Patterns of referral in first-episode schizophrenia and ultra high-risk individuals: results from an early intervention program in Italy

Cocchi, Angelo; Meneghelli, Anna; Erlicher, Arcadio; Pisano, Alessia; Cascio, Maria Teresa; Preti, Antonio

doi:10.1007/s00127-013-0736-5

Cited by 25 publications

(76 citation statements)

References 77 publications

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“…For 67.7% of our sample, help-seeking was initiated by others, most often by family members. This is consistent with other studies [23,24,25,26]. Our finding of prodromal help-seeking in 43.5% is also consistent with other studies [9,27,28,29,30,31].…”

Section: Discussionsupporting

confidence: 83%

“Lanthanic Presentation” in First-Episode Psychosis Predicts Long Service Delay: The Challenge of Detecting Masked Psychosis

Kvig

Brinchmann²,

Moe³

et al. 2017

Psychopathology

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Background/Aims: Studies of pathways to care in first-episode psychosis have documented a substantial treatment delay occurring after patients enter mental health services. An initial presentation with neurotic rather than psychotic symptoms is common in first-episode psychosis. The term “lanthanic patient” has been used to refer to patients presenting with a reason for help-seeking that is unrelated to the underlying pathology. The aim of this study is to explore whether a lanthanic presentation is related to prolonged service delay. Methods: The sample comprises 62 patients with recent-onset psychosis. Data on sociodemographic, clinical, help-seeking, and pathway indicators were collected using a comprehensive, semistructured-interview schedule. Results: Service delay accounted for more than half of the overall treatment delay. An initially presenting complaint of neurotic symptoms was related to prolonged service delay. The effect remained after controlling for other potential risk factors of service delay. Conclusion: Anomalous experiences of pleasure, desire, or motivation are common in emerging psychosis. These difficulties are often misinterpreted as complaints of depression and anxiety by health professionals. The presence of such symptoms can introduce a focal vision on the part of health care professionals on the immediate presentation rather than the underlying psychopathology, leading to the underdetection of psychosis.

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Section: Discussionsupporting

confidence: 83%

“Lanthanic Presentation” in First-Episode Psychosis Predicts Long Service Delay: The Challenge of Detecting Masked Psychosis

Kvig

Brinchmann²,

Moe³

et al. 2017

Psychopathology

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“…A history of suicide attempt and of illicit substance abuse was also considered as an indicator of illness severity. Indeed, as these events/conditions are likely to raise concern in the family, they may also induce contact‐seeking with psychiatric services (Cocchi et al, ). CAARMS : a semi‐structured clinical interview designed to cover different features of attenuated psychopathology, as well as functioning (via the integrated Social and Occupational Functioning Assessment Scale module) (Yung et al, ). It takes approximately 1 to 1.5 hours to be administered and consists of 27 items (each one rated in terms of intensity [0‐6] and frequency/duration [0‐6]) that can be clustered in seven subscales: “Positive Symptoms”, “Cognitive Change, Attention and Concentration”, “Emotional Disturbance”, “Negative Symptoms”, “Behavioural Change”, “Motor/Physical Changes”, and “General Psychopathology”.…”

Section: Methodsmentioning

confidence: 99%

The “Reggio Emilia At‐Risk Mental States” program: A diffused, “liquid” model of early intervention in psychosis implemented in an Italian Department of Mental Health

Pelizza

Azzali

Paterlini

et al. 2019

Early Intervention Psych

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Aim From September 2012, the Reggio Emilia Department of Mental Health developed a specific program (the “Reggio Emilia At‐Risk Mental States” [ReARMS] protocol) as a diffused, “liquid” infrastructure for early intervention in psychosis. Aims of the current study are (a) to describe the ReARMS macroscopic organization and (b) to examine specific process indicators during the first 5 years of clinical activity. Methods All participants (n = 300) were young help‐seekers, aged 13 to 35 years, who completed the Comprehensive Assessment of At‐Risk Mental States (CAARMS). Results At baseline, 95 (31.7%) participants did not meet CAARMS‐defined criteria, while 205 (68.3%) were offered a dedicated protocol of care: 154 (75.1%) of them were enrolled in the program, 19 (9.3%) refused and 32 (15.6%) dropped out during the first year of treatment. Individuals enrolled in the ReARMS protocol were mainly referred by general practitioners (33.3%), emergency room/general hospital (24%) or they were self‐referred (15%). In comparison with ultra‐high risk individuals, patients with first episode psychosis showed significantly higher mean age at entry and preponderance of males, as well as higher percentages of history of substance abuse and previous hospitalization. Conclusions An early intervention in psychosis service in Italian child/adolescent and adult mental health services are feasible and clinically relevant, also in adolescents, who have a high risk of falling through the child‐adult service gap as they cross the transition boundary between services.

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“…Fridgen et al, 2013;Rüsch et al, 2013;Von Reventlow et al, 2013). There have, however, been attempts to characterize pathways to (Schultze-Lutter et al, 2009;Shin et al, 2010;Cocchi et al, 2013;Stowkowy et al, 2013;Von Reventlow et al, 2013;Wiltink et al, 2013) and engagement with services in those who seek help (Green et al, 2011). However, only a minority of studies with relatively small sample sizes assessed symptoms or behaviours that initiated the contact (Addington et al, 2002;Stowkowy et al, 2013).…”

Section: Introductioǹmentioning

confidence: 94%

Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?

Falkenberg

Valmaggia

Byrnes

et al. 2015

Psychiatry Research

120

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Patterns of referral in first-episode schizophrenia and ultra high-risk individuals: results from an early intervention program in Italy

Cited by 25 publications

References 77 publications

“Lanthanic Presentation” in First-Episode Psychosis Predicts Long Service Delay: The Challenge of Detecting Masked Psychosis

“Lanthanic Presentation” in First-Episode Psychosis Predicts Long Service Delay: The Challenge of Detecting Masked Psychosis

The “Reggio Emilia At‐Risk Mental States” program: A diffused, “liquid” model of early intervention in psychosis implemented in an Italian Department of Mental Health

Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?

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