Journal ArticleDOI
Early intervention in psychosis: The critical period hypothesis
TLDR
Prospective studies of first-episode schizophrenics support the critical period hypothesis and indicate that progression, where it occurs, does so early in the disorder, with patients reaching a relatively stable plateau within 2 years of the first psychotic episode.Abstract:
Background We consider the evidence for the proposition that the early phase of psychosis (including the period of untreated psychosis) is a critical period' in which (a) long-term outcome is predictable, and (b) biological, psychological and psychosocial influences are developing and show maximum plasticity. Method First-episode prospective studies, predictors of outcome and the genesis of patients' key appraisals of their psychosis are reviewed. Results The data support the notion of the ‘plateau effect’, first coined by Tom McGlashan, which suggested that where deterioration occurs, it does so aggressively in the first 2-3 years; and that critical psychosocial influences, including family and psychological reactions to psychosis and psychiatric services, develop during this period. Conclusions The early phase of psychosis presents important opportunities for secondary prevention. We outline a prototype of intervention appropriate to the critical period. The data challenge the widely held assumption that first-episode psychosis is a benign illness posing little risk.read more
Citations
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Journal ArticleDOI
The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis
Tom K. J. Craig,Philippa Garety,Paddy Power,Nikola Rahaman,Susannah Colbert,Miriam Fornells-Ambrojo,Graham Dunn +6 more
TL;DR: Limited evidence shows that a team delivering specialised care for patients with early psychosis is superior to standard care for maintaining contact with professionals and for reducing readmissions to hospital.
Journal ArticleDOI
A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness
Lone Petersen,Pia Jeppesen,Anne Thorup,M. Abel,Johan Øhlenschlæger,Torben Østergaard Christensen,Gertrud Krarup,Per E. Jørgensen,Merete Nordentoft +8 more
TL;DR: At one year's follow-up, psychotic symptoms changed favourably to a mean of 1.09 (standard deviation 1.27) with an estimated mean difference between groups of −0.31 (95% confidence interval −0-0.07, P = 0.02) in favour of integrated treatment.
Journal ArticleDOI
Duration of untreated psychosis: a critical examination of the concept and its importance.
Ross M.G. Norman,Ashok Malla +1 more
TL;DR: Evidence thus far suggests that DUP may be related to ease of reducing psychotic symptoms once treatment begins for first episode patients, but there is no evidence of a relationship to likelihood of relapse.
Journal ArticleDOI
Early intervention in psychosis.
TL;DR: It is argued that sustaining early gains in psychosis services requires both a reappraisal of generic services and an understanding of the active ingredients of early intervention, which can be tailored for longer input in cases with poorer outcome trajectories.
Journal ArticleDOI
Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis: A Systematic Review, Meta-analysis, and Meta-regression
Christoph U. Correll,Britta Galling,Britta Galling,Aditya Pawar,Anastasia Krivko,Chiara Bonetto,Mirella Ruggeri,Thomas J. Craig,Merete Nordentoft,Merete Nordentoft,Vinod H. Srihari,Sinan Guloksuz,Sinan Guloksuz,Christy L.M. Hui,Eric Y.H. Chen,Marcelo Valencia,Francisco Juárez,Delbert G. Robinson,Delbert G. Robinson,Nina R. Schooler,Mary F. Brunette,Kim T. Mueser,Robert A. Rosenheck,Patricia Marcy,Jean Addington,Sue E. Estroff,James Robinson,David L. Penn,Joanne B. Severe,John M. Kane,John M. Kane +30 more
TL;DR: In this paper, the authors compared early intervention services (EIS) with treatment as usual (TAU) for early-phase psychosis and found that EIS was associated with better outcomes than TAU at the end of treatment for all 13 meta-analyzable outcomes.
References
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TL;DR: The Brief Psychiatric Rating Scale (BRS) as mentioned in this paper was developed to provide a rapid assessment technique particularly suited to the evaluation of patient change, and it is recommended for use where efficiency, speed, and economy are important considerations.
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Cannabis Abuse and the Course of Recent-Onset Schizophrenic Disorders
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Journal ArticleDOI
Prevalence of Substance Abuse in Schizophrenia: Demographic and Clinical Correlates
Kim T. Mueser,Paul R. Yarnold,Douglas F. Levinson,Hardeep Singh,Alan S. Bellack,Kimmy S. Kee,Randall L. Morrison,Kashinath G. Yadalam +7 more
TL;DR: The findings show that environmental factors may be important determinants of substance abuse among schizophrenic-spectrum patients and that clinical differences related to abuse vary with different types of drugs.