Skip to main content Accessibility help
×
Home
Hostname: page-component-55b6f6c457-5kt27 Total loading time: 0.276 Render date: 2021-09-24T04:18:02.026Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Early intervention for schizophrenic disorders

Implementing optimal treatment strategies in routine clinical services

Published online by Cambridge University Press:  06 August 2018

Ian R. H. Falloon*
Affiliation:
Department of Psychiatry and Behavioural Science, University of Auckland, New Zealand
John H. Coverdale
Affiliation:
Department of Psychiatry and Behavioural Science, University of Auckland, New Zealand
Tannis M. Laidlaw
Affiliation:
Department of Psychiatry and Behavioural Science, University of Auckland, New Zealand
Sally Merry
Affiliation:
Department of Psychiatry and Behavioural Science, University of Auckland, New Zealand
Robert R. Kydd
Affiliation:
Department of Psychiatry and Behavioural Science, University of Auckland, New Zealand
Pierluigi Morosini
Affiliation:
Laboratorio di Epidemilogica e Biostatistica, Istituto Superiore di Sanitá, Roma, Italy
*
Correspondence: Professor Falloon, Department of Psychiatry and Behavioural Science, University of Auckland, Private Bag 92019, Auckland, New Zealand

Abstract

Background Early detection and intervention in schizophrenic disorders is an important challenge for psychiatry.

Method Review of literature on effective biomedical and psychosocial intervention strategies.

Results Comprehensive programmes of drug and psychosocial interventions with adults who show early signs and symptoms of schizophrenic disorders may contribute to a lower incidence and prevalence of major episodes of schizophrenia. These programmes combine early detection of psychotic features by primary care services, with close liaison with mental health professionals. Long-term monitoring of signs of recurrence, with further intervention, appears essential to maintain these benefits.

Conclusions Field trials demonstrate that effective early treatment strategies can be routinely applied in clinical practice.

Type
Research Article
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Bond, G. R., McGrew, T. H. & Fekete, D. P. (1995) Assertive outreach for frequent users of psychiatric hospitals: A meta-analysis. Journal of Mental Health Administration, 22, 416.CrossRefGoogle ScholarPubMed
Buchanan, R.W. (1995) Clozapine: efficacy and safety. Schizophrenia bulletin, 21, 579591.CrossRefGoogle ScholarPubMed
Burns, T., Raftery, J., Beardsmore, A., et al (1993) A controlled trial of home-based acute psychiatric care: II. Clinical and social outcomes. British Journal of Psychiatry, 163, 5561.CrossRefGoogle Scholar
Cardin, V. A., McGill, C. W. & Falloon, I. R. H. (1985) An economic analysis: costs, benefits and effectiveness. In Family Management of Schizophrenia (ed. Falloon, I. R. H.). Baltimore, MD: Johns Hopkins University Press.Google Scholar
Crow, T. J., MacMillan, J. F., Johnson, A. L., et al (1986) A randomised controlled trial of prophylactic neuroleptic treatment. British Journal of Psychiatry, 148, 120127.CrossRefGoogle ScholarPubMed
Der, G., Gupta, G. & Murray, R. M. (1990) Is schizophrenia disappearing? Lancet, 335, 513516.CrossRefGoogle Scholar
Dixon, L. B. & Lehman, A. F. (1995) Family interventions for schizophrenia. Schizophrenia Bulletin, 21, 631643.CrossRefGoogle Scholar
Doane, J. A., Goldstein, M. J., Miklowitz, D. J., et al (1986) The impact of individual and family treatment on the affective climate of families of schizophrenics. British Journal of Psychiatry, 148, 279287.CrossRefGoogle ScholarPubMed
Eagles, J. M. & Whalley, L. J. (1985) Decline in the diagnosis of schizophrenia among first admissions to Scottish mental hospitals from 1969–1978. British Journal of Psychiatry, 146, 151154.CrossRefGoogle Scholar
Falloon, I. R. H. (1985) Family Management of Schizophrenia. Baltimore, MD: Johns Hopkins University Press.Google ScholarPubMed
Falloon, I. R. H. (1992) Early intervention for first episodes of schizophrenia: a preliminary exploration. Psychiatry, 55, 415.CrossRefGoogle ScholarPubMed
Falloon, I. R. H. & Shanahan, W. J. (1990) Community management of schizophrenia, British Journal of Hospital Medicine, 43, 6266.Google Scholar
Falloon, I. R. H., Shanahan, W. J. & Laporta, M. (1992) Prevention of major depressive episodes: Early intervention with family-based stress management. Journal of Mental Health, 1, 5360.CrossRefGoogle Scholar
Falloon, I. R. H. & Fadden, G. (1993) Integrated Mental Health Care. Cambridge: Cambridge University Press.Google Scholar
Falloon, I. R. H., Coverdale, J. H. & Brooker, C. (1996) Psychosocial interventions in schizophrenia: a review. International Journal of Mental Health, 25, 323.CrossRefGoogle Scholar
Goldberg, S. C., Klerman, G. L. & Cole, J. O. (1965) Changes in schizophrenic psychopathology and ward behaviour as a function of phenothiazine treatment. British Journal of Psychiatry, 111, 120133.CrossRefGoogle ScholarPubMed
Guy, W. (1976) ECDEU Assessment Manual for Psychopharmacology. Washington, DC: US Department of Health, Education and Welfare.Google Scholar
Hahlweg, K., Durr, H. & Muller, U. (1995) Familienbetreung schizophrener Patiente. Weinham: Beltz, Psychologie Verlags Union.Google Scholar
Hogarty, G. E., Anderson, C. M., Reiss, D. J., et al (1991) Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two-year effects of a controlled study on relapse and adjustment. Archives of General Psychiatry, 48, 340347.CrossRefGoogle Scholar
Johnstone, E. C., MacMillan, J. F., Frith, C. D., et al (1990) Further investigations of predictors of outcome following first schizophrenic episodes. British Journal of Psychiatry, 157, 182189.CrossRefGoogle Scholar
Joyce, P. R. (1987) Changing trends in first admissions and readmissions for mania and schizophrenia in New Zealand. Australia and New Zealand Journal of Psychiatry, 21, 8286.CrossRefGoogle ScholarPubMed
Kane, J. M. & Marder, S. R. (1993) Psychopharmacologic treatment of schizophrenia. Schizophrenia Bulletin, 19, 287302.CrossRefGoogle ScholarPubMed
Kane, J. M. & McGlashan, T. H. (1995) Treatment of schizophrenia. Lancet, 346, 820825.CrossRefGoogle ScholarPubMed
Kraus, M. & Müller-Thomsen, T. (1993) Schizophrenia with onset in adolescence: An 11-year follow-up. Schizophrenia Bulletin, 19, 831841.CrossRefGoogle Scholar
Lam, D. H. (1991) Psychosocial family intervention in schizophrenia. A review of empirical studies. Psychological Medicine, 21, 423441.CrossRefGoogle ScholarPubMed
Lehman, A. F., Carpenter, W. T., Goldman, H. H., et al (1995) Treatment outcomes in schizophrenia: implications for practice, policy and research. Schizophrenia Bulletin, 21, 669675.CrossRefGoogle ScholarPubMed
MacPherson, R., Jerrom, B. & Hughes, A. (1996) A controlled study of education about drug treatment in schizophrenia. British Journal of Psychiatry, 168, 709717.CrossRefGoogle Scholar
Marl, J. D. J. & Streiner, D. L. (1994) An overview of family interventions and relapse of schizophrenia: Meta-analysis of research findings. Psychological Medicine, 24, 565578.Google Scholar
McEvoy, J. P., Hogarty, G. E. & Steingard, S. (1991) Optimal dose of neuroleptic in acute schizophrenia. A controlled study of neuroleptic threshold and higher haloperidol dose. Archives of General Psychiatry, 48, 739745.CrossRefGoogle ScholarPubMed
McGorry, P. D., Edwards, J., Mihalopoulos, C., et al (1996) EPPIC: An evolving system of early detection and optimal management. Schizophrenia Bulletin, 22, 305326.CrossRefGoogle ScholarPubMed
Munk-Jorgensen, P. (1986) Decreasing first admission rates of schizophrenia among males in Denmark from 1970 to 1984: changing diagnostic patterns? Acta Psychiatrica Scandinavica, 73, 645650.CrossRefGoogle ScholarPubMed
Muijen, M., Marks, I., Connolly, J., et al (1992) Home-based care and standard hospital care for patients with severe mental illness: a randomised controlled trial. British Medical Journal, 304, 749754.CrossRefGoogle ScholarPubMed
O'Sullivan, S., Gedye, R., Falloon, I. R. H., et al (1994) A Mental Health Education Programme for Schools. Auckland: Department of Psychiatry and Behavioural Science, University of Auckland.Google Scholar
Penn, D. L. & Mueser, K. T. (1996) Research update on the psychosocial treatment of schizophrenia. American Journal of Psychiatry, 153, 607617.Google ScholarPubMed
Prince, M. & Phelan, M. (1994) Invisible schizophrenia: A postal survey of the incidence and management of new cases of schizophrenia in primary care. Journal of Mental Health, 3, 9198.CrossRefGoogle Scholar
Quality Assurance Project (1984) Treatment outlines for the management of schizophrenia. Australia and New Zealand Journal of Psychiatry, 18, 1938.CrossRefGoogle Scholar
Rosser, R. M. & Kind, P. (1978) A scale of valuations of states of illness: Is there a social consensus? International Journal of Epidemiology, 7, 347358.CrossRefGoogle Scholar
Schooler, N. R. (1991) Maintenance medication for schizophrenia: Strategies for dose reduction. Schizophrenia Bulletin, 17, 311324.CrossRefGoogle ScholarPubMed
Scott, J. E. & Dixon, L. B. (1995a) Assertive community treatment and case management for schizophrenia. Schizophrenia Bulletin, 21, 657668.CrossRefGoogle Scholar
Scott, J. E. & Dixon, L. B. (1995b) Psychological interventions for schizophrenia. Schizophrenia Bulletin, 21, 621630.CrossRefGoogle Scholar
Shepherd, M., Watt, D., Falloon, I., et al (1989) The Natural History of Schizophrenia. Psychological Medicine Monograph 16. Cambridge: Cambridge University Press.Google Scholar
Solomon, P., Draine, J., Mannion, E., et al (1996) Impact of brief family psychoeducation on self–efficacy. Schizophrenia Bulletin, 22, 4150.CrossRefGoogle ScholarPubMed
Stein, L. I. & Test, M. A. (1980) An alternative to mental hospital treatment: I. Conceptual model, treatment program, and clinical evaluation. Archives of General Psychiatry, 37, 392399.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Porceddu, K., et al (1994a) The Salford Family Intervention Project: Relapse of schizophrenia after five and eight years. British Journal of Psychiatry, 165, 829832.CrossRefGoogle Scholar
Tarrier, N., Beckett, R., Harwood, S., et al (1994b) A trail of two cognitive behavioural methods of treating drug-resistant residual psychotic symptoms in schizophrenic patients: I. Outcome. British Journal of Psychiatry, 162, 524532.CrossRefGoogle Scholar
Van Putten, T., Marder, S. R., Wirsching, W. C., et al (1991) Neuroleptic plasma levels. Schizophrenia Bulletin, 17, 197216.CrossRefGoogle ScholarPubMed
Ventura, J., Green, M. F., Shaner, A., et al (1993) Training and quality assurance with the Brief Psychiatric Rating Scale: ‘The drift busters”. International Journal of Methods in Psychiatric Research, 3, 221224.Google Scholar
Wallace, C. J. & Liberman, R. P. (1985) Social skills training for patients with schizophrenia: a controlled clinical trial. Psychiatry Research, 15, 239247.CrossRefGoogle ScholarPubMed
Wilkinson, G., Piccinelli, M., Falloon, I., et al (1995) An evaluation of community-based psychiatric care for people with treated long-term mental illness. British Journal of Psychiatry, 167, 2637.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Description and Classification Psychiatric Symptoms. An Instruction Manual for the PSE and CATEGO System. Cambridge: Cambridge University Press.Google Scholar
Wyatt, R. J. (1991) Neuroleptics and the natural course of schizophrenia. Schizophrenia BulIetin, 17, 325351.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.
36
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Early intervention for schizophrenic disorders
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Early intervention for schizophrenic disorders
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Early intervention for schizophrenic disorders
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *