4): 274281.CrossRefGoogle ScholarPubMed
29.Goldberg, K, Norman, R, Hoch, JSet al.Impact of a specialized early intervention service for psychotic disorders on patient characteristics, service use, and hospital costs in a defined catchment area. Can J Psychiatry 2006; 51 (14): 895903.CrossRefGoogle Scholar
30.Malla, A, Norman, R, Bechard-Evans, L, Schmitz, N, Manchanda, R, Cassidy, C.Factors influencing relapse during a 2-year follow-up of first-episode psychosis in a specialized early intervention service. Psychol Med 2008; 38(11): 1585–93.CrossRefGoogle Scholar
31.Petersen, L, Jeppesen, P, Thorup, Aet al.A randomised multicentre trial of integrated versus standard treatment for patients with a first episode psychotic illness. BMJ 2005; 331(7517): 602CrossRefGoogle Scholar
32.Menezes, N, Arenovich, T, Zipursky, R.A Systemtatic review of longitudinal outcome studies of first episode psychosis. Psychol Med 2006; 36(10): 1349–62.CrossRefGoogle ScholarPubMed
33.Bertelsen, M, Jeppesen, P, Petersen, Let al.Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Arch Gen Psychiatry 2008; 65(7): 762–71.CrossRefGoogle ScholarPubMed
34.Mihalopoulos, C, Harris, M, Henry, L, Harrigan, S.McGorry, P.Is Early Intervention in Psychosis Cost-Effective over the Long Term?Schizophr Bull 2009 06 9. [Epub ahead of print] DOI: 10.1093/schbul/sbp054Google Scholar
35.Access Economics Pty Limited. Cost effectiveness of early intervention for psychosis. Report for Orygen Research Centre. Melbourne, Australia, 2008.Google Scholar
36.Scully, PJ, Quinn, JF, Morgan, MGet al.First-episode schizophrenia, bipolar disorder and other psychoses in a rural Irish catchment area: incidence and gender in the Cavan-Monaghan study at 5 years. Br J Psychiatry Suppl. 2002; 43: s39.CrossRefGoogle Scholar
37.Baldwin, P, Browne, D, Scully, PJet al.Epidemiology of first-episode psychosis: illustrating the challenges across diagnostic boundaries through the Cavan-Monaghan study at 8 years. Schizophr Bull 2005; 31(3): 624–38.CrossRefGoogle Scholar
38.McCauley, M, Rooney, S, Clarke, K, Carey, T, Owens, J.Home-based treatment in Monaghan: the first two years. IrJ Psych Med 2003; 20(1): 1114.CrossRefGoogle ScholarPubMed
39.Clarke, M, Whitty, P, Browne, Set al.Untreated illness and outcome of psychosis. Br J Psychiatry 2006; 189: 235–40.CrossRefGoogle ScholarPubMed
40.Renwick, L, Gavin, B, McGlade, Net al.Early intervention for psychosis service: Views from primary care. Early Intervention in Psychiatry 2008; 2(4): 285290.CrossRefGoogle ScholarPubMed
41.A Vision for Change: Report of the Expert Group on Mental Health Policy. Department of Health and Children. Dublin: Stationery Office, 2006.Google Scholar