Impact of an Early Identification Program for First-Episode Psychosis on the Duration of Untreated Psychosis
Impact of an Early Identification Program for First-Episode Psychosis on the Duration of Untreated Psychosis. Multicenter, Randomized Stepped-wedge Study
Centre Hospitalier Universitaire de Saint Etienne
416 participants
Jun 6, 2023
INTERVENTIONAL
Conditions
Summary
The First-Episode Psychosis (FPE) is a severe disorder that can include delusions, cognitive disorders and suicidal behavior. In the majority of cases (more than 80%) it evolves into schizophrenia. Numerous studies show that the rapidity of the initial management of FPE would reduce the risk of negative evolution and would have a decisive impact on the short and long term prognosis. The rapidity of this management can be measured by the duration of untreated psychosis, or DUP (Duration of Untreated Psychosis), the time interval between the appearance of the first frank psychotic symptoms and the initiation of adequate psychiatric care. The objective of this study is to show the impact of an intervention facilitating access to specialized care for PEP on the reduction of DUP. This intervention consists of an early identification program for FPE, the PRESTO program, specifically targeting 3 determining steps in the reduction of DUP: * Informing the general population about psychotic disorders * Knowledge of front line actors (APL: general practitioners, school and university medicine, teenager's house, associative networks educators, emergency services, firefighters, etc.) about FPE and its management * Articulation between APL and specialized psychiatric care
Eligibility
Inclusion Criteria3
- Patients with a diagnosis of schizophrenia, schizoaffective disorder, schizophreniform disorder, or brief psychotic disorder established according to DMS 5
- Never having taken neuroleptic treatment for antipsychotic purposes, except for the current episode and for a duration of \< 6 month
- Oral consent of the patient or, for minors, of his/her parents to participate in the study
Exclusion Criteria2
- Patients already treated and followed for FPE
- Brief psychotic state not requiring specific management
Interventions
The program combines : 1. A population-based information component (information campaign aimed at the general population). 2. A training component for the LPAs (Front Line Actors: general practitioners, school and university medicine, pharmacists, teenagers school and university medicine, pharmacists, teenagers' homes, association networks, SAMU, firemen, etc.). 3. Facilitated access to care for FPE patients in the form of a "pivot" mobile team that can directly meet the patient at the request of the LPA, initiate care and ensure the relay within a the relay within 4 weeks to the existing specialized psychiatric structures on the site (CMP, CATTP (CMP, CATTP, day hospital, hospitalization unit, child and adolescent psychiatry services) adolescent psychiatry services)
Locations(6)
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NCT05813457