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Early detection of psychosis: positive effects on 5-year outcome

Published online by Cambridge University Press:  14 October 2010

T. K. Larsen ,
I. Melle ,
B. Auestad ,
U. Haahr ,
I. Joa ,
J. O. Johannessen ,
S. Opjordsmoen ,
B. R. Rund ,
J. I. Rossberg  and
E. Simonsen
...Show all authors
T. K. Larsen*
Affiliation:
Stavanger University Hospital, Psychiatric Clinic, Stavanger, Norway Department of Clinical Medicine, Section Psychiatry, University of Bergen, Norway
I. Melle
Affiliation:
Oslo University Hospital, Oslo, Norway Institute of Psychiatry, University of Oslo, Norway
B. Auestad
Affiliation:
Faculty of Science and Technology, University of Stavanger, Norway
U. Haahr
Affiliation:
Psychiatric Research Unit and University of Copenhagen, Zealand Region Psychiatry Roskilde, Denmark
I. Joa
Affiliation:
Stavanger University Hospital, Psychiatric Clinic, Stavanger, Norway
J. O. Johannessen
Affiliation:
Stavanger University Hospital, Psychiatric Clinic, Stavanger, Norway
S. Opjordsmoen
Affiliation:
Oslo University Hospital, Oslo, Norway Institute of Psychiatry, University of Oslo, Norway
B. R. Rund
Affiliation:
Vestre Viken Hospital Trust/Department of Psychology, University of Oslo, Norway
J. I. Rossberg
Affiliation:
Oslo University Hospital, Oslo, Norway Institute of Psychiatry, University of Oslo, Norway
E. Simonsen
Affiliation:
Psychiatric Research Unit and University of Copenhagen, Zealand Region Psychiatry Roskilde, Denmark
P. Vaglum
Affiliation:
Department of Behavioral Sciences in Medicine, University of Oslo, Norway
S. Friis
Affiliation:
Oslo University Hospital, Oslo, Norway Institute of Psychiatry, University of Oslo, Norway
T. McGlashan
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
*
*Address for correspondence: T. K. Larsen, M.D., Stavanger University Hospital, Division of Psychiatry, Armauer Hansensv 20, p.b. 8100, N-4068 Stavanger, Norway. (Email: tkmaclarsen@mac.com)
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Abstract

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.

Method

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) programme with public information campaigns and low-threshold psychosis detection teams was established in one healthcare area (ED-area), but not in a comparable area (no-ED area). Both areas ran equivalent treatment programmes 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 modelling showed better scores for the ED group on the Positive and Negative Syndrome Scale negative, depressive and cognitive factors and for global assessment of functioning for 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.

Keywords

Early interventionfirst-episode psychosisoutcome
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 7 , July 2011 , pp. 1461 - 1469
Copyright
Copyright © Cambridge University Press 2010

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