Clinical Edge

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Team-Based Care For First-Episode Psychosis

NAVIGATE method compared to community care

Comprehensive care for first-episode psychosis can improve outcomes, according to a 21 state study that evaluated the impact of NAVIGATE, a comprehensive, multidisciplinary, team-based treatment approach. Improvement was best in those with shorter duration of untreated psychosis.

404 individuals at 34 clinics were randomly assigned to NAVIGATE or community care. Patients had schizophrenia and related disorders for 6 months or less, and averaged 23 years of age. Diagnosis, duration of untreated psychosis, and clinical outcomes were assessed via live, two-way video by masked evaluators.

The 223 patients who received NAVIGATE care stayed in treatment longer, had better quality of life and psychopathology, and performed better at work and school, vs the 181 patients who received community care.

NAVIGATE participants whose duration of untreated psychosis was less than 74 weeks had greater improvement in quality of life and psychopathology compared with those with longer duration of untreated psychosis and those in community care.

Citation: Kane J, Robinson D, Schooler N, et al. Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. Am J Psychiatry. 2015; October 21, 2015.