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Related Experiment Videos

Early Intervention for psychosis.

M Marshall1, A Lockwood

  • 1School of Psychiatry and Behavioural Sciences, University of Manchester, Academic Unit, Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston., Lancashire, UK, PR2 4HT.

The Cochrane Database of Systematic Reviews
|April 24, 2004
PubMed
Summary

Early intervention for schizophrenia shows promise, with some phase-specific treatments reducing psychosis progression and hospital admissions. However, more research is needed to confirm these benefits for early detection and specialized teams.

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Area of Science:

  • Psychiatry and Mental Health
  • Clinical Psychology
  • Evidence-Based Medicine

Background:

  • Early intervention in schizophrenia involves early detection and phase-specific treatment, distinct from standard care.
  • While established internationally, the evidence base for early detection, phase-specific treatments, and specialized early intervention teams remains unclear.

Purpose of the Study:

  • To evaluate the effectiveness of early detection and treatment for prodromal symptoms.
  • To assess the impact of early intervention teams for first-episode psychosis.
  • To determine the efficacy of phase-specific treatments in first-episode psychosis.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) and relevant non-randomized trials.
  • Searched multiple databases (CINAHL, Cochrane, EMBASE, MEDLINE, PsycINFO) and contacted networks.

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  • Extracted data independently, calculating relative risks and weighted mean differences.

    • Main Results:

    • One small RCT indicated a phase-specific intervention (risperidone/CBT) reduced psychosis development at 6 months for prodromal symptoms (NNT=4).
    • Another RCT found family therapy plus outpatient care reduced admissions in first-episode psychosis (NNT=3), though applicability was questionable.
    • A third study showed no significant difference in relapse rates between family therapy plus specialized team care versus specialized team care alone.

    Conclusions:

    • Insufficient trials were identified to draw definitive conclusions on early intervention strategies.
    • Ongoing trials may provide further insights, but a coordinated international research program is needed.
    • The potential for positive change in psychiatric practice through early intervention requires further research to address unanswered questions.