Early Intervention in Psychiatry最新文献

{"title":"Reduction of DUP in early intervention programmes: No pain… almost no gain","authors":"Morgane Frischherz,&nbsp;Philippe Conus,&nbsp;Philippe Golay","doi":"10.1111/eip.13580","DOIUrl":"10.1111/eip.13580","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Considering the negative impact of long duration of untreated psychosis (DUP) on outcome, its reduction has become one of the aims of early intervention programmes. The TIPP programme (Treatment and early Intervention in Psychosis Program) was implemented in 2004 in Lausanne and hoped to reduce DUP, without any specific campaign in this regard, through the provision of accessible and specialized treatment. The aim of this study was to evaluate the evolution of patients' DUP over time and the characteristics of patients with extreme DUP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical follow-up data of 380 patients aged 18–35 years with a first psychotic episode who entered the TIPP programme between 2004 and 2017 were analysed. The evolution of DUP over time as well as referring entities and destination after the programme were assessed. The characteristics of patients with extreme DUPs (&gt;percentile 90) were compared with that of other patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean value of the DUP was 452.11 days with a median of 88 days. DUP decreased only moderately over time. We also observe a decrease in discharges to specialized outpatient care at our university hospital. The main characteristics of patients with extreme DUP were early age of onset of psychosis, diagnosis of schizophrenia and presence of history of psychiatric treatment for other conditions before onset of psychosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These figures suggest that the DUP has reduced over time but that without specific interventions at this level, this reduction is only moderate.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161328","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":"Clinical presentation of first episode psychosis in people with and without HIV in KwaZulu-Natal, South Africa","authors":"Usha Chhagan,&nbsp;Vuyokazi Ntlantsana,&nbsp;Enver Karim,&nbsp;Lindokuhle Thela,&nbsp;Andrew Tomita,&nbsp;Bonginkosi Chiliza,&nbsp;Saeeda Paruk","doi":"10.1111/eip.13561","DOIUrl":"10.1111/eip.13561","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Mental disorders and HIV are the main contributors to the increase in years lived with disability rates per person in sub-Saharan Africa. A complex inter-relationship exists between HIV and mental illness, especially in a region with a high HIV prevalence. We examined the duration of untreated psychosis (DUP), and the nature of psychotic and cognitive symptoms in people with first episode psychosis (FEP) living with and without HIV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults aged between 18 and 45 years were assessed using a clinical interview, physical examination and several psychiatric tools. These included the Mini International Neuro-psychiatric Interview to confirm psychosis, Positive and Negative Syndrome Scale, International HIV Dementia Scale and other scales to measure symptom variables. HIV ELISA was used for HIV serology testing, with measures being carried out within 6 weeks of the first presentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 172 people presenting with FEP, 36 (21%) had comorbid HIV, those with both being older and more likely to be female (<i>p</i> &lt; .001). Clinically, participants with FEP and HIV scored lower on the positive subscale (<i>p</i> = .008). There were no statistically significant differences for DUP or cognitive screening. Of those living with HIV and FEP (<i>n</i> = 36) comorbidity, nine were newly diagnosed with HIV at the time of the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Individuals presenting with FEP and comorbid HIV were older, female and reported more mood symptoms. The identification of nine new HIV infections also reflects the ongoing need to test for HIV in people presenting with severe mental illness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157185","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":"Referral pathways to early intervention services for psychosis and their influence on perceptions of care: An interpretive phenomenological analysis","authors":"Brannon Senger,&nbsp;Quinn MacDonald,&nbsp;Alissa Pencer,&nbsp;Candice E. Crocker,&nbsp;Jean Hughes,&nbsp;Philip G. Tibbo","doi":"10.1111/eip.13553","DOIUrl":"10.1111/eip.13553","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Most young adults experiencing psychosis enter early intervention services (EIS) via inpatient and emergency departments. These experiences are suggested to negatively impact their views of treatment and engagement in EIS. However, limited research has examined the impact of young adults' prior help-seeking experiences on these outcomes. The present study aimed to explore how young adults engaged in EIS have experienced initial help-seeking and make sense of these experiences in the context of their current treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using an interpretative phenomenological analysis approach, semi-structured interviews were conducted with 12 young adults (mean age = 24.83) within their first 3–12 months of treatment in EIS. Interviews aimed to examine their experiences of help-seeking and referral to EIS as well as the impact of these experiences on their subsequent perception of, and engagement with EIS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>3 superordinate themes emerged: <i>(1) Navigating the Maze of Healthcare (2) Dignity</i> and <i>(3) Impact of Help-Seeking and Referral Experiences</i>. Participants with referral pathways involving urgent care services described more adversity during their referral pathway and tended to describe help-seeking experiences as contributing to negative views towards EIS and diminished engagement in treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The impact of early negative experiences with healthcare on views towards EIS and engagement is evident in participants' accounts. Sense making was further contextualized by participants' illness insight, degree of recovery, and social support throughout experiences. Emergent themes highlight the need for psychiatric services to emphasize service users' dignity and for EIS to provide opportunities for patients to process past negative mental healthcare experiences to strengthen engagement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154136","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":"Validating cognitive screening in young people with first-episode psychosis: The CogScreen protocol","authors":"Alexandra Stainton,&nbsp;Shayden Bryce,&nbsp;Audrey Rattray,&nbsp;Allie Pert,&nbsp;Isabel Zbukvic,&nbsp;Evangeline Fisher,&nbsp;Debbie Anderson,&nbsp;Stephen C. Bowden,&nbsp;Symphony Chakma,&nbsp;Nicholas Cheng,&nbsp;Scott Clark,&nbsp;Caroline Crlenjak,&nbsp;Shona Francey,&nbsp;Caroline Gao,&nbsp;Donna Gee,&nbsp;Elle Gelok,&nbsp;Anthony Harris,&nbsp;Lilianne Hatfield,&nbsp;Liza Hopkins,&nbsp;Candice Jensen,&nbsp;Rachel Morell,&nbsp;Chris O'Halloran,&nbsp;Scot Purdon,&nbsp;K. Oliver Schubert,&nbsp;Alana Scully,&nbsp;Hejun Tang,&nbsp;Adrian Thomas,&nbsp;Andrew Thompson,&nbsp;Jacqueline Uren,&nbsp;Stephen J. Wood,&nbsp;Wendi Zhao,&nbsp;Kelly Allott","doi":"10.1111/eip.13558","DOIUrl":"10.1111/eip.13558","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Cognitive impairments are a core feature of first-episode psychosis (FEP) and one of the strongest predictors of long-term psychosocial functioning. Cognition should be assessed and treated as part of routine clinical care for FEP. Cognitive screening offers the opportunity to rapidly identify and triage those in most need of cognitive support. However, there are currently no validated screening measures for young people with FEP. <i>CogScreen</i> is a hybrid effectiveness-implementation study which aims to evaluate the classification accuracy (relative to a neuropsychological assessment as a reference standard), test–retest reliability and acceptability of two cognitive screening tools in young people with FEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants will be 350 young people (aged 12–25) attending primary and specialist FEP treatment centres in three large metropolitan cities (Adelaide, Sydney, and Melbourne) in Australia. All participants will complete a cross-sectional assessment over two sessions including two cognitive screening tools (Screen for Cognitive Impairment in Psychiatry and Montreal Cognitive Assessment), a comprehensive neuropsychological assessment battery, psychiatric and neurodevelopmental assessments, and other supplementary clinical measures. To determine the test–retest reliability of the cognitive screening tools, a subset of 120 participants will repeat the screening measures two weeks later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The protocol, rationale, and hypotheses for <i>CogScreen</i> are presented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>\u0000 <i>CogScreen</i> will provide empirical evidence for the validity and reliability of two cognitive screening tools when compared to a comprehensive neuropsychological assessment. The screening measures may later be incorporated into clinical practice to assist with rapid identification and treatment of cognitive deficits commonly experienced by young people with FEP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097135","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":"Identifying and managing treatment resistance early with the integration of a clozapine clinic within an early intervention for psychosis service","authors":"Brian O'Donoghue,&nbsp;Linda Mora,&nbsp;Marie Bismark,&nbsp;Andrew Thompson,&nbsp;Patrick McGorry","doi":"10.1111/eip.13578","DOIUrl":"10.1111/eip.13578","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite being the most effective antipsychotic medication for treatment-resistant psychosis, clozapine is often under-utilized with long delays to initiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to determine whether the integration of a clozapine clinic within an early intervention for psychosis service resulted in a change in the rate and time to initiation of clozapine, the number of trials of different antipsychotic medications prior to clozapine, community initiation and discontinuation rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A clozapine clinic was established in the Early Psychosis Prevention and Intervention Centre in Melbourne. This was a pre- and post-evaluation study design. The ‘clozapine clinic’ cohort included those who commenced on clozapine from 01 January 2016 to 30 June 2018.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prior to the clozapine clinic, 24 young people commenced clozapine over the 30-month period compared to 36 in the clozapine clinic cohort (RR = 1.30, 95% CI: 0.75–2.28, <i>p</i> = .32). In the pre-clozapine clinic cohort, 4.6% of all those with a first episode of psychosis were commenced on clozapine compared to 6% in the clozapine clinic cohort. Prior to the clozapine clinic, the median time to the commencement of clozapine was 72 weeks (IQR: 38, 87), compared to 53.5 weeks (IQR: 38, 81.5) in the clozapine clinic (<i>Z</i> = −0.86, <i>p</i> = .393). The mean number of different antipsychotic medications prior to commencing clozapine remained stable at 3.2 (SD ± 1.1) in both cohorts (<i>t</i> = −0.20, <i>p</i> = .841). There was a lower rate of discontinuation in the clozapine clinic (43.5% vs. 14.7%, HR = 0.30, 95% CI: 0.09–0.98, <i>p</i> = .046).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While this study was underpowered and there are limitations to the naturalistic study design, the findings lend support to the integration of a clozapine clinic within early intervention for psychosis services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086963","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":"Effectiveness of video-based psychiatric rehabilitation for patients with early-phase schizophrenia spectrum: A randomized controlled trial","authors":"Chunfen Zhou,&nbsp;Haimin Li,&nbsp;Zhuoqiu Zhang,&nbsp;Shuiying Li,&nbsp;Shuang Wu,&nbsp;Youran Dai,&nbsp;Xiuying Zhang,&nbsp;Hua Lai,&nbsp;Qian Zhou,&nbsp;Mengshu Yang,&nbsp;Xiaofeng Zuo,&nbsp;Jinna Ning,&nbsp;Jiaxin Wu,&nbsp;Tianfen Zheng,&nbsp;Na Li,&nbsp;Ling Liu,&nbsp;Xuemin Zou,&nbsp;Lifang Liu,&nbsp;Xiaoqi Luo,&nbsp;Jie Yang,&nbsp;Yi Wang,&nbsp;Lulu Zheng,&nbsp;Ya Luo,&nbsp;Ying Chen,&nbsp;Hong Deng","doi":"10.1111/eip.13556","DOIUrl":"10.1111/eip.13556","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to establish a comprehensive set of recovery-oriented rehabilitation programs for individuals with schizophrenia, comparing the efficacy of video-based rehabilitation to traditional face-to-face interventions. The primary objective was to assess whether video-based rehabilitation could serve as a viable alternative for individuals with schizophrenia residing in remote areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized controlled study was used to recruit 80 patients with schizophrenia in a stable post-hospitalization stage following discharge. Participants were categorized into three groups: 24 in the control group, 21 in the face-to-face group, and 35 in the remote group. Assessment parameters included psychiatric symptoms, social skills, family function and self-stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 68 participants completed the program. The findings indicated significant differences (<i>p</i> &lt; .05) between the control group and intervention group, particularly in the Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance Scale (PSP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The rehabilitation program, tailored for patients in the early phase of the schizophrenia spectrum, demonstrates both effectiveness and feasibility in enhancing clinical symptoms and social functions. Notably, interventions conducted via video proved to be equally effective as those administered face-to-face.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086957","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":"Insomnia symptoms as a mediator between school connectedness and suicidal ideation in Chinese adolescents: A three-wave longitudinal model","authors":"Mingze Sun,&nbsp;Andrew Scherffius,&nbsp;Meng Sun,&nbsp;Chunping Chen,&nbsp;Dongfang Wang","doi":"10.1111/eip.13579","DOIUrl":"10.1111/eip.13579","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>School connectedness is related to suicidal ideation (SI) in adolescents. However, little is known about the mediating role of insomnia symptoms in the school connectedness–SI link. This study aimed to examine the longitudinal mediating effect of insomnia symptoms on the relationship between school connectedness and SI as well as the moderating effect of sex using a three-wave longitudinal design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 3110 adolescents completed three online surveys. Data were collected over the course of 1 year, in three waves 6 months apart. Participants completed the School Connectedness Scale, Youth Self-Rating Insomnia Scale, Self-rating Idea of Suicide Scale, Beck Depression Inventory and a self-compiled demographic questionnaire. Linear regressions and mediation analyses were performed to examine the associations between school connectedness, insomnia symptoms and SI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>School connectedness had a significant mediating effect on SI through insomnia symptoms (<i>β</i>\u0000 _a×b = −.03, 95% confidence interval = −0.04, −0.02) after controlling for demographics and depressive symptoms. Mediation analyses showed that insomnia symptoms accounted for 23.1% of the total effects in the entire sample, with 13.3% in males and 27.3% in females. Sex had no significant moderating effect on the school connectedness–SI link association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The association between school connectedness and SI appears to be mediated by insomnia symptoms. Assessing and promoting school connectedness, as well as intervening and treating distress associated with insomnia, may have important clinical implications for reducing the risk of SI in adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086966","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":"Eco-anxiety among regional Australian youth with mental health problems: A qualitative study","authors":"Candice P. Boyd,&nbsp;Julie Jamieson,&nbsp;Kari Gibson,&nbsp;Michelle Duffy,&nbsp;Michelle Williamson,&nbsp;Hester Parr","doi":"10.1111/eip.13549","DOIUrl":"10.1111/eip.13549","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In Australia, climate-related disasters disproportionately affect rural, regional and remote young people with effects ranging from severe flooding and catastrophic fires to unbearable heat and yet most studies on eco-anxiety are based on reports by urban youth who do not have direct experiences of such impacts. Furthermore, there is a dearth of research on how eco-anxiety impacts those who already experience mental health problems. The present study aims to address this gap by focussing on the lived experiences of regional Australian youth with recent experience of climate-related disasters alongside clinical insights from those involved in their care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Two groups, a clinician and client group, were recruited through headspace Port Macquarie—a primary youth mental health service in a regional city of New South Wales, Australia. In all, 25 participants took part in focus group discussions, including 13 clinicians and 12 clients of the service. Clients and clinicians responded to a version of the same questions: (1) whether the effects of climate change impact on regional youth with mental health problems, (2) how young people cope with eco-anxiety and (3) how regional communities can help young people cope with eco-anxiety better. Group discussions were audio-recorded and transcribed. Transcripts were analysed according to the principles of Interpretative Phenomenological Analysis using a team approach.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Three dimensions of eco-anxiety were identified by clinicians and clients—helplessness in the present, hopelessness about the future and acute stress and anxiety related to experiences of severe flooding and fires. Clinicians and clients also thought that a misalignment between young people and older generations, including government, was a source of eco-anxiety and having a collective voice was seen as important for regional youth as was community support through social media sites. Clinicians thought that eco-anxiety was ‘in the background’ for their clients, whereas the clients who participated were clearly experiencing eco-anxiety. Whereas clinicians could identify potential coping strategies, clients could not.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Eco-anxiety can be experienced by regional youth with mental health problems as both an acute response to natural hazards and a more sustained sense of hopelessness about the future. Impacts of acute anxiety and chronic hopelessness, with its associated depression ri","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"18 12","pages":"1022-1031"},"PeriodicalIF":2.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081188","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 associated with improved outcomes in the first psychotic episode at a specialized outpatient clinic in northeastern Brazil","authors":"Isabela de Fatima Pina de Almeida,&nbsp;Aldo Ferreira Castello Branco Vilar,&nbsp;Benjamim Figueiredo Braga Pires Júnior,&nbsp;Rodrigo Coelho Marques,&nbsp;Leonardo Machado","doi":"10.1111/eip.13563","DOIUrl":"10.1111/eip.13563","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The present study aimed to evaluate data from patients admitted to the first-episode psychotic (FEP) outpatient clinic at the Hospital of Clinics of the Federal University of Pernambuco from July 2018 to July 2021, seeking to identify factors related to better clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted using a convenience sample, including all patients between 15 and 65 years of age who were admitted to the FEP outpatient clinic from July 2018 to July 2021. Descriptive statistical analysis was performed using mean and standard deviation or median and interquartile range for continuous quantitative variables, and absolute number/percentage for qualitative variables. Paired <i>T</i>-test, a parametric test, was used to compare PANSS scores upon admission and after 6 months. Spearman's correlation test was employed to assess the correlation between duration of untreated psychosis (DUP) and treatment response with other variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sample consisted of 85.3% male individuals, with 50% of patients aged between 19 and 30 years, and 82% residing in the metropolitan area of Recife. Seventy percent of patients responded to the treatment implemented by the outpatient clinic, and only 30% required psychiatric hospitalization within 6 months of follow-up. The majority of patients had a history of psychoactive substance use (82.4%); however, the use of these substances did not impact the prognosis within the analysed sample. The median DUP was 4 weeks, and a shorter DUP was associated with a lower probability of psychiatric hospitalization and a greater treatment response (reduction &gt;50% in PANSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A shorter DUP was associated with a lower likelihood of psychiatric hospitalization and a greater treatment response. Furthermore, the specialized early psychosis outpatient clinic itself appears to yield positive outcomes, as 70% of the treated patients exhibited a positive treatment response.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081191","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":"Prevalence of metabolic syndrome and its associated factors in first-treatment drug-naïve schizophrenia patients: A large-scale cross-sectional study","authors":"Suoya Hu,&nbsp;Xuebing Liu,&nbsp;Yanting Zhang,&nbsp;Jun Ma","doi":"10.1111/eip.13565","DOIUrl":"10.1111/eip.13565","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic syndrome (MetS), a condition that includes several risk factors specific for cardiovascular disease, is commonly detected among patients with schizophrenia (SCZ). This study elucidated the factors contributing to the development and severity of MetS in first-treatment drug-naïve (FTDN) patients with SCZ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study enrolled 668 individuals with FTDN SCZ, aged 18–49 years, who had no exposure to antipsychotic medications and been hospitalized between February 2017 and June 2022 at the largest psychiatric specialty institution in central China. Patient sociodemographic and general clinical data were collected, and their psychopathology scores and illness severity were assessed using the Positive and Negative Symptom Scale (PANSS) and Clinical Global Impression Scale–Severity of Illness (CGI-SI), respectively. MetS score was calculated to determine the disease severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of MetS among this study population was 10.93%. Binary logistic regression analysis revealed onset age, female sex, total cholesterol, and red blood and white blood cell counts as risk factors for MetS, and deemed free tetraiodothyronine (FT₄) and CGI-SI score as protective factors. Multiple linear regression analysis result confirmed older SCZ onset age as a risk factor for elevated MetS score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study determined the prevalence of MetS in patients with FTDN SCZ and revealed the factors that influence the occurrence and severity of the disease. These findings will allow development of specific prevention and treatment strategies in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081194","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}