Assertive outreach for “difficult to engage” patients: A useful tool for a subgroup of patients in specialized early psychosis intervention programs

Alameda, Luis; Golay, Philippe; Baumann, Philipp; Morandi, Stéphane; Ferrari, Carina; Conus, Philippe; Bonsack, Charles

doi:10.1016/j.psychres.2016.03.010

Cited by 20 publications

(13 citation statements)

References 45 publications

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“…A large number of patients find adequate health care in the usual care programs, as shown in research on CM interventions that involve psychiatric patients with psychosis. Patients who benefit from CM have been shown to be those with greater social and psychosocial needs, more psychiatric symptoms, and higher service use (37), with others not needing this specific intensive care (38). If CM is applied to a large group, the effect on a smaller subgroup would likely be diluted and not as visible in the outcome measures.…”

Section: Discussionmentioning

confidence: 99%

Effect of Case Management Interventions for Patients with Substance Use Disorders: A Systematic Review

et al. 2017

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BackgroundSubstance use disorder (SUD) is an important health problem that requires a complex range of care because of the chronic nature of the disorder and the multiple psychosocial problems involved. Current outpatient programs often have difficulties in delivering and coordinating ongoing care and access to different health-care providers. Various case management (CM) models have been developed, first for patients in other psychiatric domains and then for patients with SUD, in order to improve treatment outcomes.AimThis paper aims to assess the effectiveness of CM for patients with SUD.MethodsWe performed a systematic review of CM interventions for patients with SUD by analyzing randomized controlled studies published on the subject between 1996 and 2016 found on the electronic database PubMed.Results and conclusionFourteen studies were included in the analysis. Differences between studies in outcome measures, populations included, and intervention characteristics made it difficult to compare results. Most of these studies reported improvement in some of the chosen outcomes. Treatment adherence mostly improved, but substance use was reported to decrease in only a third of the studies. Overall functioning improved in about half of the studies. The heterogeneity of the results might be linked to these differences between studies. Further research is needed in the field.

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Section: Discussionmentioning

confidence: 99%

Effect of Case Management Interventions for Patients with Substance Use Disorders: A Systematic Review

et al. 2017

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“…Affective instability was rated by the PANSS item “Affective instability,” which assesses unstable, fluctuating, inadequate and/or poorly controlled emotional responses. Treatment adherence was assessed on a 3-point scale of Treatment Adherence Scale [TAS ( 57 )] ranging from 0 to 2: 0 = no adherence; 1 = partial adherence (from 25 to 75% of the time during the evaluation period); 2 = total adherence (from 75 to 100% of the time during the evaluation period).…”

Section: Methodsmentioning

confidence: 99%

Cannabis, a Significant Risk Factor for Violent Behavior in the Early Phase Psychosis. Two Patterns of Interaction of Factors Increase the Risk of Violent Behavior: Cannabis Use Disorder and Impulsivity; Cannabis Use Disorder, Lack of Insight and Treatment Adherence

et al. 2018

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Background: Previous literature suggests that prevalence of cannabis use in the early phase of psychosis is high, and that early psychosis patients are at high-risk for violent behavior. However, the link between cannabis use and violent behavior in early psychosis patients is unclear. We carried out a study on a sample of early psychosis patients, in order to explore the impact of cannabis use on the risk of violent behavior (VB), while taking into account (1) potential confounding factors and, (2) interactions with other dynamic risk factors of VB.Method: In a sample of 265 early psychosis patients, treated at the Treatment and Early Intervention in Psychosis Program (TIPP) in Lausanne, we used logistic regression models to explore the link between various dynamic risk factors of VB [positive symptoms, substance use disorder (drugs including cannabis, alcohol and others drugs), insight, impulsivity, affective instability, and treatment adherence], and VB occurring during treatment. In order to understand hierarchical effects attributable to the combinations of risk factors on VB we conducted a Classification and Regression Tree (CART).Results: Our results show that cannabis use disorder is a risk factor for VB. The associations among risk factors suggest the presence of two patient profiles with an increased rate of VB: the first is composed of patients with cannabis use disorder and impulsivity, and the second of patients combining cannabis use disorder, absence of insight and non-adherence to treatment. The results also show the moderating role of insight and adherence to treatment on the rate of VB in patients with cannabis use disorder.Conclusion: This study suggests that cannabis use disorder is a significant risk factor for VB amongst early psychosis patients, particularly when combined with either impulsivity, lack of insight and non-adherence to treatment. These results suggest that preventive strategies could be developed on the basis of such patient profiles.

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“…Las dos primeras características amplían la población diana tanto a los individuos en riesgo que presentan síntomas prodrómicos o EMARs pero no un PEP (Humiston et al, 2004) como a las personas con un PEP que no están siendo tratadas adecuadamente (Wyatt y Henter, 2001). La tercera característica transversal pone de relieve la importancia de que estos servicios estén formados por equipos multidisciplinares orientados al seguimiento asertivo comunitario (Alameda et al, 2016) y con cargas asistenciales inferiores a la de los equipos de salud mental comunitaria convencionales (Csillag et al, 2017).…”

Section: Intervención Temprana En Psicosis (Itp)unclassified

Actualización en La Prevención De Los Trastornos Del Espectro Psicótico

Fonseca‐Pedrero¹,

Inchausti²

2018

Pap. Psicol.

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El objetivo de este trabajo fue realizar una actualización en el campo de la prevención de los trastornos del espectro psicótico, concretamente en detección precoz e intervención temprana. En primer lugar, se aborda la conceptualización del síndrome de psicosis y su prevención. A continuación, se comentan los diferentes procedimientos e instrumentos de medida para la evaluación de la supuesta condición de riesgo. Seguidamente, se revisan las intervenciones tempranas disponibles en psicosis, se expone el modelo de estadificación, se examina la eficacia de tales intervenciones y se comentan algunas limitaciones y propuestas de modificación. Se dibujan algunas debilidades y fortalezas en este campo así como sus perspectivas futuras. Finalmente, a modo de conclusión, se realiza una breve recapitulación.

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Assertive outreach for “difficult to engage” patients: A useful tool for a subgroup of patients in specialized early psychosis intervention programs

Cited by 20 publications

References 45 publications

Effect of Case Management Interventions for Patients with Substance Use Disorders: A Systematic Review

Effect of Case Management Interventions for Patients with Substance Use Disorders: A Systematic Review

Cannabis, a Significant Risk Factor for Violent Behavior in the Early Phase Psychosis. Two Patterns of Interaction of Factors Increase the Risk of Violent Behavior: Cannabis Use Disorder and Impulsivity; Cannabis Use Disorder, Lack of Insight and Treatment Adherence

Actualización en La Prevención De Los Trastornos Del Espectro Psicótico

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