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M232. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS IN MINNESOTA

BACKGROUND: People who are experiencing a First Episode of Psychosis (FEP) often have limited recovery from non-integrated treatment approaches in usual settings. Treatment of FEP typically entails high rates of non-adherence, disengaging from treatment, and increased rates of relapse (Mueser et al....

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Autores principales: Fischer, Jamie, Mervis, Joshua, Begnel, Erin, Meyer-Kalos, Piper
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234110/
http://dx.doi.org/10.1093/schbul/sbaa030.544
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author Fischer, Jamie
Mervis, Joshua
Begnel, Erin
Meyer-Kalos, Piper
author_facet Fischer, Jamie
Mervis, Joshua
Begnel, Erin
Meyer-Kalos, Piper
author_sort Fischer, Jamie
collection PubMed
description BACKGROUND: People who are experiencing a First Episode of Psychosis (FEP) often have limited recovery from non-integrated treatment approaches in usual settings. Treatment of FEP typically entails high rates of non-adherence, disengaging from treatment, and increased rates of relapse (Mueser et al., 2015; Kane et al., 2016). NAVIGATE is an evidence-based approach implemented in the Recovery After an Initial Schizophrenia Episode treatment project. METHODS: The present study is a review of archival data with NAVIGATE model teams in Minnesota. Clinical information from 118 people with FEP was reviewed from the first 6-months of treatment, with a subset analyzed for the first 12-months. Individuals were assessed with clinician ratings of current needs, illness management, and global functioning. Self-report assessments addressed symptoms and illness management from the client’s perspective. Data was analyzed using repeated measures analysis of variance with post-hoc honest significant difference testing. Additional data analysis utilized McNemar’s test, a repeated measures test using counts and a chi-square distribution. RESULTS: Total current needs did not change significantly across time. All other domains assessed showed significant differences between intake and 6-months. All other domains except total needs showed significant differences between intake and 12-months. No domains showed significant differences between 6-months and 12-months. Substance use was not reduced over time. Antipsychotic medication use was not reduced over time. Hospitalizations were substantially reduced from intake to 6-months. DISCUSSION: Almost all symptoms improved from intake to 6-months. No additional treatment gains were observed from 6-months to 12-months. Improvements from intake were stable from 6-months to 12-months. Most symptoms improved from intake to 6-months but not beyond. The NAVIGATE model was a successful intervention as implemented in Minnesota. Overall, symptom reduction gains were durable at 12-months, hospitalizations were reduced from intake to 6-months, but the intervention did not improve substance use. Substance use, continued improvement of symptoms beyond the 6-month mark, and further improvements in symptoms or reduced hospitalizations are areas for future research and treatment development.
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spelling pubmed-72341102020-05-23 M232. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS IN MINNESOTA Fischer, Jamie Mervis, Joshua Begnel, Erin Meyer-Kalos, Piper Schizophr Bull Poster Session II BACKGROUND: People who are experiencing a First Episode of Psychosis (FEP) often have limited recovery from non-integrated treatment approaches in usual settings. Treatment of FEP typically entails high rates of non-adherence, disengaging from treatment, and increased rates of relapse (Mueser et al., 2015; Kane et al., 2016). NAVIGATE is an evidence-based approach implemented in the Recovery After an Initial Schizophrenia Episode treatment project. METHODS: The present study is a review of archival data with NAVIGATE model teams in Minnesota. Clinical information from 118 people with FEP was reviewed from the first 6-months of treatment, with a subset analyzed for the first 12-months. Individuals were assessed with clinician ratings of current needs, illness management, and global functioning. Self-report assessments addressed symptoms and illness management from the client’s perspective. Data was analyzed using repeated measures analysis of variance with post-hoc honest significant difference testing. Additional data analysis utilized McNemar’s test, a repeated measures test using counts and a chi-square distribution. RESULTS: Total current needs did not change significantly across time. All other domains assessed showed significant differences between intake and 6-months. All other domains except total needs showed significant differences between intake and 12-months. No domains showed significant differences between 6-months and 12-months. Substance use was not reduced over time. Antipsychotic medication use was not reduced over time. Hospitalizations were substantially reduced from intake to 6-months. DISCUSSION: Almost all symptoms improved from intake to 6-months. No additional treatment gains were observed from 6-months to 12-months. Improvements from intake were stable from 6-months to 12-months. Most symptoms improved from intake to 6-months but not beyond. The NAVIGATE model was a successful intervention as implemented in Minnesota. Overall, symptom reduction gains were durable at 12-months, hospitalizations were reduced from intake to 6-months, but the intervention did not improve substance use. Substance use, continued improvement of symptoms beyond the 6-month mark, and further improvements in symptoms or reduced hospitalizations are areas for future research and treatment development. Oxford University Press 2020-05 2020-05-18 /pmc/articles/PMC7234110/ http://dx.doi.org/10.1093/schbul/sbaa030.544 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Session II
Fischer, Jamie
Mervis, Joshua
Begnel, Erin
Meyer-Kalos, Piper
M232. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS IN MINNESOTA
title M232. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS IN MINNESOTA
title_full M232. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS IN MINNESOTA
title_fullStr M232. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS IN MINNESOTA
title_full_unstemmed M232. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS IN MINNESOTA
title_short M232. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS IN MINNESOTA
title_sort m232. coordinated specialty care for first episode psychosis in minnesota
topic Poster Session II
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234110/
http://dx.doi.org/10.1093/schbul/sbaa030.544
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