A community based early intervention program for schizophrenia developed by a psychiatric department in the suburbs of Lisbon is described. The program included treatment with psychotropic drugs, regular evaluations by a multidisciplinary community team (outpatient clinic and home visits), family interventions, psycho educational groups, individual psychotherapy, family and occupational therapy, and cognitive remediation intervention.
A group of 77 patients with a first episode of psychosis diagnosed between January 2001 and October 2006, and followed for no more than two years at first assessment was enrolled in the program. The patients were predominantly males (82%), single (94%), living with their parents (72.7%), and between 18 and 25 years old (53.2%). One third of the sample had 9 years of education, and 72.7% met ICD-10 criteria for schizophrenia, while 69% met DSM-III-R criteria for prodromic symptoms.
During follow-up 16 patients (20%) dropped out, 18.1% were admitted as inpatients during the first 6 months after the diagnosis (Phase II), and 15.5% in the following 18 months (Phase III). There was a decline in occupational/employment rates, mainly in the male gender. Most female patients had Duration of Untreated Psychosis (DUP) between 1-2 years and most male patients had a DUP higher than 2 years.
The protocol was useful in the development of a Multidisciplinary Community Team Intervention for the assertive follow-up of patients with a first episode of schizophrenia. Its main limitation is the lack of comparison with a standard care treated sample.