Early Intervention In Psychotic Disorders

Multiple voices throughout the last century have preached the merits of various treatments for schizophrenia, ranging from cold baths to the currently accepted standards such as neuroleptic medication. Along with these ongoing treatments, there have been quiet commentaries, made mostly from the sidelines, suggesting the need to shift and refocus the way we think and talk about schizophrenia. Harry Stack Sullivan noted in 1927 that, 'The psychiatrist sees too many end states and deals professionally with too few of the pre psychotic" (Sullivan 192711994, p. 135). Similar thoughts have been echoed by purveyors of modem treatment for psychosis such as Thomas H. McGlashan: "Like others before me, I tried to make a difference . . . but like the others my efforts were largely in vain. I came upon the scene too late; most of the damage was already done" (McGlashan, 1996). Similar interest in the early phase of schizophrenia has developed across the globe and consolidated into a tentative, yet meaningful deliberation about the potential for prevention of psychotic illness through early identification and intervention. In the past decade, international support has grown from: Ian Falloon's prodromal intervention project in Great Britain (Falloon et aI. , 1996); Patrick McGorry's and Jane Edward's first episode psychosis program in Melbourne, Australia (McGorry et al.

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Evidence indicates a correlation between early intervention and improved response in psychiatric disorders. Yet the majority of evidence is from high-income countries, and there is a lack of evidence and resources on the impact of early intervention across cultures and in low- and middle-income countries. Early Intervention in Psychiatric Disorders across Cultures aims to bridge this gap by focusing on the evidence and methods of intervention in less affluent countries. It covers mood disorders, personality disorders, addictions, and other psychiatric conditions, whilst most research has focused on psychoses and bipolar disorder. Over 17 chapters, this resource guides the reader through an array of approaches to early intervention, from brain imaging and available care pathways, to cultural and societal factors. Part of the Oxford Cultural Psychiatry series, this resource offers readers a picture of the current health care pathways available as well as social, cultural, and ethical considerations to apply in practice.

With expert guidance on developing specialty care service models for young people experiencing first-episode psychosis, the book offers a multimodal approach that aims for recovery and remission.

Despite years of research, debate and changes in mental health policy, there is still a lack of consensus as to what recovery from psychosis actually means, how it should be measured and how it may ultimately be achieved. In Recovering from a First Episode of Psychosis: An Integrated Approach to Early Intervention, it is argued that recovery from a first episode of psychosis (FEP) is comprised of three core elements: symptomatic, social and personal. Moreover, all three types of recovery need to be the target of early intervention for psychosis programmes (EIP) which provide evidence-based, integrated, bio-psychosocial interventions delivered in the context of a value base offering hope, empowerment and a youth-focused approach. Over the 12 chapters in the book, the authors, all experienced clinicians and researchers from multi-professional backgrounds, demonstrate that long-term recovery needs to replace short term remission as the key target of early psychosis services and that, to achieve this, we need a change in the way we deliver EIP: one that takes account of the different stages of psychosis and the ‘bespoke’ targeting of integrated medical, psychological and social treatments during the ‘critical period’. Illustrated with a wealth of clinical examples, this book will be of great interest to clinical psychologists, psychiatrists, psychiatric nurses and other associated mental health professionals.

The early recognition and treatment of psychosis--particularly in adolescents and young adults--is increasingly accepted as an important factor in the individual experience of mental illness, which can have major implications for mental health care and treatment. This book is one of the first books available on the treatment of psychosis.

This new volume reviews early detection approaches and possible subsequent interventions for psychosis. After introductory chapters, various methods for early detection not only in adults, but also adolescents are described. In this context, the validity of the psychosis high-risk state is debated along with whether early detection is indeed helpful, or actually stigmatizing, for the patient. Further contributions review neuroimaging, including structural and functional MRI, as well as pattern recognition methods and measurement of connectivity abnormalities. Neurocognitive and neurophysiological assessments are also discussed in detail. The last part focuses on early intervention for emerging psychosis, including psychological methods, non-pharmacological substances and pharmacological treatments. Overall conclusions and future perspectives are provided in a final chapter. This book is a state-of-the-art review of current options. It is important reading for researchers and clinicians faced with recognizing and treating psychosis in the most timely and effective manner possible.

The treatment of early psychosis has been bedevilled by an entrenched pessimism, stemming from the asylum era and the Kraepelinian model of schizophrenia. More recently, however, there has been a surge of interest in preventively oriented treatment of patients showing the first signs of psychotic illness, with the realization that these illnesses are frequently highly responsive to early treatment. This is the first text to focus on the potential of early detection of psychosis, and the practicalities of treatment. Based on the pioneering experience and research of a now well-established prevention and intervention centre, and with contributions from international authorities, the book outlines a framework for intervention, reviews the evidence available to guide clinical practice, and describes models of treatment. Incorporating many personal narratives and case histories, it is strong on theory, sensitive on practical issues, and will challenge, inform and guide clinicians.