Early Detection of First-episode Psychosis: the Effect on 1-year Outcome

Overview

Journal Schizophr Bull

Publisher Oxford University Press

Specialty Psychiatry

Date 2006 Jul 1

PMID 16809640

Citations 19

Authors

Tor K Larsen

Ingrid Melle

Bjorn Auestad

Svein Friis

Ulrik Haahr

Jan Olav Johannessen

Stein Opjordsmoen

Bjorn Rishovd Rund

Erik Simonsen

Per Vaglum

Thomas McGlashan

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven.

Objective: To study whether 1-year outcome will be better in a health care sector with early detection (ED) of psychosis compared with sectors with no early detection (no-ED).

Design: A quasi-experimental study with ED in 2 experimental sectors and no-ED in 2 control sectors. ED was achieved through low-threshold ED teams and information campaigns about psychosis for the public, schools, and primary health care providers. The ED and no-ED health care areas offered an equivalent assessment and treatment program during the first year. Two hundred and eighty-one patients were included; 88% were reassessed after 1 year.

Results: The ED-area patients (N = 141) had a median duration of untreated psychosis of 5 weeks at baseline compared with 16 weeks for patients in the no-ED area (N = 140). Positive and general symptoms, global assessment of functioning, quality of life, time to remission, and course of psychosis at 1 year after the start of treatment were not different between ED and no-ED groups. Outcome was significantly better for the ED area for negative symptoms.

Conclusions: The ED, no-ED differences at baseline become attenuated by 1 year but not the difference in negative symptoms, suggesting secondary prevention in this domain of psychopathology. However, this possibility requires further testing by follow-up and replication.

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