Early detection of first-episode psychosis: the effect on 1-year outcome.
Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven.


OBJECTIVE
To study whether 1-year outcome will be better in a health care sector with early detection (ED) of psychosis compared with sectors with no early detection (no-ED).


METHODS
A quasi-experimental study with ED in 2 experimental sectors and no-ED in 2 control sectors. ED was achieved through low-threshold ED teams and information campaigns about psychosis for the public, schools, and primary health care providers. The ED and no-ED health care areas offered an equivalent assessment and treatment program during the first year. Two hundred and eighty-one patients were included; 88% were reassessed after 1 year.


RESULTS
The ED-area patients (N = 141) had a median duration of untreated psychosis of 5 weeks at baseline compared with 16 weeks for patients in the no-ED area (N = 140). Positive and general symptoms, global assessment of functioning, quality of life, time to remission, and course of psychosis at 1 year after the start of treatment were not different between ED and no-ED groups. Outcome was significantly better for the ED area for negative symptoms.


CONCLUSIONS
The ED, no-ED differences at baseline become attenuated by 1 year but not the difference in negative symptoms, suggesting secondary prevention in this domain of psychopathology. However, this possibility requires further testing by follow-up and replication.
Larsen
Tor K
TK
Psychiatric Clinic, University of Stavanger, Armauer Hansensv. 20, PB 8100, N-4068 Stavanger, Norway. tklarsen@online.no
Melle
Ingrid
I
Auestad
Bjørn
B
Friis
Svein
S
Haahr
Ulrik
U
Johannessen
Jan Olav
JO
Opjordsmoen
Stein
S
Rund
Bjørn Rishovd
BR
Simonsen
Erik
E
Vaglum
Per
P
McGlashan
Thomas
T
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000600:supply & distribution; D008875:Middle Aged; D009664:Norway; D010043:Outcome and Process Assessment, Health Care; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000628:therapy; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents