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Effectiveness and optimal duration of early intervention treatment in adult-onset psychosis: a randomized clinical trial.
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- المؤلفون: Hui, Christy Lai Ming1; Wong, Andreas Kar Hin1; Ho, Elise Chun Ning1; Lam, Bertha Sze Ting1; Hui, Priscilla Wing Man1; Tao, Tiffany Junchen1; Chang, Wing Chung1,2; Chan, Sherry Kit Wa1,2; Lee, Edwin Ho Ming1; Suen, Yi Nam1; Lam, May Mei Ling1; Chiu, Cindy Pui Yu1; Li, Frendi Wing Sai3; Leung, Kwok Fai4; McGhee, Sarah M.5; Law, Chi Wing6; Chung, Dicky Wai Sau7; Yeung, Wai Song8; Yiu, Michael Gar Chung9; Pang, Edwin Pui Fai9
- المصدر:
Psychological Medicine. Apr2023, Vol. 53 Issue 6, p2339-2351. 13p.
- الموضوع:
- معلومة اضافية
- نبذة مختصرة :
Background: Contrasting the well-described effects of early intervention (EI) services for youth-onset psychosis, the potential benefits of the intervention for adult-onset psychosis are uncertain. This paper aims to examine the effectiveness of EI on functioning and symptomatic improvement in adult-onset psychosis, and the optimal duration of the intervention. Methods: 360 psychosis patients aged 26–55 years were randomized to receive either standard care (SC, n = 120), or case management for two (2-year EI, n = 120) or 4 years (4-year EI, n = 120) in a 4-year rater-masked, parallel-group, superiority, randomized controlled trial of treatment effectiveness (Clinicaltrials.gov: NCT00919620). Primary (i.e. social and occupational functioning) and secondary outcomes (i.e. positive and negative symptoms, and quality of life) were assessed at baseline, 6-month, and yearly for 4 years. Results: Compared with SC, patients with 4-year EI had better Role Functioning Scale (RFS) immediate [interaction estimate = 0.008, 95% confidence interval (CI) = 0.001–0.014, p = 0.02] and extended social network (interaction estimate = 0.011, 95% CI = 0.004–0.018, p = 0.003) scores. Specifically, these improvements were observed in the first 2 years. Compared with the 2-year EI group, the 4-year EI group had better RFS total (p = 0.01), immediate (p = 0.01), and extended social network (p = 0.05) scores at the fourth year. Meanwhile, the 4-year (p = 0.02) and 2-year EI (p = 0.004) group had less severe symptoms than the SC group at the first year. Conclusions: Specialized EI treatment for psychosis patients aged 26–55 should be provided for at least the initial 2 years of illness. Further treatment up to 4 years confers little benefits in this age range over the course of the study. [ABSTRACT FROM AUTHOR]
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