scholarly journals A pilot evaluation of a novel First Episode and Rapid Early Intervention service for Eating Disorders (FREED)

2018 ◽  
Vol 26 (2) ◽  
pp. 129-140 ◽  
Author(s):  
Jessica McClelland ◽  
John Hodsoll ◽  
Amy Brown ◽  
Katie Lang ◽  
Elena Boysen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Early Intervention ◽  
First Episode ◽  
Early Intervention Service ◽  
Intervention Service

scholarly journals M114. DELUSIONAL CONTENT AT INITIAL PRESENTATION TO A CATCHMENT-BASED EARLY INTERVENTION SERVICE FOR PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S178-S178
Author(s):  
Ann-Catherine Lemonde ◽  
Ridha Joober ◽  
Ashok Malla ◽  
Srividya Iyer ◽  
Martin Lepage ◽  
...  
Keyword(s):  
Early Intervention ◽  
Representative Sample ◽  
Clinical Samples ◽  
First Episode ◽  
Psychotic Episode ◽  
Detailed Knowledge ◽  
Service Users ◽  
Early Intervention Service ◽  
Clinical Variables ◽  
Intervention Service

Abstract Background During a psychotic episode, patients frequently suffer from severe maladaptive beliefs known as delusions. Despite the abundant literature investigating the simple presence or absence of these beliefs, there exists little detailed knowledge regarding their actual content and severity at the onset of illness. Investigating delusions in early clinical samples is critical, because their relatively young, treatment-naïve presentations are less likely to be confounded by the effects of long-term illness or previous interventions. Furthermore, a more detailed view of the association between clinical factors and delusion severity, both globally and per theme, in a larger and more representative sample may improve psychological models and ultimately treatment options. This study reports on delusions during the initiation of indicated treatment for a first episode psychosis (FEP). Methods Data were systematically collected from a sample of 637 service users entering an early intervention service for FEP. The FEP service provides a comprehensive standardized assessment battery with longitudinal follow-up for two years of treatment. The average severity and frequency of each delusional theme at baseline was reported using the Scale for Assessment of Positive Symptoms. Delusional severity, both globally and per theme, was examined across a number of sociodemographic and clinical variables. Results Delusions of a moderate severity or higher were present in the vast majority of individuals experiencing onset of a FEP (94.0%), with persecutory (77.7%), reference (65.5%), and grandiose (40.2%) being the most common themes. Eighty-one percent of service users presented with two or more delusion themes. Persecutory delusions remained consistent in severity across diagnoses, but were more severe with older age of onset (r = .144). No meaningful differences in delusional severity were observed across sex, affective versus non-affective psychosis, or presence/absence of substance abuse or dependence. Global delusion severity was associated with anxiety (r = .205) but not with depression (r = .052), with specific relationships emerging per theme. Delusions commonly referred to as passivity experiences and/or thought alienation, mind reading delusions (r = .242) and delusions of control (r = .247), were related to hallucinatory experiences. We will also examine delusions longitudinally by investigating their relationship to the duration of untreated psychosis and outcomes, along with the stability of delusional content across episodes. Discussion Unlike the more selected samples, confounded treatment effects, and/or varying levels of chronicity seen in previous reports, this community representative sample offers a rare clinical lens into the severity and content of delusions in FEP. While delusional severity remained consistent across certain sociodemographic and clinical variables, this was not always the case. Future work may wish to investigate the evolution of delusions over time, including focusing on specific themes and/or their overlaps, including with smaller samples and in-depth, phenomenologically oriented interviews.

Cognitive remediation combined with an early intervention service in first episode psychosis

2014 ◽  
Vol 130 (4) ◽  
pp. 300-310 ◽  
Author(s):  
T. Østergaard Christensen ◽  
L. Vesterager ◽  
G. Krarup ◽  
B. B. Olsen ◽  
M. Melau ◽  
...  
Keyword(s):  
Early Intervention ◽  
Cognitive Remediation ◽  
First Episode Psychosis ◽  
First Episode ◽  
Early Intervention Service ◽  
Intervention Service ◽  
Episode Psychosis

Structural Neuroimaging in First-Episode Psychosis: a review of neuroimaging practice in an early intervention service

2011 ◽  
Vol 26 (S2) ◽  
pp. 947-947
Author(s):  
S. Otero ◽  
R. Mehrotra
Keyword(s):  
Early Intervention ◽  
Statistical Significance ◽  
First Episode Psychosis ◽  
First Episode ◽  
Analysis Tool ◽  
Early Intervention Service ◽  
Structural Neuroimaging ◽  
Intervention Service ◽  
Episode Psychosis ◽  
Significant Difference

IntroductionThe UK NICE technology guidance “Structural Neuroimaging in First-Episode Psychosis” concludes that CT/MRI is not routinely recommended as an initial investigation for first-episode psychosis.ObjectivesTo evaluate the use of CT/MRI in a group of Early Intervention Service (EIS) patients with a first-episode psychosis aged 18–35 years at presentation.AimsTo develop practice guidelines for use of neuroimaging in first-episode psychosis.MethodsAll 107 patients registered with the EIS in Hounslow, London, UK, were eligible for inclusion in this review. Data was collected from the medical records and the Picture Archiving and Communications System. Data was analysed using a microsoft excel data analysis tool. Additionally, comparisons were made between the group of patients with normal scans and that with abnormal scans. Statistical significance was determined using the chi-squared method with a significance of P < 0.05.Results17 patients had documented neuroimaging results. 4 scans were abnormal. There was no significant difference between the group with normal and abnormal scans in terms of gender, abnormalities of physical/neurological health, blood tests and whether the patient had any additional medical conditions. Abnormal scan results did not influence treatment or outcome for any patient.ConclusionsThe abnormal scans were not correlated to clinical indices of history, examination and laboratory tests. Abnormal scans appear to have a low yield in terms of clinical effectiveness. The findings support selective use of neuroimaging in this cohort of patients. The indications for it usage would appear to rely on clinical judgement as well clinical findings.

scholarly journals Understanding Pathways to Care of Individuals Entering a Specialized Early Intervention Service for First-Episode Psychosis

2018 ◽  
Vol 69 (6) ◽  
pp. 648-656 ◽  
Author(s):  
Leopoldo J. Cabassa ◽  
Sarah Piscitelli ◽  
Morgan Haselden ◽  
Rufina J. Lee ◽  
Susan M. Essock ◽  
...  
Keyword(s):  
Early Intervention ◽  
First Episode Psychosis ◽  
Pathways To Care ◽  
First Episode ◽  
Early Intervention Service ◽  
Intervention Service ◽  
Episode Psychosis

scholarly journals What are the benefits of evidence-based supported employment for patients with first-episode psychosis?

2004 ◽  
Vol 28 (8) ◽  
pp. 281-284 ◽  
Author(s):  
Miles Rinaldi ◽  
Karen Mcneil ◽  
Mike Firn ◽  
Marsha Koletsi ◽  
Rachel Perkins ◽  
...  
Keyword(s):  
Early Intervention ◽  
Supported Employment ◽  
First Episode Psychosis ◽  
Educational Activity ◽  
First Episode ◽  
Evidence Based ◽  
Early Intervention Service ◽  
Model Fidelity ◽  
Intervention Service ◽  
Episode Psychosis

Aims and MethodTo examine the effectiveness of integrating evidence-based supported employment into an early intervention service for young people with first-episode psychosis. Demographic, clinical and vocational data were collected over a 12-month period to evaluate the effect on vocational outcomes at 6 months and 12 months of the employment of a vocational specialist, and to assess model fidelity.ResultsFollowing vocational profiling and input from the vocational specialist and the team, there were significant increases in the proportion of clients engaged in work or educational activity over the first 6 months of the intervention, and in a subsample over a second 6-month period. The evidence-based Supported Employment Fidelity Scale was used to measure the degree of implementation, which scored 71, signifying ‘good implementation’.Clinical ImplicationsThe results suggest that implementing evidence-based supported employment within an early intervention service increases employment and education opportunities for patients within the service.

scholarly journals Delusional content at initial presentation to a catchment-based early intervention service for psychosis

2020 ◽  
pp. 1-7
Author(s):  
Ann-Catherine Lemonde ◽  
Ridha Joober ◽  
Ashok Malla ◽  
Srividya N. Iyer ◽  
Martin Lepage ◽  
...  
Keyword(s):  
Early Intervention ◽  
Community Sample ◽  
Age At Onset ◽  
First Episode ◽  
Future Research ◽  
Psychotic Episode ◽  
Detailed Knowledge ◽  
Early Intervention Service ◽  
Clinical Variables ◽  
Intervention Service

Background During a psychotic episode, patients frequently suffer from severe maladaptive beliefs known as delusions. Despite the abundant literature investigating the simple presence or absence of these beliefs, there exists little detailed knowledge regarding their actual content and severity at the onset of illness. Aims This study reports on delusions during the initiation of indicated treatment for first-episode psychosis (FEP). Method Data were systematically collected from a sample of 636 patients entering a catchment-based early intervention service for FEP. The average severity and frequency of each delusional theme at baseline was reported with the Scale for the Assessment of Positive Symptoms. Delusional severity (globally and per theme) was examined across a number of sociodemographic and clinical variables. Results Delusions were present in the vast majority of individuals experiencing onset of FEP (94%), with persecutory (77.7%) being the most common theme. Persecutory delusions remained consistent in severity across diagnoses, but were more severe with older age at onset of FEP. No meaningful differences in delusional severity were observed across gender, affective versus non-affective psychosis, or presence/absence of substance use disorder. Globally, delusion severity was associated with anxiety, but not depression. Delusions commonly referred to as passivity experiences were related to hallucinatory experiences. Conclusions This community sample offers a rare clinical lens into the severity and content of delusions in FEP. Although delusional severity was consistent across certain sociodemographic and clinical variables, this was not always the case. Future research should now consider the course of delusion themes over time.

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