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Early Detection in Psychosis: 5 year Outcome in the Scandinavian Tips-Study

Published online by Cambridge University Press:  16 April 2020

T.K. Larsen
Affiliation:
Psychiatry, Stavanger University Hospital, Stavanger, Norway
I. Melle
Affiliation:
Oslo University Hospital, Oslo, Norway
B. Auestad
Affiliation:
Faculty of Science and Technology, University of Stavanger, Stavanger, Norway
U. Haahr
Affiliation:
Psychiatric Research Unit and University of Copenhagen, Roskilde, Denmark
I. Joa
Affiliation:
Psychiatry, Stavanger University Hospital, Stavanger, Norway
J.O. Johannessen
Affiliation:
Psychiatry, Stavanger University Hospital, Stavanger, Norway
S. Opjordsmoen
Affiliation:
Oslo University Hospital, Oslo, Norway
B. Rishovd-Rund
Affiliation:
Vestre Viken Hospital Trust/Department of Psychology, Norway
J.I. Rossberg
Affiliation:
Oslo University Hospital, Oslo, Norway
E. Simonsen
Affiliation:
Psychiatric Research Unit and University of Copenhagen, Roskilde, Denmark
P. Vaglum
Affiliation:
Department of Behavioral Sciences in Medicine, University of Oslo, Oslo, Norway
S. Friis
Affiliation:
Oslo University Hospital, Oslo, Norway
T. McGlashan
Affiliation:
Yale University School of Medicine, New Haven, CT, USA

Abstract

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Background

During the last decades we have seen a new focus on early treatment of psychosis. Several reviews have shown that duration of untreated psychosis (DUP) is correlated to better outcome. However, it is still unknown whether early treatment will lead to a better long term outcome. This study reports the effects of reducing DUP on 5-year course and outcome.

Methods

During 1997-2000 a total of 281 consecutive patients aged > 17 years with first episode non-affective psychosis were recruited of which 192 participated in the 5-year follow-up. A comprehensive early detection (ED) program with public information campaigns and low-threshold psychosis detection teams was established in one health-care area (ED-area), but not in a comparable area (No-ED area). Both areas ran equivalent treatment programs during the first 2 years and need-adapted treatment thereafter.

Results

At the start of treatment ED-patients had shorter DUP and less symptoms than No-ED-patients. There were no significant differences in treatment (psychotherapy and medication) for the 5 years. Mixed-effects modeling showed better scores for the ED-group on PANSS negative, depressive and cognitive factors and for GAF social functioning at 5 year follow-up. The ED-group also had more contacts with friends. Regression analysis did not find that these differences could be explained by confounders.

Conclusions

Early treatment had positive effects on clinical and functional status at 5 year follow-up in first episode psychosis.

Type
S01-01
Copyright
Copyright © European Psychiatric Association 2011

References

Larsen, T. K.,et al. Early detection of psychosis: positive effects on 5-year outcome. Psychological Medicine, Available on CJO 14 Oct 2010.Google Scholar
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