Analysis of the initial treatment phase in first-episode psychosis.
BACKGROUND
The Early Psychosis Prevention and Intervention Centre (EPPIC) commenced operation in Melbourne, Australia, in 1992. It offers a model for management of first-episode psychosis, utilising principles of early detection, low-dose medication and comprehensive psychosocial interventions within the least restrictive setting.


METHODS
Data were examined from the first three months of treatment for all consecutive people with first-episode psychosis (n = 231) accepted in the programme in 1995-1996. A subsample of patients (n = 120) was assessed comparing clinical ratings with variables of gender, diagnosis, hospitalisation, and medication.


RESULTS
Hospitalisations were brief, and avoided for a third of the people. Low-dose antipsychotic medication was maintained in both in-patient and community settings. Those people with manic psychosis were more likely to be hospitalised. Hospitalised people received higher antipsychotic dosages, and had a greater rate of reduction in Brief Psychiatric Rating Scale psychotic subscale scores at three months follow-up. Eighty per cent of a representative subsample had responded to treatment and 63% were in remission by the end of the three months.


CONCLUSIONS
This naturalistic study suggests that the feasibility of implementing the EPPIC model in a range of clinical settings is promising and applicable in practice.
Early Psychosis Prevention and Intervention Centre, Parkville, Victoria, Australia. eppic@vicnet.net.au
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P
Power
K
K
Elkins
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Adlard
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C
Curry
P
P
McGorry
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S
Harrigan
D000328:Adult; D017668:Age of Onset; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D017050:Episode of Care; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000517:prevention & control*; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria
D014150:Antipsychotic Agents; D001569:Benzodiazepines