[Specialised first-episode psychosis services: a systematic review of the literature].
Identifieur interne : 000044 ( PubMed/Curation ); précédent : 000043; suivant : 000045[Specialised first-episode psychosis services: a systematic review of the literature].
Auteurs : L. Skalli [Canada] ; L. NicoleSource :
- L'Encephale [ 0013-7006 ] ; 2011.
English descriptors
- KwdEn :
- Ambulatory Care, Antipsychotic Agents (administration & dosage), Combined Modality Therapy, Comprehensive Health Care, Continuity of Patient Care, Crisis Intervention, Delivery of Health Care, Family Therapy, Follow-Up Studies, Hospitalization (statistics & numerical data), Humans, Psychoanalytic Therapy, Psychotherapy, Psychotic Disorders (psychology), Psychotic Disorders (rehabilitation), Randomized Controlled Trials as Topic, Scandinavian and Nordic Countries, Schizophrenia (rehabilitation), Schizophrenic Psychology, Secondary Prevention, Social Security (utilization), Utilization Review.
- MESH :
- chemical , administration & dosage : Antipsychotic Agents.
- geographic : Scandinavian and Nordic Countries.
- psychology : Psychotic Disorders.
- rehabilitation : Psychotic Disorders, Schizophrenia.
- statistics & numerical data : Hospitalization.
- utilization : Social Security.
- Ambulatory Care, Combined Modality Therapy, Comprehensive Health Care, Continuity of Patient Care, Crisis Intervention, Delivery of Health Care, Family Therapy, Follow-Up Studies, Humans, Psychoanalytic Therapy, Psychotherapy, Randomized Controlled Trials as Topic, Schizophrenic Psychology, Secondary Prevention, Utilization Review.
Abstract
Schizophrenia and its related disorders are prevalent, disabling and costly. Recent longitudinal studies found that the first two to five years of schizophrenia-spectrum disorders are characterised by symptomatic and functional deterioration. This led to the hypothesis of the existence of a critical period in the treatment of individuals suffering from psychosis: an assertive intervention during the first two to five years of psychosis could improve long term outcomes and prevent the emergence of psychosocial deficits.
DOI: 10.1016/j.encep.2010.08.004
PubMed: 21600336
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">[Specialised first-episode psychosis services: a systematic review of the literature].</title><author><name sortKey="Skalli, L" sort="Skalli, L" uniqKey="Skalli L" first="L" last="Skalli">L. Skalli</name><affiliation wicri:level="1"><nlm:affiliation>Direction de l'enseignement, hôpital Louis-H.-Lafontaine, 7401 Hochelaga, H1N 3M5, Montréal, Québec, Canada. leilaskalli@hotmail.com</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Direction de l'enseignement, hôpital Louis-H.-Lafontaine, 7401 Hochelaga, H1N 3M5, Montréal, Québec</wicri:regionArea></affiliation></author><author><name sortKey="Nicole, L" sort="Nicole, L" uniqKey="Nicole L" first="L" last="Nicole">L. Nicole</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2011">2011</date><idno type="RBID">pubmed:21600336</idno><idno type="pmid">21600336</idno><idno type="doi">10.1016/j.encep.2010.08.004</idno><idno type="wicri:Area/PubMed/Corpus">000044</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000044</idno><idno type="wicri:Area/PubMed/Curation">000044</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000044</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Specialised first-episode psychosis services: a systematic review of the literature].</title><author><name sortKey="Skalli, L" sort="Skalli, L" uniqKey="Skalli L" first="L" last="Skalli">L. Skalli</name><affiliation wicri:level="1"><nlm:affiliation>Direction de l'enseignement, hôpital Louis-H.-Lafontaine, 7401 Hochelaga, H1N 3M5, Montréal, Québec, Canada. leilaskalli@hotmail.com</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Direction de l'enseignement, hôpital Louis-H.-Lafontaine, 7401 Hochelaga, H1N 3M5, Montréal, Québec</wicri:regionArea></affiliation></author><author><name sortKey="Nicole, L" sort="Nicole, L" uniqKey="Nicole L" first="L" last="Nicole">L. Nicole</name></author></analytic><series><title level="j">L'Encephale</title><idno type="ISSN">0013-7006</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ambulatory Care</term><term>Antipsychotic Agents (administration & dosage)</term><term>Combined Modality Therapy</term><term>Comprehensive Health Care</term><term>Continuity of Patient Care</term><term>Crisis Intervention</term><term>Delivery of Health Care</term><term>Family Therapy</term><term>Follow-Up Studies</term><term>Hospitalization (statistics & numerical data)</term><term>Humans</term><term>Psychoanalytic Therapy</term><term>Psychotherapy</term><term>Psychotic Disorders (psychology)</term><term>Psychotic Disorders (rehabilitation)</term><term>Randomized Controlled Trials as Topic</term><term>Scandinavian and Nordic Countries</term><term>Schizophrenia (rehabilitation)</term><term>Schizophrenic Psychology</term><term>Secondary Prevention</term><term>Social Security (utilization)</term><term>Utilization Review</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antipsychotic Agents</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Scandinavian and Nordic Countries</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en"><term>Psychotic Disorders</term><term>Schizophrenia</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term></keywords><keywords scheme="MESH" qualifier="utilization" xml:lang="en"><term>Social Security</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Ambulatory Care</term><term>Combined Modality Therapy</term><term>Comprehensive Health Care</term><term>Continuity of Patient Care</term><term>Crisis Intervention</term><term>Delivery of Health Care</term><term>Family Therapy</term><term>Follow-Up Studies</term><term>Humans</term><term>Psychoanalytic Therapy</term><term>Psychotherapy</term><term>Randomized Controlled Trials as Topic</term><term>Schizophrenic Psychology</term><term>Secondary Prevention</term><term>Utilization Review</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Schizophrenia and its related disorders are prevalent, disabling and costly. Recent longitudinal studies found that the first two to five years of schizophrenia-spectrum disorders are characterised by symptomatic and functional deterioration. This led to the hypothesis of the existence of a critical period in the treatment of individuals suffering from psychosis: an assertive intervention during the first two to five years of psychosis could improve long term outcomes and prevent the emergence of psychosocial deficits.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21600336</PMID><DateCreated><Year>2011</Year><Month>05</Month><Day>23</Day></DateCreated><DateCompleted><Year>2011</Year><Month>08</Month><Day>15</Day></DateCompleted><DateRevised><Year>2014</Year><Month>11</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">0013-7006</ISSN><JournalIssue CitedMedium="Internet"><Volume>37 Suppl 1</Volume><PubDate><Year>2011</Year><Month>May</Month></PubDate></JournalIssue><Title>L'Encephale</Title><ISOAbbreviation>Encephale</ISOAbbreviation></Journal><ArticleTitle>[Specialised first-episode psychosis services: a systematic review of the literature].</ArticleTitle><Pagination><MedlinePgn>S66-76</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.encep.2010.08.004</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Schizophrenia and its related disorders are prevalent, disabling and costly. Recent longitudinal studies found that the first two to five years of schizophrenia-spectrum disorders are characterised by symptomatic and functional deterioration. This led to the hypothesis of the existence of a critical period in the treatment of individuals suffering from psychosis: an assertive intervention during the first two to five years of psychosis could improve long term outcomes and prevent the emergence of psychosocial deficits.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">The objectives of this review are to describe different specialised first-episode psychosis services (FEP) and report their results at different times of follow-up in order to determine what specific approaches they should include, the optimal duration of treatment, and the characteristics of the patients who benefit the most from such programs.</AbstractText><AbstractText Label="METHOD" NlmCategory="METHODS">We systematically reviewed psycINFO and MEDLINE in search of studies dealing with efficacy or efficiency of specialized FEP programs. We only included research that had at least one comparison group and excluded those dealing with primary prevention of psychosis or prodromal interventions.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Five, all Scandinavian, programs and their results at different follow-up times are presented. The Parachute project started in 1994 in Sweden with the objectives to use low dosages of antipsychotics (AP), to minimize hospitalisations, to offer specialized individual and familial psychotherapy, and to assure continuity of care during a five-year period. It compared the Parachute study group with a prospective and a historical group. At three years, the Parachute group had spent less days hospitalised (but more days in a crisis home), was associated with a lower percentage of patients receiving disability allowances and had a trend toward better efficiency than the control groups. The Danish National schizophrenia project started in 1997 and included 16 centers that offered a two-year specialised FEP treatment. Patients were randomly assigned to treatment as usual (TU), treatment as usual enriched with support psychodynamic psychotherapy (SPP) and integrated treatment (IT). At the end of the two-year treatment period, patients receiving IT had significantly less positive symptoms, less negative symptoms and better scores in the global assessment scale (GAS) than TU. The Opus project started in 1998 in Denmark. It is a randomised, controlled study comparing a two-year FEP integrated treatment (IT) with standard treatment (ST). After the two-year period, patients were transferred to ST and were assessed at five years (three years after the end of the IT). At the end of the active phase of treatment, patients in IT group had better positive, negative and GAS scores, used lower dosages of AP and used less illicit drugs. At five-years, the only difference between IT and ST groups was that the IT group was associated with more patients living independently. The Open Dialogue project started in 1994 in Finland. It compared conventional treatment (CT) with acute psychosis integrated treatment (API) and Open dialogue approach in acute psychosis treatment (ODAP). At the two-year assessment, API and ODAP groups had less relapses, spent less days hospitalised, used less AP and had better GAS scores than CT. The ODAP group had better scores on the brief psychiatric rating scale than the API group and was associated with fewer patients receiving disability allowances than the CT group. At five-years, there was no difference in the outcomes between API and ODAP, but the authors suggest that the ODAP group was more efficient, because it had similar results as the API group while using less resources. The Soteria Nacka project started in 1990 in Sweden. It compared patients receiving only outpatient specialised FEP treatment (CE) with those receiving outpatient and crisis home specialised FEP treatment (CC). At the five-year assessment, the CC group had better GAS scores than the CE group, but only for patients suffering from a psychosis in the schizophrenia-spectrum. Also, less patients in the CC group used AP and when they did, they had lower dosages. The CC group was also associated with more patients working or studying at the end of the five-year follow-up and with significantly more patients in remission compared to the CE group. Finally, the Opus project, Parachute project and Soteria Nacka found that patients suffering from a psychosis in the schizophrenia-spectrum are those who benefit the most from the specialized, comprehensive, FEP-programs.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The programs specialised in the treatment of FEP show encouraging results mainly during their active phase. This review suggests that a two-year treatment period is not long enough to enable patients to maintain the improvements obtained during the active phase of an integrated treatment. Future studies should aim to determine--the characteristics of the patients that most benefit from--the specific interventions that should be included in and--the ideal duration of treatment of the comprehensive FEP programs.</AbstractText><CopyrightInformation>Copyright © 2010 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Skalli</LastName><ForeName>L</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Direction de l'enseignement, hôpital Louis-H.-Lafontaine, 7401 Hochelaga, H1N 3M5, Montréal, Québec, Canada. leilaskalli@hotmail.com</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nicole</LastName><ForeName>L</ForeName><Initials>L</Initials></Author></AuthorList><Language>fre</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D004740">English Abstract</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><VernacularTitle>Programmes pour premiers épisodes psychotiques: une revue systématique de la littérature.</VernacularTitle><ArticleDate DateType="Electronic"><Year>2010</Year><Month>10</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>France</Country><MedlineTA>Encephale</MedlineTA><NlmUniqueID>7505643</NlmUniqueID><ISSNLinking>0013-7006</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014150">Antipsychotic Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000553" MajorTopicYN="N">Ambulatory Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014150" MajorTopicYN="N">Antipsychotic Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003131" MajorTopicYN="N">Combined Modality Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003191" MajorTopicYN="Y">Comprehensive Health 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MajorTopicYN="N">Secondary Prevention</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012943" MajorTopicYN="N">Social Security</DescriptorName><QualifierName UI="Q000656" MajorTopicYN="N">utilization</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014600" MajorTopicYN="N">Utilization Review</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2009</Year><Month>06</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2010</Year><Month>05</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>5</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>5</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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