Wednesday, March 19, 2014

Early Intervention Appears to Cut First Psychosis Hospitalizations

A program spanning a dozen years provides evidence that early identification and community-wide intervention could help reduce the burden of psychosis on young patients and their families. The Portland [Maine] Identification and Early Referral program (PIER) began in 2001 and identified youths and young adults aged 12 to 35 at high risk for psychosis. After assessment, these individuals were provided treatment for 24 months. The researchers compared rates of first hospital admission for psychosis in the Greater Portland area with three similar urban areas in Maine.

The intervention provided was the Family-aided Assertive Community Treatment (FACT), a mix of psychoeducational multifamily group treatment, assertive community treatment, and supported employment and education, wrote William McFarlane, M.D., of the Maine Medical Center, and colleagues online in Psychiatric Services in Advance.

Based on data from 148 individuals, there were 29.7 fewer first hospitalizations per year over the course of the study, compared with the two years before the start of the study. The mean annual rates of first admissions dropped by 26 percent in Portland but rose by a (nonsignificant) 8 percent in the control areas. “In addition, in the Greater Portland area the rate of first hospital admission for psychosis was inversely correlated with PIER intakes, suggesting that changes in the admission rate were largely associated with the intervention program,” concluded the authors. “The approach shows promise in reducing the tremendous personal, social, and economic burdens imposed by psychotic disorders.”

For more in Psychiatric News about early intervention in psychosis, see the articles, “Maryland Undertakes Ambitious Effort at Early ID of Psychosis” and "Expert Says Early Identification of Psychosis Should Be Priority."

(Image: James Steidl/


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