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Analysis of the initial treatment phase in first-episode psychosis

Published online by Cambridge University Press:  06 August 2018

Paddy Power ,
Kathryn Elkins ,
Steven Adlard ,
Christina Curry ,
Patrick McGorry  and
Susan Harrigan
Paddy Power*
Affiliation:
Early Psychosis Prevention and Intervention Centre, Parkville, Victoria
Kathryn Elkins
Affiliation:
Early Psychosis Research Centre, Department of Psychiatry, University of Melbourne
Steven Adlard
Affiliation:
Early Psychosis Prevention and Intervention Centre, Parkville, Victoria
Christina Curry
Affiliation:
Early Psychosis Research Centre, Department of Psychiatry, University of Melbourne
Patrick McGorry
Affiliation:
Early Psychosis Prevention and Intervention Centre, Parkville, Victoria
Susan Harrigan
Affiliation:
Centre for Young People's Mental Health, Parkville, Department of Psychiatry, University of Melbourne, Australia
*
Correspondence: Dr Paddy Power, Early Psychosis Research Centre, Centre for Young People's Mental Health, 35 Poplar Road, Parkville, Victoria, 3052, Australia. Fax: 613 9342 2858; e-mail: [email protected]
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Abstract

Background The Early Psychosis Prevention and Intervention Centre (EPPIC) commenced operation in Melbourne, Australia, in 1992. It offers a model for management of first-episode psychosis, utilising principles of early detection, low-dose medication and comprehensive psychosocial interventions within the least restrictive setting.

Method Data were examined from the first three months of treatment for all consecutive people with first-episode psychosis (n=231) accepted in the programme in 1995–1996. A subsample of patients (n=120) was assessed comparing clinical ratings with variables of gender, diagnosis, hospitalisation, and medication.

Results Hospitalisations were brief, and avoided for a third of the people. Low-dose antipsychotic medication was maintained in both in-patient and community settings. Those people with manic psychosis were more likely to be hospitalised. Hospitalised people received higher antipsychotic dosages, and had a greater rate of reduction in Brief Psychiatric Rating Scale psychotic sub-scale scores at three months follow-up. Eighty per cent of a representative subsample had responded to treatment and 63% were in remission by the end of the three months.

Conclusion This naturalistic study suggests that the feasibility of implementing the EPPIC model in a range of clinical settings is promising and applicable in practice.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 172 , Issue S33: Verging on reality , June 1998 , pp. 71 - 76
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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