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Schizophrenia - Early intervention

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Early intervention in psychosis ‘amounts to deciding if a psychotic disorder has commenced and then offering effective treatment at the earliest possible point and secondly ensuring that intervention constitutes best practice for this phase of illness, and is not just the translation of standard treatments developed for later stages and more persistently ill subgroups of the disorder’,(McGorry et.al., 1996 p.305).

The importance of early intervention follows from evidence for a critical period in the development of schizophrenia. Research in the UK has shown that in these early years prompt treatment can affect the long term course of psychosis and schizophrenia and that delays in first treatment can increase early relapse rates. (Macmillan et al, 1986)

consequences of treatment delayEdit

McGorry and Jackson 1999 reported that the mean duration of psychosis before first treatment was one to two years.

During this period it has has been shown that individuals and their relatives experience considerable distress due to ineffective and demoralising attempts to get help and various traumatic events. Approximately 20 to 30% of young people experiencing their first onset of psychosis have been found to have been a danger to themselves or others before receiving effective treatment, including suicide attempts (Lincoln and McGorry, 1999).


See alsoEdit

References & BibliographyEdit

Key textsEdit

BooksEdit

  • McGorry, P., and Jackson. H., (1999). Recognition and management of Early psychosis. A preventative approach.Cambridge. Cambridge University Press.

PapersEdit

  • Birchwood, M., McGorry, P., and Jackson, H. (1997). Early Intervention in Schizophrenia. British Journal of

Psychiatry, 170, 2 – 5

  • Edwards J, Harris MG, Bapat S. (2005) Developing services for first-episode psychosis and the critical period.Br J Psychiatry Suppl. Aug;48:s91-7. PMID 16055816
  • Burnett, R., Mallett, R., Bhugra, D (1999). The first Contact of Patients With Schizophrenia With Psychiatric Services. Psychological Medicine, 29: 475-484.
  • Chattergree, A., and Liberman. J. (1999). Studies of biological variable In first Episode of Schizophrenia: A comparative review. In P.D., *McGorry and H.J. Jackson (eds) The recognition and management of early psychosis.Cambridge. Cambridge University Press.
  • Emsley R.A. (1999) Rispiridone in the treatment of first-episode psychotic patients: a double-blind multicenter study. Schizophrenia Bulletin; 25: 721-729.
  • Falloon, I.R.M. (1992) Early intervention for first episode of schizophrenia: A preliminary exploration. Psychiatry,55, 4 – 15.
  • Kulkarni, J., and Power, P., (1999). Initial treatment in first episode In McGorry.P., Jackson.H., (eds)The recognition and management of early psychosis. Cambridge. Cambridge University Press.
  • Lieberman J.A., Jody D., Geisler S., Alvir J., Loebel A., Szymanski S., Woerner M., and Borenstein, M., (1993).Time course and biologic correlates of treatment response in first episode schizophrenia. Archives of General Psychiatry 50, 369 – 376.
  • Lincon C, McGorry P. (1999). Pathways to care in early psychosis: Clinical and Consumer Perspectives. In P.D. McGorry and H.J.Jackson (eds). The recognition and management of Early psychosis. Cambridge. Cambridge University Press.
  • McGorry, P; Chanen, A; McCarthy, E; Van riel, R; McKenzie, D; Singh, B. (1991) Post traumatic stress disorder following recent onset psychosis: an unrecognised post psychotic syndrome. Journal of Nervous & Mental Disease 179; 253-258.
  • McGorry, P; Edwards, J.G; Mihalopoulos, C; Harrigan, S; Jackson, H.J (1996). EPPIC: an evolving system of early detection & optimal management. Schizophrenia Bulletin, 22: 305-326.
  • NEPP (1998) Australian Guidelines for Early Intervention.
  • Syzmanski, S.R; Cannon, T.D; Gallacher, F; Erwin, R.J; Gur, R.E. (1996). Course of treatment response in firstepisode and chronic schizophrenia. American Journal of Psychiatry, 153(4), 519-525.

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