title: When the healthcare does not follow the evidence: The case of the lack of early intervention programs for psychosis in Spain.
abstract: There is now sufficient evidence to support the importance of interventions in the early stages of psychosis. The delay in the detection and treatment of the first-episode psychosis is related to a lower and slower recovery, as well as a higher risk of relapse. Despite this fact, early intervention units or teams are still not regularly implemented in mental health service settings in Spain. In this opinion article, a review is presented of the main arguments for defending the need to implement these programs and strategies in order to achieve this aim. There are a number of programs for early intervention for psychosis currently working in other countries, with a therapeutic program that includes pharmacological and psychosocial interventions, together with public awareness, information dissemination, and family-professional collaboration activities. Published literature on the experience of these programs indicates that early intervention is not only effective in terms of the improvement of health status, but is also economically efficient. The main steps and recommendations needed to implement such early intervention programs in our country are described.
authors.affiliation: Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón (IiSGM). Facultad de Medicina, Universidad Complutense, CIBERSAM, Madrid, España. Electronic address: carango@hggm.es.
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
authors.affiliation: Unidad de Esquizofrenia Clínic, Institut Clínic de Neurociències, Hospital Clínic de Barcelona. Departament de Medicina, Universitat de Barcelona. IDIBAPS, CIBERSAM, Barcelona, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Bernardo
authors.affiliation: Fundació Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, España.
authors.forename: Pere
authors.initials: P
authors.lastname: Bonet
authors.affiliation: Asociación Madrileña de Amigos y Familiares de Personas con Esquizofrenia, AMAFE, Madrid, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Cabrera
authors.affiliation: Departamento de Medicina y Psiquiatría, Universidad de Cantabria. Hospital Universitario Marqués de Valdecilla, IDIVAL, CIBERSAM, Santander, España.
authors.forename: Benedicto
authors.initials: B
authors.lastname: Crespo-Facorro
authors.affiliation: Servicio de Psiquiatría, Complejo Hospitalario de Navarra. Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, España.
authors.forename: Manuel J
authors.initials: MJ
authors.lastname: Cuesta
authors.affiliation: Confederación Salud Mental España, FEAFES, Madrid, España.
authors.forename: Nel
authors.initials: N
authors.lastname: González
authors.affiliation: Unidad de Atención Temprana Joven de Fundación Manantial, Madrid, España.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Parrabera
authors.affiliation: Unidad Docente de Psiquiatría y Psicología Médica, Universidad de Valencia, Valencia, España.
authors.forename: Julio
authors.initials: J
authors.lastname: Sanjuan
authors.affiliation: Confederación Salud Mental España, FEAFES, Madrid, España.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Serrano
authors.affiliation: Programa de Trastornos Bipolares, Departamento de Psiquiatría, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, España.
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, Reino Unido.
authors.forename: Belinda R
authors.initials: BR
authors.lastname: Lennox
authors.affiliation: Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Copenhague, Dinamarca.
authors.forename: Marianne
authors.initials: M
authors.lastname: Melau
mesh_terms: D061345:Early Medical Intervention / Q000379:methods / Q000458:organization & administration / Q000600:supply & distribution*; D019317:Evidence-Based Medicine; D006297:Health Services Accessibility; D006801:Humans; D011618:Psychotic Disorders / Q000175:diagnosis / Q000628:therapy*; D012008:Recurrence; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D013030:Spain; D016896:Treatment Outcome
keywords: Duración de la psicosis no tratada; Duration of untreated psychosis; Early intervention; Esquizofrenia; First episode psychosis; Intervención temprana; Primer episodio psicótico; Psicosis; Psychosis; Schizophrenia