Abstract:
PURPOSE:Most specialized Early Psychosis (EP) programs include assertive outreach (AO) principles, either for all patients or as an intensive case management (ICM) subprogram in selected situations. The objective of this study is to examine prevalence, characteristics and outcomes of patients who needed additional ICM in a specialized EP program. METHODS:In a 3-year prospective naturalistic study of 229 consecutive EP patients treated at TIPP-Lausanne we compared characteristics of those who needed ICM and those who did not. RESULTS:60 (26.2%) TIPP patients needed ICM. At baseline, ICM-patients showed a poorer academic premorbid functioning (p=0.019); lower level of insight (p<0.001); had a previous history of alcohol (p=0.043) and cannabis (p=0.040) use. ICM-patients were less likely to be adherent to medication during the early phase of treatment but differences disappeared during follow-up. ICM-patients showed globally a poorer functional level and higher level of positive and negative symptoms during the follow-up. CONCLUSIONS:About one quarter of EP patients needed a combination of ICM and assertive outreach. Despite the high treatment adherence in both groups, psychotic symptoms remained higher in ICM-patients. In a real live setting with limited resources, combination of ICM and AO in selected situations seems a valid solution.
journal_name
Psychiatry Resjournal_title
Psychiatry researchauthors
Alameda L,Golay P,Baumann P,Morandi S,Ferrari C,Conus P,Bonsack Cdoi
10.1016/j.psychres.2016.03.010subject
Has Abstractpub_date
2016-05-30 00:00:00pages
212-9eissn
0165-1781issn
1872-7123pii
S0165-1781(15)30750-2journal_volume
239pub_type
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