EPA guidance on the early intervention in clinical high risk states of psychoses
This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysis o...
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| Published in | European psychiatry Vol. 30; no. 3; pp. 388 - 404 |
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| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Elsevier Masson SAS
01.03.2015
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0924-9338 1778-3585 1778-3585 |
| DOI | 10.1016/j.eurpsy.2015.01.013 |
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| Abstract | This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysis of current empirical evidence on the efficacy of psychological and pharmacological interventions in CHR samples. Eligible studies had to investigate conversion rate and/or functioning as a treatment outcome in CHR patients defined by the ultra-high risk and/or basic symptom criteria. Besides analyses on treatment effects on conversion rate and functional outcome, age and type of intervention were examined as potential moderators. Based on data from 15 studies (n=1394), early intervention generally produced significantly reduced conversion rates at 6- to 48-month follow-up compared to control conditions. However, early intervention failed to achieve significantly greater functional improvements because both early intervention and control conditions produced similar positive effects. With regard to the type of intervention, both psychological and pharmacological interventions produced significant effects on conversion rates, but not on functional outcome relative to the control conditions. Early intervention in youth samples was generally less effective than in predominantly adult samples. Seven evidence-based recommendations for early intervention in CHR samples could have been formulated, although more studies are needed to investigate the specificity of treatment effects and potential age effects in order to tailor interventions to the individual treatment needs and risk status. |
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| AbstractList | This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysis of current empirical evidence on the efficacy of psychological and pharmacological interventions in CHR samples. Eligible studies had to investigate conversion rate and/or functioning as a treatment outcome in CHR patients defined by the ultra-high risk and/or basic symptom criteria. Besides analyses on treatment effects on conversion rate and functional outcome, age and type of intervention were examined as potential moderators. Based on data from 15 studies (n=1394), early intervention generally produced significantly reduced conversion rates at 6- to 48-month follow-up compared to control conditions. However, early intervention failed to achieve significantly greater functional improvements because both early intervention and control conditions produced similar positive effects. With regard to the type of intervention, both psychological and pharmacological interventions produced significant effects on conversion rates, but not on functional outcome relative to the control conditions. Early intervention in youth samples was generally less effective than in predominantly adult samples. Seven evidence-based recommendations for early intervention in CHR samples could have been formulated, although more studies are needed to investigate the specificity of treatment effects and potential age effects in order to tailor interventions to the individual treatment needs and risk status.This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysis of current empirical evidence on the efficacy of psychological and pharmacological interventions in CHR samples. Eligible studies had to investigate conversion rate and/or functioning as a treatment outcome in CHR patients defined by the ultra-high risk and/or basic symptom criteria. Besides analyses on treatment effects on conversion rate and functional outcome, age and type of intervention were examined as potential moderators. Based on data from 15 studies (n=1394), early intervention generally produced significantly reduced conversion rates at 6- to 48-month follow-up compared to control conditions. However, early intervention failed to achieve significantly greater functional improvements because both early intervention and control conditions produced similar positive effects. With regard to the type of intervention, both psychological and pharmacological interventions produced significant effects on conversion rates, but not on functional outcome relative to the control conditions. Early intervention in youth samples was generally less effective than in predominantly adult samples. Seven evidence-based recommendations for early intervention in CHR samples could have been formulated, although more studies are needed to investigate the specificity of treatment effects and potential age effects in order to tailor interventions to the individual treatment needs and risk status. This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysis of current empirical evidence on the efficacy of psychological and pharmacological interventions in CHR samples. Eligible studies had to investigate conversion rate and/or functioning as a treatment outcome in CHR patients defined by the ultra-high risk and/or basic symptom criteria. Besides analyses on treatment effects on conversion rate and functional outcome, age and type of intervention were examined as potential moderators. Based on data from 15 studies (n=1394), early intervention generally produced significantly reduced conversion rates at 6- to 48-month follow-up compared to control conditions. However, early intervention failed to achieve significantly greater functional improvements because both early intervention and control conditions produced similar positive effects. With regard to the type of intervention, both psychological and pharmacological interventions produced significant effects on conversion rates, but not on functional outcome relative to the control conditions. Early intervention in youth samples was generally less effective than in predominantly adult samples. Seven evidence-based recommendations for early intervention in CHR samples could have been formulated, although more studies are needed to investigate the specificity of treatment effects and potential age effects in order to tailor interventions to the individual treatment needs and risk status. Abstract This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysis of current empirical evidence on the efficacy of psychological and pharmacological interventions in CHR samples. Eligible studies had to investigate conversion rate and/or functioning as a treatment outcome in CHR patients defined by the ultra-high risk and/or basic symptom criteria. Besides analyses on treatment effects on conversion rate and functional outcome, age and type of intervention were examined as potential moderators. Based on data from 15 studies ( n = 1394), early intervention generally produced significantly reduced conversion rates at 6- to 48-month follow-up compared to control conditions. However, early intervention failed to achieve significantly greater functional improvements because both early intervention and control conditions produced similar positive effects. With regard to the type of intervention, both psychological and pharmacological interventions produced significant effects on conversion rates, but not on functional outcome relative to the control conditions. Early intervention in youth samples was generally less effective than in predominantly adult samples. Seven evidence-based recommendations for early intervention in CHR samples could have been formulated, although more studies are needed to investigate the specificity of treatment effects and potential age effects in order to tailor interventions to the individual treatment needs and risk status. This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysis of current empirical evidence on the efficacy of psychological and pharmacological interventions in CHR samples. Eligible studies had to investigate conversion rate and/or functioning as a treatment outcome in CHR patients defined by the ultra-high risk and/or basic symptom criteria. Besides analyses on treatment effects on conversion rate and functional outcome, age and type of intervention were examined as potential moderators. Based on data from 15 studies ( n = 1394), early intervention generally produced significantly reduced conversion rates at 6- to 48-month follow-up compared to control conditions. However, early intervention failed to achieve significantly greater functional improvements because both early intervention and control conditions produced similar positive effects. With regard to the type of intervention, both psychological and pharmacological interventions produced significant effects on conversion rates, but not on functional outcome relative to the control conditions. Early intervention in youth samples was generally less effective than in predominantly adult samples. Seven evidence-based recommendations for early intervention in CHR samples could have been formulated, although more studies are needed to investigate the specificity of treatment effects and potential age effects in order to tailor interventions to the individual treatment needs and risk status. |
| Author | Ruhrmann, S. Schmidt, S.J. van der Gaag, M. Schultze-Lutter, F. Salokangas, R.K.R. Nordentoft, M. Klosterkötter, J. Riecher-Rössler, A. Marshall, M. Schimmelmann, B.G. Raballo, A. Morrison, A. Meneghelli, A. Maric, N.P. |
| Author_xml | – sequence: 1 givenname: S.J. surname: Schmidt fullname: Schmidt, S.J. organization: University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland – sequence: 2 givenname: F. surname: Schultze-Lutter fullname: Schultze-Lutter, F. organization: University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland – sequence: 3 givenname: B.G. surname: Schimmelmann fullname: Schimmelmann, B.G. organization: University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland – sequence: 4 givenname: N.P. surname: Maric fullname: Maric, N.P. organization: School of Medicine, University of Belgrade and Clinic of Psychiatry, Clinical Center of Serbia, Belgrade, Serbia – sequence: 5 givenname: R.K.R. surname: Salokangas fullname: Salokangas, R.K.R. organization: Department of Psychiatry, University of Turku, Turku, Finland – sequence: 6 givenname: A. surname: Riecher-Rössler fullname: Riecher-Rössler, A. organization: Center for Gender Research and Early Detection, Psychiatric University Clinics of Basel, Basel, Switzerland – sequence: 7 givenname: M. surname: van der Gaag fullname: van der Gaag, M. organization: Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands – sequence: 8 givenname: A. surname: Meneghelli fullname: Meneghelli, A. organization: Dipartimento di Salute Mentale, Centro per l’Individuazione e l’Intervento Precoce nelle Psicosi-Programma 2000, Ospedale Niguarda Ca’ Granda, Milan, Italy – sequence: 9 givenname: M. surname: Nordentoft fullname: Nordentoft, M. organization: Mental Health Center of Copenhagen, University of Copenhagen, Copenhagen, Denmark – sequence: 10 givenname: M. surname: Marshall fullname: Marshall, M. organization: School of Medicine, University of Manchester, Manchester, UK – sequence: 11 givenname: A. surname: Morrison fullname: Morrison, A. organization: School of Psychological Sciences, University of Manchester, Manchester, UK – sequence: 12 givenname: A. surname: Raballo fullname: Raballo, A. organization: Department of Mental Health, Reggio Emilia Public Health Center, Reggio Emilia, Italy – sequence: 13 givenname: J. surname: Klosterkötter fullname: Klosterkötter, J. email: Joachim.klosterkotter@uk-koeln.de organization: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany – sequence: 14 givenname: S. surname: Ruhrmann fullname: Ruhrmann, S. organization: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25749390$$D View this record in MEDLINE/PubMed |
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| Snippet | This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk... Abstract This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical... |
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| SubjectTerms | Adolescent Adolescents Adult Antipsychotic Agents - therapeutic use Antipsychotics Cognitive-behavioral therapy Early Diagnosis Early intervention in Europe Early Medical Intervention - statistics & numerical data Humans Internal Medicine Male Meta-analysis Mood Disorders - diagnosis Mood Disorders - therapy Neuroprotective Practice Guidelines as Topic Prevention Psychiatric Status Rating Scales Psychiatry Psychosis Psychotic Disorders - diagnosis Psychotic Disorders - therapy Risk Risk Factors Schizophrenia - diagnosis Schizophrenia - therapy Treatment Outcome Youth |
| Title | EPA guidance on the early intervention in clinical high risk states of psychoses |
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