Thursday, April 5, 2018

Early Intervention Service Improves Long-Term Survival in Patients With First-Episode Psychosis

Patients experiencing a first episode of schizophrenia-spectrum disorder who participate in an early intervention program may be less likely to die by suicide over the long term, suggests a study published Wednesday in JAMA Psychiatry.

Patients aged 15 to 25 with first-episode schizophrenia-spectrum (FES) disorders who received two years of early intervention services in Hong Kong were less likely to die by suicide (4.4%) than those who received standard care (7.5%) over the 12 years they were followed, according to Sherry Kit Wa Chan, M.R.C.Psych., of the University of Hong Kong and colleagues.

To evaluate the effect of early intervention on suicide risk, the study authors compared the suicide rates of 617 patients with FES who received the early intervention service with 617 patients with FES who received standard general psychiatric care over a 12-year period. Hong Kong’s early intervention service, deployed region-wide in 2001, is a phase-specific, assertive intervention based on the protocol of the Psychological Intervention Program in Early Psychosis.

The researchers found that patients receiving the early intervention service had significantly better survival, with the main difference observed during the first three years.

Patients with a high number of suicide attempts prior to being treated successfully were more likely to die by suicide during the first three years of the study. Meanwhile, patients with impaired occupational functioning prior to illness, poor treatment adherence, and higher relapse rates were more likely to die by suicide during years 4 to 12 of the study. “This finding highlights the importance of the further improvement of the early intervention model to effectively reduce the relapse rate,” the authors noted.

The significance of suicide attempts during the period of untreated psychosis highlights the importance of developing successful treatments faster for patients, the researchers wrote. In addition, “[s]uicide at different stages of schizophrenia was associated with unique risk factors, highlighting the importance of a phase-specific service,” the authors wrote.

For related information, see the Psychiatric News article “High Mortality Rate Found in Youth Newly Diagnosed With Psychosis.”

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