Talk:Early intervention in psychosis

its a start?

need some help with this.... —Preceding unsigned comment added by Earlypsychosis (talk • contribs) 04:13, 21 December 2008 (UTC)

need some help from other early psychosis converts

Earlypsychosis (talk) 08:23, 4 January 2009 (UTC)

Then there will be more references, especially in the ^{[citation needed]} places, I will start a stub in Russian Wikipedia. And you could use the diberri's tool for reference formatting, comes out very useful: Wikipedia template filling. Best regards, --CopperKettle 03:21, 10 January 2009 (UTC)

Cause

Before one can discuss prevention of psychosis one has to come to some conclusions about the cause. Am in the middle of reading an interested book on the subject. The stuff out of world war two were they found that 50% of troops would have a mental break down after a month of combat and nearly all would have a break down after 6 months of active combat. Environmental causes however are out of vogue and currently neurotransmitters and PET scans are the in thing.--Doc James (talk · contribs · email) 23:44, 2 February 2009 (UTC)

I disagree. No one has yet identified a cause, but we are well on the way to preventing psychosis - and reducing further epsiodes (both primary and secondary prevention). Psychosis is a vague construct, with multiple causes, with different individual and cultural expressions (see http://www.understandingpsychosis.com]). The continued search for that one cause (usually funded by drug companies) has limited our understanding of this condition. Its no longer vogue to think of either environmental or biological causes - an abstract dichotomy in our world of continiums.

To date we know that family history, drug use (especially THC in early adolescence), early trauma, inner city living, ethnicity and many other factors contribute to the severity of the condition. The most alarming is that delays to treatment impact on the severity of the condition. Many of these delays are a function of how the mental health system has been structured. Earlypsychosis (talk) 07:44, 8 February 2009 (UTC)

POV Check

I have not thoroughly reviewed this but the lede statements "a new paradigm for psychiatry[citation needed]" and "has developed rapidly as an established clinical model" seem contradicted by the Cochrane review cited further in the article. Xasodfuih (talk) 17:20, 15 February 2009 (UTC)

thanks for your comments and additions I will work on this, but any systematic review of the literature will show a surge of articles on the topic within the last 10 years, has result in the reform of services in the UK (huge increase in established teams and clients served), supported by leading academic institutions and researchs - (IOP in London, Thomas McGlashan in Yale), new journals started (Early intervention), international association (IEPA) and a good series of conferences since 1996. The term new paradigm for psychiatry is a direct quote from conference in Staford upon Avon in 1997 by one the keynote speakers - maybe Paul Bebbington. I will check. —Preceding unsigned comment added by Earlypsychosis (talk • contribs) 19:13, 15 February 2009 (UTC)

and the WHO Early Psychosis Declaration 2004 Earlypsychosis (talk) 19:18, 15 February 2009 (UTC)

http://www.esi-topics.com/schizophrenia/interviews/Dr-Richard-Wyatt.html Earlypsychosis (talk) 12:26, 16 February 2009 (UTC)

how can I reference from a leading pscyhiatrist on a website

This is now probably one of the hottest areas of research currently ongoing in psychotic disorders. [1] Jeffrey A. Lieberman Earlypsychosis (talk) 08:25, 18 February 2009 (UTC)

I'm not sure if I understand your question correctly. If you want to know what to write when editing the article so the website will show up as a source, try something like this:

<ref>{{cite web| url=http://archive.sciencewatch.com/sept-oct2007/sw_sept-oct2007_page3.htm| title=Columbia’s Jeffrey A. Lieberman: A Mind to Prevent Schizophrenia| publisher=ScienceWatch| date=September / October 2007| accessdate=2009-18-02}}</ref>

Hope that helps. -Lilac Soul ^{(talk • contribs • count)} 08:35, 18 February 2009 (UTC)

wondering whether a link to this website is sufficient to proved that early psychosis has developed rapidly as a clinical model. Currently on [2] to see if there has been an increasing trend of growing literature on the topic and how much the topic has impacted, but cannt really find anything apart from Yung and McGorry writing high impact papers, along with the Robinson 1999 paper. Earlypsychosis (talk) 09:01, 18 February 2009 (UTC)

"Hottest research area" is one thing, "an established clinical model" quite another (vision statements from WHO notwithstanding). It's perfectly okay to cite some key opinion leaders (although preferably more than one) to support the former claim. For the latter, you'd need some evidence that it works, or at least that it's widely implemented even though it doesn't work (which would be quite in the face of evidence-based medicine). "A proposed but empirically unconfirmed clinical model" seems more appropriate given the current evidence. Xasodfuih (talk) 22:19, 18 February 2009 (UTC)

evidence added as cited in the NICE guidelines for schizophrenia (March 2009)

• Craig TK, Garety P, Power P; et al. (2004). "The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis". BMJ. 329 (7474): 1067. doi:10.1136/bmj.38246.594873.7C. PMC 526115. PMID 15485934. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Petersen L, Nordentoft M, Jeppesen P; et al. (2005). "Improving 1-year outcome in first-episode psychosis: OPUS trial". Br J Psychiatry Suppl. 48: s98–103. doi:10.1192/bjp.187.48.s98. PMID 16055817. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Grawe RW, Falloon IR, Widen JH, Skogvoll E (2006). "Two years of continued early treatment for recent-onset schizophrenia: a randomised controlled study". Acta Psychiatr Scand. 114 (5): 328–36. doi:10.1111/j.1600-0447.2006.00799.x. PMID 17022792. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

No longer empirically unconfirmed clinical model Earlypsychosis (talk) 07:25, 1 May 2009 (UTC)

References

the article has 20 references as at 17th Feb.Earlypsychosis (talk) 11:22, 16 February 2009 (UTC)

I concur, so I've removed the template. If anyone finds anything that needs sourcing, please consider using the {{fact}} template in the appropriate places. -Lilac Soul ^{(talk • contribs • count)} 11:37, 16 February 2009 (UTC)

I had added it because of the lack of citations in the lede. Xasodfuih (talk) 21:58, 18 February 2009 (UTC)

Links

Just some critical material that I've stumbled upon. When I'm finished translating Autism, I'll take a look at this..

• Prevention Of Psychosis Study, Ethical or Not? - Furious Seasons. --CopperKettle 15:41, 23 February 2009 (UTC)

this is not a good representation of the early psychosis model, as the material focuses on the current RCTs on pharmacological treatment of pre-psychotic (or prodrome or at risk mental state) patients - and it is easy for all (including those working in the field McGorry PD, Yung A, Phillips L (2001). "Ethics and early intervention in psychosis: keeping up the pace and staying in step". Schizophr. Res. 51 (1): 17–29. PMID 11479062. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) to see why there are ethical problems with that!. This is a very small research component of the model.

The early psychosis approach is an intervention for those already psychotic and aims to change the course of the condition...ie a secondary prevention approach to prevent repeated episodes of psychosis (or schizophrenia). We know that the typical pathway for those in the early stages of psychosis is difficult, often involving many years of having the symptoms (duration of untreated psychosis), many help seeking attempts, and a continued decline in social and vocational functioning.(see Lincoln C, Harrigan S, McGorry PD (1998). "Understanding the topography of the early psychosis pathways. An opportunity to reduce delays in treatment". Br J Psychiatry Suppl. 172 (33): 21–5. PMID 9764122.{{cite journal}}: CS1 maint: multiple names: authors list (link))

When clinical teams do offer services for pre psychotic clients, the approach is often one of an "active watching brief", psychoeducation, and psychological interventions for young adults (see Gleeson J, Larsen TK, McGorry P (2003). "Psychological treatment in pre- and early psychosis". J Am Acad Psychoanal Dyn Psychiatry. 31 (1): 229–45. PMID 12722897.{{cite journal}}: CS1 maint: multiple names: authors list (link))

the early psychosis article lacks some more general overview articles and I am working on adding them soon. Pat MCgorry is the credited with the original idea and his writing is good. The best and latest one is McGorry PD, Killackey E, Yung A (2008). "Early intervention in psychosis: concepts, evidence and future directions". World Psychiatry. 7 (3): 148–56. PMC 2559918. PMID 18836582. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) and Killackey E, Yung AR, McGorry PD (2007). "Early psychosis: where we've been, where we still have to go". Epidemiol Psichiatr Soc. 16 (2): 102–8. PMID 17619539.{{cite journal}}: CS1 maint: multiple names: authors list (link)

OK, thanks for the clarification and the sources! --CopperKettle 05:32, 25 February 2009 (UTC)

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