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[Prognostic modelling and proactive intervention in psychosis: efficacy and cost-effectiveness]
Tijdschrift Voor Psychiatrie
|October 26, 2016
Summary
Researchers developed a screening tool (PQ-16) to identify individuals at ultra-high risk for psychosis. An intervention, cognitive behavioural therapy, reduced psychosis risk by 50% and proved cost-effective.
Area of Science:
- Psychiatry
- Clinical Psychology
- Public Health
Background:
- Patient outcomes vary significantly across diagnoses, necessitating identification of individuals at high risk for poor outcomes or future psychopathology.
- A critical need exists to identify individuals at ultra-high risk for developing serious mental health conditions, particularly first-episode psychosis.
- Early identification and intervention are crucial for mitigating the severity and impact of psychiatric disorders.
Purpose of the Study:
- To develop and validate a screening instrument (PQ-16) for identifying individuals at very high risk of first-episode psychosis.
- To create and evaluate an intervention aimed at modifying illness trajectories and improving outcomes for at-risk individuals.
- To establish prognostic profiles within the ultra-high-risk group to stratify psychosis development risk.
Main Methods:
- Development of a short screening instrument, the PQ-16, to assess psychosis risk.
- Implementation of a two-step detection process with subsequent validation of predictive value.
- Application of cognitive behavioural therapy (CBT) as an intervention for ultra-high-risk patients to address risk factors and emerging symptoms.
Main Results:
- The screening instrument demonstrated a positive predictive value of 44% in identifying at-risk individuals.
- Cognitive behavioural therapy intervention significantly reduced psychosis risk by approximately 50% in the ultra-high-risk group.
- Three prognostic profiles were modeled, indicating psychosis development risks of 4%, 13%, and 70% within the ultra-high-risk cohort.
- The intervention was found to be cost-effective, reducing healthcare and societal financial burdens.
Conclusions:
- Prognostic modeling and proactive interventions are effective in improving patient health outcomes.
- Early identification and targeted interventions for ultra-high-risk individuals can significantly reduce the incidence of psychosis.
- Implementing such strategies offers a cost-effective approach to mental healthcare, benefiting both individuals and society.
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