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Intervention Centre (intervention + centre)
Selected AbstractsAssessing prolonged recovery in first-episode psychosisACTA PSYCHIATRICA SCANDINAVICA, Issue 2002L. Wong The Early Psychosis Prevention and Intervention Centre (EPPIC) is a comprehensive, specialized treatment service for individuals residing in the western metropolitan region of Melbourne who are experiencing their first psychotic episode. A subprogramme of EPPIC, the Treatment Resistance Early Assessment Team (TREAT), has been developing a framework for the management of individuals experiencing ,prolonged recovery' in early psychosis. TREAT is a consultation team that provides technical assistance to clinicians within EPPIC, comprising senior clinicians with expertise in the biopsychosocial treatment of early psychosis and persisting positive and negative symptoms. A system has recently been set up within the TREAT framework to routinely assess clinical and functional outcomes of these clients using standardized instruments. Case managers are trained to conduct assessments at multiple timepoints over the duration of their clients' treatment at EPPIC. A summary will be presented on the current sample (n=15) and examples of clinician and client feedback reports will be illustrated. Discussion is also provided on the development of training, procedures and materials to enhance integration of clinician and client outcome measures into routine clinical practice. [source] The First-Episode Psychosis Outcome Study: premorbid and baseline characteristics of an epidemiological cohort of 661 first-episode psychosis patientsEARLY INTERVENTION IN PSYCHIATRY, Issue 2 2007Philippe Conus Abstract Aims:, Studies conducted in first-episode psychosis (FEP) samples avoid many biases. However, very few studies are based on epidemiological cohorts treated in specialized FEP services. The aim of this file audit study was to examine premorbid and baseline characteristics of a large epidemiological sample of FEP. Methods:, File audit study of all patients admitted to the Early Psychosis Prevention and Intervention Centre between 1998 and 2000 using a specialized questionnaire. Results:, There were 661 patient files included in the study. Premorbid evaluation revealed high rates of substance use disorder (74.1%), history of psychiatric disorder (47.5%), past traumatic events (82.7%) suicide attempts (14.3%) and family history of psychiatric illness (55.6%). Baseline characteristics revealed high intensity of illness (mean CGI 5.5), high prevalence of lack of insight (62%) and high rate of comorbidity (70%). Conclusion:, High rates of traumatic events or episodes of mental illness before treatment for FEP must be considered when designing treatment approaches because a too narrow focus on positive psychotic symptoms will inevitably lead to incomplete treatment. Additionally, early intervention programmes need sufficient range of resources to address the multiple challenges presented by FEP patients such as high severity of illness, comorbidities and functional impairment. Finally, observation of an important degree of functional impairment despite short duration of untreated psychosis suggests that while early detection of FEP is a necessary step in early intervention, it may not be sufficient to improve functional recovery in psychosis and that efforts aimed at identifying people during the prodromal phase of psychotic disorders should be pursued. [source] Pretreatment and outcome correlates of past sexual and physical trauma in 118 bipolar I disorder patients with a first episode of psychotic maniaBIPOLAR DISORDERS, Issue 3 2010Philippe Conus Conus P, Cotton S, Schimmelmann BG, Berk M, Daglas R, McGorry PD, Lambert M. Pretreatment and outcome correlates of past sexual and physical trauma in 118 bipolar I disorder patients with a first episode of psychotic mania. Bipolar Disord 2010: 12: 244,252. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S. Objectives:, To assess the prevalence and correlates of childhood and adolescent sexual and/or physical abuse (SPA) in bipolar I disorder (BDI) patients treated for a first episode of psychotic mania. Methods:, The Early Psychosis Prevention and Intervention Centre admitted 786 first-episode psychosis patients between 1998 and 2000. Data were collected from patients' files using a standardized questionnaire. A total of 704 files were available; 43 were excluded because of a nonpsychotic diagnosis at endpoint and 3 due to missing data regarding past stressful events. Among 658 patients with available data, 118 received a final diagnosis of BDI and were entered in this study. Results:, A total of 80% of patients had been exposed to stressful life events during childhood and adolescence and 24.9% to SPA; in particular, 29.8% of female patients had been exposed to sexual abuse. Patients who were exposed to SPA had poorer premorbid functioning, higher rates of forensic history, were less likely to live with family during treatment period, and were more likely to disengage from treatment. Conclusions:, SPA is highly prevalent in BDI patients presenting with a first episode of psychotic mania; exposed patients have lower premorbid functional levels and poorer engagement with treatment. The context in which such traumas occur must be explored in order to determine whether early intervention strategies may contribute to diminish their prevalence. Specific psychological interventions must also be developed. [source] Symptomatic and functional outcome 12 months after a first episode of psychotic mania: barriers to recovery in a catchment area sampleBIPOLAR DISORDERS, Issue 3 2006Philippe Conus Objective:, Recent studies have shown that outcome in mania is worse than previously thought. Such studies have been conducted in selected samples with restrictive measures of outcome. We aimed to explore outcome and its predictors in a catchment area sample of first-episode psychotic mania of DSM-III-R bipolar I disorder. Methods:, Prospective 6 and 12 months follow-up was conducted with 87 DSM-III-R first-episode psychotic mania patients admitted to Early Psychosis Prevention and Intervention Centre between 1989 and 1997. Syndromic and symptomatic outcome were determined with the Brief Psychiatric Rating Scale; functional outcome with the Quality of Life Scale and Premorbid Adjustment Scale subitems. Results:, Symptomatic outcome was assessed in 67 patients at 6 months and 61 patients at 12 months, and functional outcome in 56 patients at 6 months and 49 patients at 12 months. Logistic regressions were conducted on 46 and 43 patients, respectively, to explore predictors of outcome. While 90% of patients achieved syndromic recovery at 6 and 12 months, 40% had not recovered symptomatically at 6 and 12 months, still presenting with anxiety or depression. A total of 66% of patients at 6 months and 61% of patients at 12 months failed to return to previous level of functioning. Age at intake, family history of affective disorder, illicit drug use and functional recovery at 6 months predicted functional outcome at 12 months. Conclusions:, This study confirms poor symptomatic and functional outcome after first-episode psychotic mania. It suggests possible usefulness of early intervention strategies in bipolar disorders and need for developing specific interventions addressing anxiety, depression and substance abuse comorbidity. [source] Randomized controlled multicentre trial of cognitive behaviour therapy in the early initial prodromal state: effects on social adjustment post treatmentEARLY INTERVENTION IN PSYCHIATRY, Issue 1 2007Andreas Bechdolf Abstract Aim:, Improvement of social adjustment is a major aim of indicated prevention in young people at risk of developing psychosis. The present study explores the effect of specific cognitive behaviour therapy (CBT) as compared with supportive counselling (SC) on social adjustment in people in a potential early initial prodromal state of psychosis (EIPS) primarily defined by self-experienced cognitive thought and perception deficits (basic symptoms). Methods:, A total of 128 help-seeking outpatients in the EIPS were randomized to receive either specific CBT or SC for 12 months. Social adjustment was assessed with the Social Adjustment Scale II (SAS II) at baseline, time of transition or post treatment Results:, From 113 patients, who completed the SAS II at intake, 67 (59.3%) completed the SAS assessments at time of transition or post treatment. Both specific CBT and SC resulted in improvements in scales of SAS II, with no significant between-group differences post treatment. Conclusions:, Although treatment in specially designed early detection and intervention centres improves functioning of people in the EIPS, specific CBT was not superior to SC. One could hypothesize that additional vocational rehabilitation, case management and involvement of multidisciplinary teams are needed to further improve short-term outcome of specific interventions on this dimension. [source] Case management educational intervention with public health nurses: cluster randomized controlled trialJOURNAL OF ADVANCED NURSING, Issue 10 2010Wen-I. liu w.-i., edwards h. & courtney m. (2010) Case management educational intervention with public health nurses: cluster randomized controlled trial. Journal of Advanced Nursing,66(10), 2234,2244. Abstract Aim., This paper is a report of a study conducted to determine the effectiveness of a community case management collaborative education intervention in terms of satisfaction, learning and performance among public health nurses. Background., Previous evaluation studies of case management continuing professional education often failed to demonstrate effectiveness across a range of outcomes and had methodological weaknesses such as small convenience samples and lack of control groups. Method., A cluster randomized controlled trial was conducted between September 2005 and February 2006. Ten health centre clusters (five control, five intervention) recruited 163 public health nurses in Taiwan to the trial. After pre-tests for baseline measurements, public health nurses in intervention centres received an educational intervention of four half-day workshops. Post-tests for both groups were conducted after the intervention. Two-way repeated measures analysis of variance was performed to evaluate the effect of the intervention on target outcomes. Results., A total of 161 participants completed the pre- and post-intervention measurements. This was almost a 99% response rate. Results revealed that 97% of those in the experimental group were satisfied with the programme. There were statistically significant differences between the two groups in knowledge (P = 0·001), confidence in case management skills (P = 0·001), preparedness for case manager role activities (P = 0·001), self-reported frequency in using skills (P = 0·001) and role activities (P = 0·004). Conclusion., Collaboration between academic and clinical nurses is an effective strategy to prepare nurses for rapidly changing roles. [source] Effects of a booster seat education and distribution program in child care centers on child restraint use among children aged 4 to 8 yearsCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2009Richard ReadingArticle first published online: 5 JUN 200 Effects of a booster seat education and distribution program in child care centers on child restraint use among children aged 4 to 8 years . ThoresonS., MyersL., GossC. & DiGuiseppiC. ( 2009 ) Archives of Pediatrics & Adolescent Medicine , 163 , 261 , 267 . Objective To compare child care centre-based booster seat education and distribution with no intervention when implemented immediately after booster seat legislation. Design Cluster randomized controlled trial. Setting Thirty-nine urban child care centres. Participants A total of 854 parents and 1010 children aged 4 to 8 years in vehicles leaving centres. Intervention We trained 168 staff members at 20 centres to give parents and children messages promoting booster seats and supplied lesson plans, children's activities, and free booster seats. Main outcome measures Observed booster seat use, ,good practice' restraint use and legal restraint use. Results Parents at intervention centres were more likely to report receiving restraint information from the centre [adjusted odds ratio (AOR), 4.06; 95% confidence interval (CI), 2.48,6.67], speaking with staff about booster seats (AOR, 3.95; 95% CI, 2.26,6.88) and using fit to decide when to move children into seat belts (AOR, 3.39; 95% CI, 1.91,5.99). Groups did not differ in proportions using booster seats (44% vs. 43%; AOR, 1.03; 95% CI, 0.62,1.73), good practice (42% vs. 41%; AOR, 1.11; 95% CI, 0.70,1.74) or legal restraints (65% vs. 65%; AOR, 0.79; 95% CI, 0.48,1.31). Results were similar for children aged 4 to 5 and 6 to 8 years. All outcomes were significantly less likely among children riding in pickup trucks or with Hispanic or black drivers. Conclusions The intervention increased parents' receipt of information from centre staff and knowledge about booster seats but not booster seat use. Research is needed to identify methods and messages that will empower centre providers to promote booster seats effectively and reach high-risk populations. [source] | ||||||||||