Early Intervention in Psychiatry最新文献

{"title":"Exposure to Antipsychotics in Youths at Clinical High Risk for Psychosis: Low VS High Doses and Their Relevance for Clinical Outcomes","authors":"Lorenzo Pelizza,&nbsp;Emanuela Leuci,&nbsp;Emanuela Quattrone,&nbsp;Alessandro Di Lisi,&nbsp;Derna Palmisano,&nbsp;Simona Pupo,&nbsp;Giuseppina Paulillo,&nbsp;Clara Pellegrini,&nbsp;Pietro Pellegrini,&nbsp;Marco Menchetti","doi":"10.1111/eip.70167","DOIUrl":"10.1111/eip.70167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Predicting prognosis in subjects at Clinical High Risk for Psychosis (CHR-P) is still challenging. In particular, there are some disregarded factors such as ongoing Antipsychotic (AP) treatment that potentially induce method errors and research bias. The specific purpose of this examination was to examine whether baseline AP exposure and its dosage identify different CHR-P groups with diverse prognostic outcomes across 2 years of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>182 CHR-P participants (93 AP-naïve, 60 low-dose AP, 33 high-dose AP) were assessed for a broad range of clinical outcomes, including psychosis transition, clinical and functional remission (measured with the Positive and Negative Syndrome Scale and the Social and Occupational Functioning Assessment Scale). Inter-group comparisons were explored using Kaplan–Meier survival analyses and binary logistic regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across the follow-up, the high-dose AP subgroup showed an increased risk of new hospitalisation and poorer functional remission compared to AP-naïve participants. Conversely, the low-dose AP subsample had a higher 2-year rate of symptomatic remission and a lower 2-year rate of self-harm behaviour compared to AP-naïve one.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>APs at low doses are associated with better symptomatic outcomes, whilst APs at high doses correlate to poorer socio-occupational functioning. Promoting personalised treatment strategies and facilitating the identification of specific CHR-P subgroups with divergent prognoses are recommended in clinical practise.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Attachment Style and Symptomatic, Social, and Personal Recovery: A Comparison Between Male and Female Patients Remitted From Their First-Episode Psychosis","authors":"Justine de With,&nbsp;Kit van der Eng,&nbsp;Iris E. Sommer,&nbsp;Marieke van der Pluijm,&nbsp;Frederike Schirmbeck,&nbsp;Lieuwe de Haan,&nbsp;HAMLETT and OPHELIA Consortium Investigators","doi":"10.1111/eip.70152","DOIUrl":"10.1111/eip.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sex differences in recovery outcomes for psychosis have been observed. In patients with psychosis, rates of insecure attachment are significantly higher in patients of both sexes compared to the general population and have been linked to several aspects of recovery. However, the possible differential effect of attachment style on recovery between men and women with psychosis is currently unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was performed in a subsample of 299 patients remitted from their first-episode psychosis (FEP) within the Handling Antipsychotic Medication Long-term Evaluation of Targeted Treatment (HAMLETT) study. First, <i>t</i>-tests were used to explore sex differences in baseline attachment style. Second, stepwise regression analyses were used to examine the association between baseline attachment style and symptomatic, social and personal recovery at three and 48 months follow-up, and the possible moderation effect of sex on these associations. Third, stepwise regression analyses were repeated with longitudinal change in symptomatic, social and personal recovery between three and 48 months follow-up as outcome measure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Male and female patients did not differ in baseline attachment style. Baseline attachment style was associated with recovery outcome at 3-months follow-up, whilst sex did not moderate this relationship. Baseline attachment style did not predict recovery outcome at 48-months follow-up, nor change in recovery outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that attachment style is an important predictor of short-term recovery outcome in patients with FEP, whilst sex differences do not appear to significantly impact this relationship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12985686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Self-Stigma in the First Year of First-Episode Psychosis","authors":"Júlia Rolduà-Ros,&nbsp;Regina Vila-Badia,&nbsp;Manuel Abella,&nbsp;Alícia Colomer-Salvans,&nbsp;Clara Serra-Arumí,&nbsp;Ariadna Corbella-Sotil,&nbsp;Arnau Carmona,&nbsp;Elena Rubio-Abadal,&nbsp;Del Cacho N,&nbsp;Anna Butjosa,&nbsp;Antonio R Moreno-Poyato,&nbsp;Teresa Lluch-Canut,&nbsp;Tor J,&nbsp;Beltrán Jiménez-Fernández,&nbsp;PROFEP Group,&nbsp;Judith Usall","doi":"10.1111/eip.70149","DOIUrl":"10.1111/eip.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Self-stigma negatively impacts recovery, treatment adherence and functioning in patients with first-episode psychosis (FEP). Despite its clinical importance, little is known about which early clinical factors are associated with increased self-stigma during the first year after onset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To study sex differences in self-stigma in a FEP sample. Additionally, examine which demographic, clinical and psychosocial variables predict self-stigma in people with a FEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-two individuals (26 females; 46 males) with a FEP participated in this descriptive, cross-sectional study. All participants were recruited from the Mental Health care sector of Parc Sanitari Sant Joan de Déu and the Child and Maternal Hospital of Sant Joan de Déu and Hospital Germans Trias i Pujol in the city of Barcelona and its metropolitan area. The Internalised Stigma of Mental Health Inventory (ISMI) was administered to assess self-stigma. This scale is divided into five subscales: alienation, stereotype endorsement, perceived or experienced discrimination, social isolation and stigma resistance. In addition to the ISMI, psychotic symptoms (PANSS; Emsley five-factor), functioning (PSP), duration of untreated psychosis (DUP), diagnosis and cannabis (THC) use were also recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No sex differences were found in any self-stigma subscale, nor in the total score. A longer DUP, a higher consumption of THC and greater anxiety/depression Emsley factor emerged as the strongest predictors of higher self-stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The variables most strongly associated with self-stigma are DUP, THC use and the anxiety/depression Emsley factor. Early interventions focused on these aspects could significantly enhance the self-concept of individuals with FEP and reduce the long-term negative impact of self-stigma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of the Impact of Admission to a Psychiatric Hospital on Quality of Life in Patients With a First Episode Psychosis","authors":"Clare Graham,&nbsp;Gráinne Murphy,&nbsp;Sharon Chi Tak Lee,&nbsp;Mary Clarke,&nbsp;Keith Gaynor","doi":"10.1111/eip.70166","DOIUrl":"10.1111/eip.70166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Quality of Life (QoL) is an important outcome measure for people with a first episode psychosis (FEP). Despite high numbers of patients being admitted to psychiatric hospitals following an FEP, the impact of hospital admission on outcome measures such as QoL is under-investigated. This study aimed to systematically review evidence of the impact of hospital admission on QoL in patients with an FEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted in line with the PRISMA Guidelines. PsychINFO, Medline, CINAHL, and EMBASE were searched from 2000 to 2022, examining the impact of QoL for people with an FEP following a hospital admission. Quantitative, qualitative, and mixed methods studies were included in the search. Study quality was assessed using the Mixed Methods Assessment Tool. Data was analysed using narrative synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven hundred and eight two abstracts were found. Fifty-three full texts were reviewed. Data was extracted for eight articles. Across the eight studies, four discrete QoL measures were employed. Results showed that QoL scores were consistent over time, with little statistical change from baseline to follow-up. Across studies, participants reported low average QoL scores. Across studies, information on the treatment components and duration of hospital admission were scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is a relative paucity of studies that have examined QoL in relation to hospital admission. QoL scores remained consistent over time, suggesting that QoL is relatively well preserved at the first episode. Further research is needed on the impact of inpatient-based interventions in FEP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Suicidal Ideation, Personality Traits, and Stress Hormones in Final-Year Medical Students","authors":"Feyza Nur Ozbahar,&nbsp;Hamit Sirri Keten,&nbsp;Seyithan Taysi","doi":"10.1111/eip.70165","DOIUrl":"10.1111/eip.70165","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to investigate the relationship between suicide risk, personality traits, and stress-related hormone levels among final-year medical students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted between October 2022 and June 2023 with the senior students of Gaziantep University Faculty of Medicine. Participants responded to the Suicide Probability Scale (SPS) and the Eysenck Personality Questionnaire, along with a questionnaire inquiring sociodemographic characteristics. Venous blood samples were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One of the 80 participants (1.3%) reported previous attempted suicide and 16 (20.0%) reported suicidal thoughts. The mean SPS score was significantly higher in patients with psychiatric disorders (<i>p</i> = 0.006) and suicidal ideation (<i>p</i> = 0.001). Extraversion score (<i>p</i> = 0.017) was lower and neuroticism score (<i>p</i> = 0.002) was higher in participants with suicidal ideation. The adrenocorticotropic hormone (ACTH), prolactin, cortisol, atrial natriuretic peptide, cholecystokinin, and growth hormone levels were similar in those with and without suicidal ideation (<i>p</i> &gt; 0.05). There was a positive, weak correlation between ACTH level and SPS score (<i>r</i> = 0.228, <i>p</i> = 0.042).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study, 1 out of every 5 interns had suicidal thoughts. The presence of psychiatric disorders and suicidal ideation was associated with an increase in the SPS score. The participants with suicidal ideation had higher neuroticism scores and lower extroversion scores. Although ACTH levels did not significantly differ between groups with and without suicidal ideation, a weak positive correlation with SPS scores was identified. Given that medical students are considered a group at risk of suicide, they should be monitored for suicide during their education and intervened with psychiatric, social, and medical support mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enabling Successful Transitions From Hospital Back to Campus: An Example of an Innovative Navigator Service for Post-Secondary Students With Acute Mental Health Needs","authors":"Kristin Cleverley,&nbsp;Sarah Brennenstuhl,&nbsp;Andrea J. Levinson,&nbsp;Chris Bartha,&nbsp;Carole-Anne Chiasson,&nbsp;Lexi Ewing,&nbsp;Melissa Griffin,&nbsp;Rosalind McManus,&nbsp;Saba Nasir","doi":"10.1111/eip.70161","DOIUrl":"10.1111/eip.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Increasing numbers of post-secondary students (PSS) are reporting mental health problems, and service needs often outweigh campus capacity, especially among PSS with acute issues. Stronger pathways linking campus and hospital-based care have therefore been recommended. In collaboration with Canada's largest university and largest mental health and addictions hospital, a Navigation Service for PSS accessing the emergency department (ED) was launched in 2022. The service provides developmentally appropriate, trauma-informed transition support to PSS following hospital discharge to prevent recurrent crises. This paper describes service development, design, and usage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Health administrative data from the first 2 years of service use were analysed to describe the population of PSS using the ED. Factors associated with service referral, service registration and ED return after service discharge were examined using logistic regression and Fisher's exact tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six hundred and forty-nine PSS used the ED between September 2022 and August 2024 and of these 331 (51%) were referred to the service. Referrals were significantly associated with younger age, female gender, lack of provincial health insurance, and suicidal ideation; lower odds of referral were associated with substance use. ED return after discharge from the service (11.8%) was significantly lower than among those never referred (22.1%, <i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The service fills an essential gap in the landscape of student mental health services by ensuring PSS requiring hospital intervention can safely return to campus. Two years of data provide important insights regarding who is getting a referral and what can be done to improve service access.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Movements to Momentum: A Qualitative Exploration of What Global Mental Health Movements Teach us About Building Collaboration for Early Intervention in Bipolar Disorder","authors":"Melissa Hasty,&nbsp;Craig Macneil,&nbsp;Olivia Bruce,&nbsp;Cadelle Stewart,&nbsp;Emma E. Morton,&nbsp;Vani Jain,&nbsp;Lori Smith,&nbsp;Andre Rebeiz,&nbsp;Sue M. Cotton","doi":"10.1111/eip.70153","DOIUrl":"10.1111/eip.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A global movement focused on early intervention in bipolar disorder is long overdue. Given a dearth of work towards establishing coordinated efforts in this field, we aimed to explore what can be learned from successful global mental health movements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We interviewed nine experts involved in the development of global mental health movements. Reflexive thematic analysis was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven themes were generated: (1) Establishing Clear Direction is a Critical Foundation, (2) There are Pros and Cons with Consensus in Ideas and Approaches, (3) Early Visible Action Catalyses Momentum, (4) People are the Heart of a Movement, (5) Persuasive Messaging Utilising Diverse Communication Approaches is Needed, (6) Size and Structure Can Impact Effectiveness, and (7) Challenges Faced Scaling Up and Maintaining a Movement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These learnings provide a framework for building a Global Alliance for early intervention in bipolar disorder, centring early action, nurturing passionate leadership, and inclusive collaboration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing A Cognitive Screening Tool as Part of Routine Clinical Practice in Early Intervention for Psychosis Services: A Qualitative Analysis","authors":"Megan Cowman,&nbsp;Leona Ryan,&nbsp;Maeve Dwan-O'Reilly,&nbsp;Anna O'Mahony-Sinnott,&nbsp;Conor Gavin,&nbsp;Donagh O'Neill,&nbsp;Sharon McGuinness,&nbsp;Karen O'Shea,&nbsp;Vicki Foye,&nbsp;Karen O'Connor,&nbsp;Gary Donohoe","doi":"10.1111/eip.70162","DOIUrl":"10.1111/eip.70162","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cognitive difficulties are a core feature of first-episode psychosis (FEP) and a key predictor of recovery. Despite this, cognitive screening is not routine in early intervention services (EIS) and limited research is available on the barriers and facilitators to its uptake. In this study, we explored front line staff's experiences with implementing a cognitive screener as part of routine practice in Irish EIS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Qualitative interviews were conducted with 12 healthcare workers from three Irish EIS sites between September 2023 and July 2024. Data were analysed using Framework Analysis, with an abductive approach that mapped initial insights to the Consolidated framework for implementation research (CFIR) to identify implementation barriers and facilitators. The cognitive screener used was the Letter Number sequencing task, selected for its predictive accuracy in previous research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several key barriers and facilitators to implementation were identified. These included a lack of standardised guidelines, insufficient resources, staff uncertainty and client-related challenges. Facilitators included the perceived clinical utility of the screener, the need for increased training and support, improved client engagement and system-level changes to facilitate adoption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights a readiness among clinicians to integrate cognitive screening into routine care and identifies some of the key requirements for doing so, including formal guidance, staff training, and the use of tools that are practical and client-friendly. Responding to these needs can help bridge the gap between best-practice guidelines and routine clinical care, leading to more personalised and effective treatment for individuals with FEP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Findings on School Refusal Outcomes in Children and Adolescents Following 1-Year Psychiatric Outpatient Treatment","authors":"Yoshinori Sasaki,&nbsp;Masahide Usami,&nbsp;Yuki Hakosima,&nbsp;Kumi Inazaki,&nbsp;Yuki Mizumoto,&nbsp;Mitsuhiro Miyamae,&nbsp;Masaya Ito,&nbsp;Katsunaka Mikami,&nbsp;Noa Tsujii,&nbsp;Takayuki Okada,&nbsp;Hidehiko Takahashi","doi":"10.1111/eip.70156","DOIUrl":"10.1111/eip.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>School refusal affects many children and adolescents receiving psychiatric care; however, predictors of new-onset refusal and successful return during treatment remain unclear. This retrospective cohort study identified factors associated with (1) developing school refusal among initially attending patients and (2) returning to school among those initially refusing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed 235 psychiatric outpatients younger than 15 years who continued treatment for 1 year after a first visit between April 2022 and March 2023. Patients were categorised into maintained attendance (<i>n</i> = 131), developed school refusal (<i>n</i> = 12), resumed attendance (<i>n</i> = 34) and persistent refusal (<i>n</i> = 58). Demographic variables, diagnoses, prior absence duration and psychiatrist experience were analysed using chi-squared tests, Fisher's exact tests, Mann–Whitney U tests and multivariate logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 143 patients attending school at baseline, 12 (8.4%) developed school refusal during treatment; these patients were older (11.8 ± 2.0 vs. 9.2 ± 3.0 years, <i>p</i> &lt; 0.01) and more likely to have divorced/separated parents (33.3% vs. 6.9%, <i>p</i> &lt; 0.05) than were those who maintained attendance. Among 92 patients already refusing school, 34 (37.0%) resumed attendance. In multivariate analysis, a refusal duration &lt; 1 year independently predicted return to school (odds ratio: 3.28, 95% confidence interval: 1.32–8.15, <i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Shorter refusal duration was associated with a higher likelihood of successful return to school, underscoring the importance of early intervention. Older children and those from separated families were more vulnerable to developing school refusal, supporting the need for targeted preventive strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding Coordinated Specialty Care to Early-Stage Bipolar Disorder: Development and Implementation of the STRIDE Model","authors":"Kathleen Miley,&nbsp;Carissa Coudray,&nbsp;David Bond,&nbsp;Piper Meyer-Kalos","doi":"10.1111/eip.70155","DOIUrl":"10.1111/eip.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Coordinated specialty care (CSC) is the gold-standard early intervention model for schizophrenia-spectrum disorders. Similar models for bipolar disorder (BD) are lacking. This paper describes the development and implementation of STRIDE, an adaptation of the NAVIGATE CSC model for early-stage BD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adaptations were developed based on literature review, international expert consultation and engagement with patient, family and clinician advisory groups. STRIDE was designed to be integrated with schizophrenia-spectrum CSC services to build on existing expertise and infrastructure. Demographic and clinical data were collected at enrollment to characterise an initial STRIDE cohort of 19 participants between October 2023–June 2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A detailed model of CSC for BD was developed and implemented. Many components of NAVIGATE, including a recovery focus, shared decision making and the coordinated services of individual psychotherapy, medication management, family psychoeducation and supported education and employment were maintained. Key adaptations for BD included modification of individual psychotherapy modules to address prevention and treatment of mood episodes, addition of modules on circadian and social rhythms, affect regulation and managing common psychiatric comorbidities, development of an early-stage BD prescriber's manual and tailored family psychoeducation. Of 19 patients in the STRIDE cohort (mean age 25 years, 52.6% female), 89.5% were diagnosed with bipolar 1 disorder and 94.7% had a history of psychosis. Anxiety, depression, functional impairment and sleep disturbances were commonly reported at baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>STRIDE is a comprehensive adaptation of CSC for early-stage BD. Further work is needed to assess STRIDE's feasibility, acceptability and effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}