No CrossRef data available.
Article contents
Service evaluation of an embedded Early Intervention in Psychosis programme
Published online by Cambridge University Press: 02 February 2024
Abstract
Background:
An average of 1300 adults develop First Episode Psychosis (FEP) in Ireland each year. Early Intervention in Psychosis (EIP) is now widely accepted as best practice in the treatment of conditions such as schizophrenia. A local EIP programme was established in the Dublin South Central Mental Health Service in 2012.
Methods:
This is a cross-sectional study of service users presenting to the Dublin South Central Mental Health Service with FEP from 2016 to 2022 following the introduction of the EIP programme. We compared this to a previously published retrospective study of treatment as usual from 2002 to 2012.
Results:
Most service users in this study were male, single, unemployed and living with their partner or spouse across both time periods. Cognitive Behavioural Therapy for psychosis was provided to 12% (n = 8) of service users pre-EIP as compared to 52% (n = 30) post-programme introduction (p < 0.001), and 3% (n = 2) of service users engaged with behavioural family therapy pre-EIP as opposed to 15% (n = 9) after (p < 0.01). Rates of composite baseline physical healthcare monitoring improved significantly (p < 0.001).
Conclusion:
Exclusive allocation of multidisciplinary team staff to EIP leads to improved compliance with recommended guidelines, particularly CBT-p, formal family therapy and physical health monitoring.
- Type
- Short Report
- Information
- Copyright
- © The Author(s), 2024. Published by Cambridge University Press on behalf of College of Psychiatrists of Ireland
References
Addington, J, Van Mastrigt, S, Addington, D (2004). Duration of untreated psychosis: impact on 2-year outcome. Psychological Medicine 34, 277–284.CrossRefGoogle ScholarPubMed
Ajnakin, O, Stubbs, B, Francis, E, Gaughran, F, David, AS, Murray, RM, Lally, J (2021). Employment and relationship outcomes in first-episode psychosis: a systematic review and meta-analysis of longitudinal studies. Schizophrenia Research 231, 122–133.CrossRefGoogle Scholar
Behan, C, Kennelly, B, Roche, E, Renwick, L, Masterson, S, Lyne, J, O’Donoghue, B, Waddington, J, McDonough, C, McCrone, P (2020). Early intervention in psychosis: health economic evaluation using the net benefit approach in a real-world setting. The British Journal of Psychiatry 217, 484–490.CrossRefGoogle ScholarPubMed
Cesková, E, Radovan, P, Tomás, K, Hana, K (2007). One-year follow-up of patients with first-episode schizophrenia (comparison between remitters and non-remitters). Neuropsychiatric Disease and Treatment 3, 153–160.CrossRefGoogle ScholarPubMed
Chang, WC, Chan, GHK, Jim, OTT, Lau, ESK, Hui, CLM, Chan, SKW, Lee, EHM, Chen, EYH (2015). Optimal duration of an early intervention programme for first-episode psychosis: randomised controlled trial. The British Journal of Psychiatry 206, 492–500.CrossRefGoogle ScholarPubMed
Cheng, F, Kirkbride, JB, Lennox, BR, Perez, J, Masson, K, Lawrence, K, Hill, K, Feeley, L, Painter, M, Murray, GK, Gallagher, O, Bullmore, ET, Jones, PB (2011). Administrative incidence of psychosis assessed in an early intervention service in England: first epidemiological evidence from a diverse, rural and urban setting. Psychologicall Medicine 41, 949–958.CrossRefGoogle Scholar
Clarke, AM, McLaughlin, P, Staunton, J, Kerins, K, Power, B, Kearney, K, McGuinness, M, Whitty, P (2019). Retrospective study of first episode psychosis in the Dublin Southwest mental health service: demographics, clinical profile and service evaluation of treatment. Irish Journal of Psychological Medicine 36, 249–258.CrossRefGoogle ScholarPubMed
Correll, CU, Galling, B, Pawar, A, Krivko, A, Bonetto, C, Ruggeri, M (2018). Comparison of early intervention services vs treatment as usual for early-phase psychosis: a systematic review, meta-analysis, and meta-regression. JAMA Psychiatry 75, 555–565.CrossRefGoogle ScholarPubMed
Craig, TK, Garety, P, Power, P, Rahaman, N, Colbert, S, Fornells-Ambrojo, M, Dunn, G (2004). The lambeth early onset (LEO) team: randomised controlled trial of the effectiveness of specialised care for early psychosis. British Medical Journal 329, 1067.CrossRefGoogle ScholarPubMed
Curtis, J, Henry, C, Watkins, A, Newall, H, Samaras, K, Ward, PB (2011a). Metabolic abnormalities in an early psychosis service: a retrospective, naturalistic cross-sectional study. Early Interention in Psychiatry 5, 108–114.CrossRefGoogle Scholar
Darker, CD, Nicolson, G, Reddon, H, O’Connor, K, Jennings, R, O’Connell, N (2023). Barriers and facilitators to the implementation of an early intervention in psychosis service in three demonstration sites in Ireland. BMC Health Services Research 23, 653.CrossRefGoogle Scholar
Doyle, R, O’Keeffe, D, Hannigan, A, Kinsella, A, Behan, C, Kelly, A, Sheridan, A, Madigan, K, Lawlor, E, Clarke, M (2019). The iHOPE-20 study: mortality in first episode psychosis-a 20-year follow-up of the Dublin first episode cohort. Social Psychiatry and Psychiatric Epidemiology 54, 1337–1342.CrossRefGoogle ScholarPubMed
Fusar-Poli, P, McGorry, PD, Kane, JM (2017). Improving outcomes of first-episode psychosis: an overview. World Psychiatry 16, 251–265.CrossRefGoogle ScholarPubMed
HSE (2019). HSE National Clinical Programme for Early Intervention in Psychosis- Model of Care Executive summary. Kilmartin & Son Ltd: Dublin.Google Scholar
HSE (2022). Dublin South, Kildare, West Wicklow Early Intervention Psychosis Proposal 3 Year Phased Approach 2023 - 2026. HSE: Dublin, Ireland.Google Scholar
International Early Psychosis Association Writing Group (2005). International clinical practice guidelines for early psychosis. The British Journal of Psychiatry 48, S120–S124.Google Scholar
IRIS (2012). IRIS Guidelines Update September 2012: Revision of the Original 1998 IRIS Guidelines. IRIS Initiative Ltd.: London.Google Scholar
Kane, JM, Robinson, DG, Schooler, NR, Mueser, KT, Penn, DL, Rosenheck, RA (2016). Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. American Journal of Psychiatry 173, 362–372.CrossRefGoogle ScholarPubMed
Kay, SR, Fiszbein, A, Opler, LA (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.CrossRefGoogle ScholarPubMed
Kelly, JR, Gounden, P, McLoughlin, A, Legris, Z, O.’Carroll, T, McCafferty, R, Marques, L, Haran, M, Farrelly, R, Loughrey, K, Flynn, G, Corvin, A, Dolan, C (2022). Minding metabolism: targeted interventions to improve cardio-metabolic monitoring across early and chronic psychosis. Irish Journal of Medical Science 191, 337–346.CrossRefGoogle ScholarPubMed
Laursen, TM, Nordentoft, M, Mortensen, PB (2014). Excess early mortality in schizophrenia. Annual Review of Clinical Psychology 10, 425–448.CrossRefGoogle ScholarPubMed
Mascayano, F, van der Ven, E, Martinez-Ales, G, Basaraba, C, Jones, N, Lee, R, Bello, I, Nossel, I, Smith, S, Smith, TE, Wall, M, Susser, E, Dixon, LB (2020). Predictors of early discharge from early intervention services for psychosis in New York state. Psychiatric Services 71, 1151–1157.CrossRefGoogle ScholarPubMed
McCrone, P, Craig, TKJ, Power, P, Garety, PA (2010). Cost-effectiveness of an early intervention service for people with psychosis. The British Journal of Psychiatry 196, 377–382.CrossRefGoogle ScholarPubMed
McGrath, J, Saha, S, Chant, D, Welham, J (2008). Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiologic Reviews 30, 67–76.CrossRefGoogle ScholarPubMed
Mouko, J, Sullivan, R (2017). Systems for physical health care for mental health patients in the community: different approaches to improve patient care and safety in an early intervention in psychosis service. BMJ Quality Improvement Reports 6, u209141.w3798.CrossRefGoogle Scholar
Murphy, BP, Brewer, WJ (2011). Early intervention in psychosis: strengths and limitations of services. Advances in Psychiatric Treatment 17, 401–407.CrossRefGoogle Scholar
Niv, N, Cohen, AN, Sullivan, G, Young, AS (2007). The MIRECC version of the global assessment of functioning scale: reliability and validity. Psychiatric Services 58, 529–535.CrossRefGoogle ScholarPubMed
O’Connell, N, O’Connor, K, McGrath, D, Vagge, L, Mockler, D, Jennings, R, Darker, CD (2021). Early intervention in psychosis services: a systematic review and narrative synthesis of the barriers and facilitators to implementation. European Psychiatry 65, e2.CrossRefGoogle ScholarPubMed
O’Donoghue, B, Collett, H, Boyd, S, Zhou, Y, Castagnini, E, Brown, E, Street, R, Nelson, B, Thompson, A, McGorry, P (2022). The incidence and admission rate for first-episode psychosis in young people before and during the COVID-19 pandemic in Melbourne, Australia. Australian and New Zealand Journal of Psychiatry 56, 811–817.CrossRefGoogle ScholarPubMed
Pelizza, L, Maestri, D, Leuci, E, Quattrone, E, Azzali, S, Paulillo, G, Pellegrini, P (2021). Negative symptom configuration in patients with first episode affective psychosis: findings from the 1-year follow-up of the “Parma early psychosis program. Acta Biomedica Atenei Parmensis 92, e2021224.Google ScholarPubMed
Petruzzelli, MG, Margari, L, Bosco, A, Craig, F, Palumbi, R, Margari, F (2018). Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers. European Child & Adolescent Psychiatry 27, 171–179.CrossRefGoogle ScholarPubMed
Plana-Ripoll, O, Musliner, KL, Dalsgaard, S, Momen, NC, Weye, N, Christensen, MK, Agerbo, E, Iburg, KM, Laursen, TM, Mortensen, PB, Pedersen, CB, Petersen, LV, Santomauro, DF, Vilhjálmsson, BJ, Whiteford, HA, McGrath, JJ (2020). Nature and prevalence of combinations of mental disorders and their association with excess mortality in a population-based cohort study. World Psychiatry 19, 339–349.CrossRefGoogle Scholar
Power, P (2019). Early intervention services for psychosis in Ireland: are we there yet? Irish Journal of Psychological Medicine 36, 243–248.CrossRefGoogle ScholarPubMed
Ricciardi, A, McAllister, V, Dazzan, P (2008). Is early intervention in psychosis effective? Epidemiology and Psychiatric Sciences 17, 227–235.CrossRefGoogle ScholarPubMed
Rinaldi, M, Killackey, E, Smith, J, Shepherd, G, Singh, SP, Craig, T (2010). First episode psychosis and employment: a review. International Review of Psychiatry 22, 148–162.CrossRefGoogle ScholarPubMed
Robinson, D, Woerner, MG, Alvir, JM, Bilder, R, Goldman, R, Geisler, S, Koreen, A, Sheitman, B, Chakos, M, Mayerhoff, D, Lieberman, JA (1999). Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Archives of General Psychiatry 56, 241–247.CrossRefGoogle ScholarPubMed
Ruggeri, M, Bonetto, C, Lasalvia, A, Fioritti, A, de Girolamo, G, Santonastaso, P, Patelli, G (2015). Feasibility and effectiveness of a multi-element psychosocial intervention for first-episode psychosis: results from the cluster-randomized controlled GET UP PIANO trial in a catchment area of 10 Million inhabitants. Schizophrenia Bulletin 41, 1192–1203.CrossRefGoogle Scholar
Singh, SP (2007). Outcome measures in early psychosis: relevance of duration of untreated psychosis. The British Journal of Psychiatry 191, s58–s63.CrossRefGoogle Scholar
Whitty, P, Clarke, M, McTigue, O, Browne, S, Kamali, M, Larkin, C, O’Callaghan, E (2005). Diagnostic stability four years after a first episode of psychosis. Psychiatric Services 56, 1084–1088.CrossRefGoogle ScholarPubMed
Connolly et al. supplementary material
Connolly et al. supplementary material
File
485.4 KB