Three-year outcome of phase-specific early intervention for first-episode psychosis: a cohort study in Hong Kong

Chen, Eric; Tang, Joey; Hui, Christy Lai Ming; Chiu, Chaw-Chi; Lam, May M.L.; Law, C.W.; Yew, Carol; Wong, Gloria; Chung, Dicky W. S.; Tso, S.K.; Chan, King Ming; Yip, Ka Chee; Hung, Se Fong; Honer, William G.

doi:10.1111/j.1751-7893.2011.00279.x

Cited by 73 publications

(83 citation statements)

References 29 publications

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“…These services apply specialised clinical knowledge to the treatment of early psychosis, including assertive interventions, appropriate low doses of antipsychotic medication, family interventions, and support for substance use (International Early Psychosis Association Writing Group, 2005). In comparison with standard community mental health care such services have been shown not only to improve outcomes, such as reducing the number of days that patients are hospitalised, increasing the percentage of individuals living independently, and reducing suicide rates (Bertelsen et al, 2008;Chen et al, 2011;Nordentoft et al, 2014) but also to be economical (Hastrup et al, 2013;Park, McCrone, & Knapp, 2014).…”

Section: Introduction To Psychosismentioning

confidence: 99%

Future‐directed thinking in first‐episode psychosis

Goodby

MacLeod

2015

British J Clinic Psychol

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ObjectivesThis study employed the Future Thinking Task (MacLeod et al., 2005, Br. J. Clin. Psychol., 44, 495) to investigate whether future‐directed thinking in first‐episode psychosis is significantly different from that of matched controls, and to identify its correlates in this patient group.DesignCross‐sectional, mixed‐model, case–control design.MethodParticipants were 30 patients with first‐episode psychosis and 27 matched controls. The Future Thinking Task was used to assess future‐directed thinking in both groups. Anxiety and depression were also measured as well as self‐report measures of hopelessness, suicide ideation and a measure of negative symptoms.ResultsIndividuals with psychosis were impaired in future‐directed thinking in both positive and negative domains, particularly with respect to the coming year. Increased self‐reported hopelessness was associated with reduced positive future thinking and increased negative future thinking. Increased positive future thinking was also associated with reduced severity of negative symptoms, whilst negative future thinking was associated with suicide ideation.ConclusionsIndividuals with first‐episode psychosis show a reduction in positive future thinking in line with that seen in other clinical groups, but this is accompanied by an unexpected reduction in negative future thinking. The findings suggest a general disengagement with the future in this group that may affect recovery and functioning.Practitioner points Individuals with first‐episode psychosis may benefit from interventions to help them engage with their future, in particular in the mid‐range, up to 1 year. The Future Thinking Task may be a helpful addition to the assessment of suicide risk in those with first‐episode psychosis. Decreased positive future thinking was associated with increased severity of negative symptoms, indicating a potential new treatment angle for this resistant aspect of psychosis. The cross‐sectional design of this study does not allow for conclusions about the causal relationship between psychosis and future‐directed thinking. This study investigated future‐directed thinking in individuals with a range of psychotic illnesses employing a trans‐diagnostic approach; therefore, conclusions cannot be drawn about the nature of future‐directed thinking in individual psychotic disorders.

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Section: Introduction To Psychosismentioning

confidence: 99%

Future‐directed thinking in first‐episode psychosis

Goodby

MacLeod

2015

British J Clinic Psychol

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“…Case managers hail from backgrounds in nursing, social work, psychology, and allied disciplines. Their caseload, 20 to 25 patients at various stages of treatment, is comparable to other Canadian EI services (Nolin et al, 2014); higher than those in typical Assertive Community Treatment teams (Tyrer, 2000) and some EI services such the OPUS group in Denmark (usually 10) (Nordentoft et al, 2006); and much lower than other EI services such as the EASY program in Hong Kong Chen et al, 2012).…”

Section: Specialized Phase-specific Treatmentmentioning

confidence: 98%

Early Intervention for Psychosis

Iyer¹,

Jordan²,

MacDonald³

et al. 2015

Journal of Nervous &Amp; Mental Disease

130

117

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This paper provides an overview of early intervention (EI) services for psychosis in Canada. We describe a leading Canadian EI program's approach to enhancing access (via early case detection, open referral, and rapid response) and providing specialized phase-specific treatment. Learnings from this program's research/evaluation indicate that EI can significantly improve service user and family engagement. Achieving and maintaining symptom remission (particularly negative symptoms) may be important for better social and occupational functioning in first-episode psychosis (FEP). Our program demonstrates the feasibility of establishing and sustaining an open referral, rapid-response system to address the chronic systemic problems of long waiting lists and barriers to access. We argue that an integrated clinical-research program based on specialized EI guidelines can significantly improve outcomes and advance FEP research.

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“…There is also some limited evidence that services provided by similar specialized multidisciplinary teams in Hong Kong (e.g., Early Assessment Service for Youth) result in improvements in suicide rates, levels of symptoms and gains in employment (Chen et al, 2011). Some health economic studies also show that EIS for psychosis have the potential to reduce costs associated with losses in productivity and other healthcare costs (Mihalopoulos et al, 2009;McCrone et al, 2010McCrone et al, , 2011, but regrettably such specialized services are not always in existence or available and therefore many people with first-episode psychosis or other early onset mental illnesses are referred to usual psychiatric outpatient services.…”

Section: Introductionmentioning

confidence: 97%

“…Some of the reasons for these delays include family and/or patient reluctance to seek treatment and limited or non-accessible mental health services. This is concerning because a longer duration of untreated symptoms has been repeatedly shown to result in high relapse rates and poor long-term outcomes (Frank et al, 2009;Bird et al, 2010;Chen et al, 2011). Therefore, there is a clear need for appropriate early clinical intervention in order to improve prognosis.…”

Section: Introductionmentioning

confidence: 98%