![]() 1, 9 Several research programs for patients with early-phase schizophrenia spectrum disorders yielded promising results for early intervention services (EIS) that are specifically designed to meet the needs of patients with early-phase psychosis. 8 Because people with early-phase schizophrenia spectrum disorders have not endured many years of illness and functional decline and generally respond better to treatment, there has been an increasing focus on early identification and optimized treatment. Furthermore, individuals with schizophrenia die on average 15 to 20 years prematurely, 5 - 7 with an increasing mortality gap. The results of a 2013 meta-analysis 4 suggested that, during the last 5 decades, recovery from schizophrenia remained low (median, 13.5%), without significantly improving. ![]() 1 Schizophrenia is among the 10 most debilitating disorders in the United States, 2 being associated with high disability 3 and enormous personal and societal cost. Outcomes in people with schizophrenia spectrum disorders have remained suboptimal. These results support the need for funding and use of EIS in patients with early-phase psychosis. Superiority of EIS regarding all outcomes was evident at 6, 9 to 12, and 18 to 24 months of treatment (except for general symptom severity and depressive symptom severity at 18-24 months).Ĭonclusions and Relevance In early-phase psychosis, EIS are superior to TAU across all meta-analyzable outcomes. Results Across 10 randomized clinical trials (mean trial duration, 16.2 months range, 9-24 months) among 2176 patients (mean age, 27.5 years 1355 male), EIS was associated with better outcomes than TAU at the end of treatment for all 13 meta-analyzable outcomes. Main Outcomes and Measures The coprimary outcomes were all-cause treatment discontinuation and at least 1 psychiatric hospitalization during the treatment period. Three independent investigators extracted data for a random-effects meta-analysis and prespecified subgroup and meta-regression analyses. Study Selection Randomized trials comparing EIS vs TAU in first-episode psychosis or early-phase schizophrenia spectrum disorders.ĭata Extraction and Synthesis This systematic review was conducted according to PRISMA guidelines. Objective To compare early intervention services (EIS) with treatment as usual (TAU) for early-phase psychosis.ĭata Sources Systematic literature search of PubMed, PsycINFO, EMBASE, and without language restrictions through June 6, 2017. Importance The value of early intervention in psychosis and allocation of public resources has long been debated because outcomes in people with schizophrenia spectrum disorders have remained suboptimal. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Forest Plot: Involvement in School or Work Forest Plot: Depressive Symptom ImprovementĮFigure 16. Forest Plot: General Symptom ImprovementĮFigure 11. Forest Plot: Negative Symptom ImprovementĮFigure 10. Forest Plot: Positive Symptom ImprovementĮFigure 9. Forest Plot: Total Symptom ImprovementĮFigure 8. Forest Plot: Mean Number of Hospital AdmissionsĮFigure 6. Funnel Plot: All-Cause Treatment DiscontinuationĮFigure 5. Forest Plot: All-Cause Treatment DiscontinuationĮFigure 2. Sensitivity Subgroup Analysis (Excluding Two Studies From Mexico)ĮFigure 1. Key Secondary: Overall Results, Subgroup Analyses, and Meta-RegressionĮTable 8. ![]() Co-Primary Outcomes: Overall Results, Subgroup Analyses, and Meta-RegressionĮTable 7. Detailed Information on EIS Interventions and Standard Treatment ComparatorĮTable 5. Study, Patient, and Treatment CharacteristicsĮTable 3. Subgroup and Meta-Regression AnalysesĮMethods 5. Overview Outcome Definitions and ScalesĮMethods 4.
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