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Early Intervention Strategies (early + intervention_strategy)
Selected AbstractsAnger, hostility, and aggression among Iraq and Afghanistan war veterans reporting PTSD and subthreshold PTSDJOURNAL OF TRAUMATIC STRESS, Issue 6 2007Matthew Jakupcak Iraq and Afghanistan War veterans were grouped by level of posttraumatic stress disorder (PTSD) symptomatology and compared on self-report measures of trait anger, hostility, and aggression. Veterans who screened positive for PTSD reported significantly greater anger and hostility than those in the subthreshold-PTSD and non-PTSD groups. Veterans in the subthreshold-PTSD group reported significantly greater anger and hostility than those in the non-PTSD group. The PTSD and subthreshold-PTSD groups did not differ with respect to aggression, though both groups were significantly more likely to have endorsed aggression than the non-PTSD group. These findings suggest that providers should screen for anger and aggression among Iraq and Afghanistan War veterans who exhibit symptoms of PTSD and incorporate relevant anger treatments into early intervention strategies. [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] Early intervention with difficult to engage, ,high-risk' youth: evaluating an intensive outreach approach in youth mental healthEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2008Carsten Schley Abstract Background: Although intensive outreach (IO) models such as assertive community treatment and intensive case management have a strong evidence base in adult psychiatry, their effectiveness in the early intervention sector is unknown. Aim: To explore client characteristics and treatment effects in a group of difficult to engage, ,high-risk' young people, seen by the Intensive Mobile Youth Outreach Service (IMYOS, ORYGEN Youth Heath) in Western Metropolitan Melbourne. Methods: The clinical files of 47 clients were audited, targeting demographic and treatment outcome data prior to and during IMYOS involvement. Results: Clients typically presented with traumatic childhoods, disrupted education, repeated treatment dropout, poor mental health and ,high-risk' behaviours. Results showed a significant reduction in risk to self and others between referral and discharge, and significantly lower admissions rates and inpatient days compared with the 9 months prior to referral. Conclusions: IO might be an effective early intervention strategy to minimize risk of harm and decrease hospitalization in young people. However, conclusions are provisional as there was no control group included in this study. Further study is required, perhaps with a waiting list control. [source] | ||||||||||