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Early Intervention Backed for Early-phase Psychosis

JAMA Psychiatry; ePub 2018 May 2; Correll, et al

In early-phase psychosis, early intervention services (EIS) are superior to treatment as usual (TAU) across all meta-analyzable outcomes, according to a recent meta-analysis and meta-regression. These results support the need for funding and use of EIS in patients with early-phase psychosis. Researchers conducted a systematic literature search without language restrictions through June 6, 2017, seeking randomized trials comparing EIS vs TAU in first-episode psychosis or early-phase schizophrenia spectrum disorders. They found:

  • Across 10 randomized clinical trials (mean [SD] trial duration, 16.2 [7.4] months; range, 9-24 months) among 2,176 patients (mean [SD] age, 27.5 [4.6] years; 1,355 [62.3%] male), EIS was associated with better outcomes than TAU at the end of treatment for all 13 meta-analyzable outcomes.
  • These outcomes included the following: all-cause treatment discontinuation, at least 1 psychiatric hospitalization, involvement in school or work, total symptom severity, positive symptom severity, and negative symptom severity.
  • 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).

Citation:

Correll CU, Galling B, Pawar A, et al. Comparison of early intervention services vs treatment as usual for early-phase psychosis. A systematic review, meta-analysis, and meta-regression. [Published online ahead of print May 2, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2018.0623.

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