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Related Experiment Videos

Early intervention for psychosis.

M Marshall1, J Rathbone

  • 1The Lantern Centre, Vicarage Lane, Of Watling Street Road, Fulwood, Preston, Lancashire, UK. max.marshall@manchester.ac.uk

The Cochrane Database of Systematic Reviews
|October 21, 2006
PubMed
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Early intervention for schizophrenia shows promise, with some phase-specific treatments reducing psychosis progression. However, more research is needed to confirm the effectiveness of early detection, phase-specific treatments, and specialized teams.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Early intervention in schizophrenia aims to improve outcomes by focusing on early stages or prodromal symptoms.
  • Key components include early detection, phase-specific treatment, and specialized early intervention teams.
  • While established internationally, the evidence base for these components requires further evaluation.

Purpose of the Study:

  • To evaluate the effectiveness of early detection, phase-specific treatments, and specialized early intervention teams for individuals with prodromal symptoms or first-episode psychosis.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) focusing on preventing psychosis or improving outcomes in first-episode psychosis.
  • Searched multiple databases (CINAHL, Cochrane, EMBASE, MEDLINE, PsycINFO) and contacted networks for relevant studies.

Related Experiment Videos

  • Included RCTs and cluster-RCTs, excluding non-randomized trials, with data extraction and analysis using relative risks and intention-to-treat principles.

    • Main Results:

    • Seven RCTs with 941 participants were included; interventions varied, necessitating separate analyses.
    • One trial indicated phase-specific intervention (risperidone/CBT) reduced psychosis progression in prodromal symptoms at 6 months (RR 0.27, NNT 4).
    • Integrated treatment in first-episode schizophrenia significantly lowered attrition rates (RR 0.59, NNT 9) and improved Global Assessment of Functioning (GAF) at one year, though GAF benefits diminished by two years.

    Conclusions:

    • Insufficient trials were identified to draw definitive conclusions on early intervention strategies.
    • Substantial international interest presents an opportunity for psychiatric practice improvement.
    • A coordinated international research program is essential to address unanswered questions and maximize the potential of early intervention.