Outcome at 2-year of treatment in first-episode psychosis patients who were enrolled in a specialized early intervention program

Abstract

Treatment in early intervention services (EIS) seems superior to treatment as usual on several outcomes, but the extent of heterogeneity in response is unclear. In this study, treatment response trajectories up to 2 years in firstepisode psychosis (FEP) patients enrolled in an Italian early intervention service (EIS) have been quantified. The 24-item Brief Psychiatric Rating Scale (BPRS) was used to quantify treatment response up to 2 years in 129 participants. Conditional growth modeling and latent class growth analysis were used to test changes over time in the BPRS and separation into independent classes over time. Group differences were tested on socio-demographic and clinical variables known to be related to outcome in psychosis. Scores on the BPRS showed a statistically significant decrease in overall scores across all tested models. Four trajectories were identified across 2 years. Most patients showed a progressive decrease in the BPRS scores; a scant fraction showed a more stepped decrease from very high levels of psychopathology. No potential predictor was statistically related to the time course of BPRS scores. Most patients that undergo treatment within an EIS are characterized by amelioration, but patients that have higher baseline scores of psychopathology require more intensive treatment.

Public health primary prevention implemented by clinical high-risk services for psychosis

“…[ 34 , 71 , 76 ] Academic/occupational performance, cognitive skills • Occupational or supportive therapy on vocational/occupational functioning. [ 11 , 34 , 36 , 42 – 44 , 50 – 52 , 55 , 57 , 58 , 77 – 79 ] Academic/occupational performance • Onsite vocational reintegration, including supported employment or IPS. [ 34 , 35 , 54 , 55 , 73 , 76 , 80 ] Academic/occupational performance • Intensive networking with local/community stakeholders.…”

“…[ 30 ] Selective strategies and corresponding good mental health domains • Recreational therapy, activities or support. [ 43 , 52 , 53 , 57 , 58 , 77 ] QoL, family and significant relationships Environmental events Service characteristics • Presence in catchment areas with high levels of refugees and asylum seekers. [ 29 ] • Community engagement projects focused on asylum seekers and refugees.…”

“…[ 19 , 20 , 22 , 24 , 27 , 29 , 32 , 35 – 38 , 40 , 44 , 45 , 49 , 50 , 52 , 54 , 56 , 57 , 62 – 64 , 68 – 70 , 72 , 73 , 75 , 77 – 79 ] Mental health literacy, attitude towards mental disorders Selective strategies and corresponding good mental health domains • Problem-solving training. [ 18 , 57 , 58 , 78 , 79 ] Self-management skills • Individual or group psychoeducation. [ 18 , 28 , 31 , 36 , 49 , 50 , 58 , 65 , 71 , 72 , 74 , 78 – 81 ] Mental health literacy, self-management skills • Life/practical skills training.…”

“…[ 18 , 57 , 58 , 78 , 79 ] Self-management skills • Individual or group psychoeducation. [ 18 , 28 , 31 , 36 , 49 , 50 , 58 , 65 , 71 , 72 , 74 , 78 – 81 ] Mental health literacy, self-management skills • Life/practical skills training. [ 74 , 77 ] Self-management skills • Family psychoeducation, counselling or support.…”

“…[ 11 , 17 , 23 , 26 , 27 , 32 , 35 , 36 , 42 , 43 , 45 , 49 , 51 , 52 , 54 – 65 , 71 – 73 , 76 – 78 , 81 ] Family and significant relationships • Psychosocial support on social relationships and functioning. [ 11 , 27 , 28 , 30 , 36 , 43 , 45 , 49 , 50 , 54 , 55 , 58 , 59 , 77 ] Social skills • Educational support. [ 11 , 27 , 28 , 35 , 36 , 49 , 52 , 57 , 58 , 74 , 76 , 77 ] Academic/occupational performance • Cognitive Remediation Training [ 72 ] Cognitive skills • Physical health assessment and monitoring.…”