Early interventions in a US military FIRST episode psychosis program

Area of Science:

• Psychiatry
• Military Mental Health
• Psychotic Disorders

Background:

• First episode psychosis (FEP) requires timely intervention to improve outcomes.
• The military environment may facilitate earlier access to care for service members with FEP.
• The Psychiatric Transition Program (PTP) at Naval Medical Center San Diego (NMCSD) offers coordinated specialty care for psychotic disorders.

Purpose of the Study:

• To determine the duration of untreated psychosis (DUP) in military service members enrolled in the NMCSD PTP.
• To assess the impact of the military healthcare system on DUP for patients with FEP.

Main Methods:

• Retrospective chart review of 69 patients diagnosed with schizophrenia, schizophreniform disorder, schizoaffective disorder, or brief psychotic disorder.
• DUP defined as the interval from positive psychotic symptom emergence to antipsychotic medication initiation.
• Calculation of mean, median, and standard deviation for DUP.

Main Results:

• The mean duration to scheduled neuroleptic medication was 37 days (median: 4 days).
• The mean duration to PRN neuroleptic medication was 21 days (median: 2 days).
• These findings indicate a rapid initiation of antipsychotic treatment.

Conclusions:

• The military structure and healthcare system contribute to a significantly shortened DUP for service members with FEP.
• Early intervention in FEP is achievable within the military healthcare setting.
• The NMCSD PTP demonstrates effectiveness in providing timely care for psychotic disorders.