Early intervention in psychosis: From clinical intervention to health system implementation

被引:54
作者
Csillag, Claudio [1 ]
Nordentoft, Merete [2 ]
Mizuno, Masafumi [3 ]
McDaid, David [4 ]
Arango, Celso [5 ]
Smith, Jo [6 ]
Lora, Antonio [7 ]
Verma, Swapna [8 ]
Di Fiandra, Teresa [9 ]
Jones, Peter B. [10 ]
机构
[1] Univ Copenhagen, Mental Hlth Ctr North Zealand, Hillerod, Denmark
[2] Univ Copenhagen, Mental Hlth Ctr Copenhagen, Copenhagen, Denmark
[3] Toho Univ, Sch Med, Dept Neuropsychiat, Tokyo, Japan
[4] London Sch Econ & Polit Sci, Dept Hlth Policy, Personal Social Serv Res Unit, London, England
[5] Univ Complutense, Hosp Gen Univ Gregorio Maranon, Sch Med, CIBERSAM,IiSGM, Madrid, Spain
[6] Univ Worcester, Inst Hlth & Soc, Worcester, England
[7] Lecco Mental Hlth Dept, Lecce, Italy
[8] Inst Mental Hlth, Dept Early Psychosis Intervent, Singapore, Singapore
[9] Hlth Minist, Dept Prevent, Rome, Italy
[10] Univ Cambridge, Dept Psychiat, Cambridge, England
关键词
early intervention in psychosis (EIP); evidence-based medicine; health planning; implementation; mental health services; RANDOMIZED CONTROLLED-TRIAL; 1ST-EPISODE PSYCHOSIS; UNTREATED PSYCHOSIS; 1ST EPISODE; INTEGRATED TREATMENT; COST-EFFECTIVENESS; ECONOMIC-IMPACT; DURATION; CARE; SCHIZOPHRENIA;
D O I
10.1111/eip.12514
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
AimEarly intervention in psychosis (EIP) is a well-established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges to their implementation and presents ideas and strategies to overcome some of these obstacles. MethodsThis paper is a narrative review about the evidence supporting EIP, with examples of successful implementation of EIP and of cases where major obstacles still need to be overcome. ResultsExperience from successfully implemented EIP services into the mental healthcare system have generated evidence, concepts and specific strategies that might serve as guidance or inspiration in other countries or systems where EIP is less well developed or not developed at all. Previous experience has made clear that evidence of clinical benefits alone is not enough to promote implementation, as economic arguments and political and social pressure have shown to be important elements in efforts to achieve implementation. ConclusionsUsers' narratives, close collaboration with community organizations and support from policy-makers and known people within the community championing early intervention (EI) services are just a few of the approaches that should be considered in campaigns for implementation of EI services. Fast progress in implementation is possible.
引用
收藏
页码:757 / 764
页数:8
相关论文
共 62 条
[1]   Five years of specialised early intervention versus two years of specialised early intervention followed by three years of standard treatment for patients with a first episode psychosis: randomised, superiority, parallel group trial in Denmark (OPUS II) [J].
Albert, Nikolai ;
Melau, Marianne ;
Jensen, Heidi ;
Emborg, Charlotte ;
Mollegaard, Jens Richardt ;
Fagerlund, Birgitte ;
Gluud, Christian ;
Mors, Ole ;
Hjorthoj, Carsten ;
Nordentoft, Merete .
BMJ-BRITISH MEDICAL JOURNAL, 2017, 356
[2]  
[Anonymous], CLIN INT HLTH SYST I
[3]  
[Anonymous], 2021, RET WORK MENT HLTH I
[4]  
[Anonymous], HISTORY
[5]  
[Anonymous], AUD EARL INT PSYCH
[6]  
[Anonymous], PSYCH MAPP TRANSL IN
[7]  
[Anonymous], EARLY INTERVENTION P
[8]  
[Anonymous], IMP EARL INT PSYCH A
[9]  
[Anonymous], 2014, Psychosis and Schizophrenia in Adults: Prevention and Management
[10]  
[Anonymous], IRIS GUID UPD SEPT 2