Team-Based Care More Effective for Psychosis Than Community Care
the Psychiatry Advisor take:
Treating first episode psychosis with team-based specialty care is more effective than treating with typical care, according to research published in The American Journal of Psychiatry. Researchers also found that patients treated for psychosis early after a first episode had better outcomes.
John M. Kane, MD, professor and chairman at The Hofstra North Shore-LIJ School of Medicine and The Zucker Hillside Hospital, heads the RAISE Early Treatment Program (Recovery After an Initial Schizophrenia Episode). He is also a member of the Psychiatry Advisor editorial board.
Kane and his colleagues trained clinicians at clinics around the United States to treat psychosis patients with a specialty care program called NAVIGATE. In this program, specialists work with patients and their families to create a personalized treatment plan that can include recovery-oriented psychotherapy, low doses or antipsychotic medications, family education and support, case management, and work or education support.
Of the 404 participants enrolled in the study, 223 received treatment with the NAVIGATE program and 181 received “typical-care.” Patients treated with NAVIGATE care remained in treatment longer and experienced greater improvements in their symptoms, interpersonal relationships, quality of life, and involvement in work and school compared with typical-care patients.
The researchers also found that participants who received treatment sooner after the onset of psychosis had better outcomes. Half of the participants had untreated psychosis for under 74 weeks, and half waited for longer than 74 weeks to receive treatment. Those who received treatment in 74 weeks or less had a much greater improvement in symptoms and in their quality of life.
Patients in coordinated care remained in treatment longer and experienced greater improvements in their symptoms, compared with standard-care patients.
New research shows that treating people with first episode psychosis with a team-based, coordinated specialty care approach produces better clinical and functional outcomes than typical community care. Investigators also found that treatment is most effective for people who receive care soon after psychotic symptoms begin.
John M. Kane, MD, heads the RAISE Early Treatment Program, one of two studies that make up the Recovery After an Initial Schizophrenia Episode (RAISE) project funded by the National Institute of Mental Health (NIMH). Kane is professor and chairman of the Department of Psychiatry at The Hofstra North Shore-LIJ School of Medicine and The Zucker Hillside Hospital. The team's research is published online in The American Journal of Psychiatry.
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