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Proceedings of the NATO Advanced Research Workshop on Early Intervention in Psychiatric Disorders, Prague, Czech Republic, October 22-27, 1998
With expert guidance on developing specialty care service models for young people experiencing first-episode psychosis, the book offers a multimodal approach that aims for recovery and remission.
Despite years of research, debate and changes in mental health policy, there is still a lack of consensus as to what recovery from psychosis actually means, how it should be measured and how it may ultimately be achieved. In Recovering from a First Episode of Psychosis: An Integrated Approach to Early Intervention, it is argued that recovery from a first episode of psychosis (FEP) is comprised of three core elements: symptomatic, social and personal. Moreover, all three types of recovery need to be the target of early intervention for psychosis programmes (EIP) which provide evidence-based, integrated, bio-psychosocial interventions delivered in the context of a value base offering hope, empowerment and a youth-focused approach. Over the 12 chapters in the book, the authors, all experienced clinicians and researchers from multi-professional backgrounds, demonstrate that long-term recovery needs to replace short term remission as the key target of early psychosis services and that, to achieve this, we need a change in the way we deliver EIP: one that takes account of the different stages of psychosis and the ‘bespoke’ targeting of integrated medical, psychological and social treatments during the ‘critical period’. Illustrated with a wealth of clinical examples, this book will be of great interest to clinical psychologists, psychiatrists, psychiatric nurses and other associated mental health professionals.
There is increasing interest in the setting up of specialised centers focused on treating young people in order to secure better outcomes and prevent the accrual of disabilities. This practical handbook is aimed at mental health professionals and administrators. The rationale for early intervention is outlined and the authors describe the key elements of an early intervention strategy. There is strong emphasis on program evaluation and specific suggestions for application in an early psychosis context. Common issues and challenges in implementing early psychosis foci in the real world are highlighted. Numerous examples of early intervention strategies in operation around the globe are provided and progress on an international early psychosis consensus statement is outlined. 25 international advisors have been involved in the development of the project, making the book a unique, relevant and constructive guide for all professionals involved in this area.
The new edition of this popular handbook has been thoroughly updated to include the latest data concerning treatment of first-episode patients. Drawing from their experience, the authors discuss the presentation and assessment of the first psychotic episode and review the appropriate use of antipsychotic agents and psychosocial approaches in effective management.
This manual attempts to provide simple, adequate and evidence-based information to health care professionals in primary health care especially in low- and middle-income countries to be able to provide pharmacological treatment to persons with mental disorders. The manual contains basic principles of prescribing followed by chapters on medicines used in psychotic disorders; depressive disorders; bipolar disorders; generalized anxiety and sleep disorders; obsessive compulsive disorders and panic attacks; and alcohol and opioid dependence. The annexes provide information on evidence retrieval, assessment and synthesis and the peer view process.
Multiple voices throughout the last century have preached the merits of various treatments for schizophrenia, ranging from cold baths to the currently accepted standards such as neuroleptic medication. Along with these ongoing treatments, there have been quiet commentaries, made mostly from the sidelines, suggesting the need to shift and refocus the way we think and talk about schizophrenia. Harry Stack Sullivan noted in 1927 that, 'The psychiatrist sees too many end states and deals professionally with too few of the pre psychotic" (Sullivan 192711994, p. 135). Similar thoughts have been echoed by purveyors of modem treatment for psychosis such as Thomas H. McGlashan: "Like others before me, I tried to make a difference . . . but like the others my efforts were largely in vain. I came upon the scene too late; most of the damage was already done" (McGlashan, 1996). Similar interest in the early phase of schizophrenia has developed across the globe and consolidated into a tentative, yet meaningful deliberation about the potential for prevention of psychotic illness through early identification and intervention. In the past decade, international support has grown from: Ian Falloon's prodromal intervention project in Great Britain (Falloon et aI. , 1996); Patrick McGorry's and Jane Edward's first episode psychosis program in Melbourne, Australia (McGorry et al.
Psychological Interventions in Early Psychosis provides a comprehensive overview of the emerging research and clinical evidence base for psychological treatments across the phases of early psychosis. Beginning with identified at-risk young people, the text continues through to those in acute and recovery phases, to the needs of patients with persistent symptoms. This practical treatment handbook: draws upon the expertise of several internationally recognised clinical and research programs integrates reviews of the relevant research literature with illustrative case examples covers critical issues for the clinician in focal chapters on suicide prevention, comorbid cannabis abuse, and family work describes several modalities of treatment, such as multi-family psychoeducation, group work, psychodynamic and cognitive behavioural approaches. Specialist early psychosis services are developing rapidly worldwide. Psychological Interventions in Early Psychosis will be an essential resource for clinicians and service leaders alike.
Psychotic Disorders: Comprehensive Conceptualization and Treatments emphasizes a dimensional approach to psychosis--one of the most fascinating manifestations of altered brain behavior--that cuts across a broad array of psychiatric diagnoses from schizophrenia to affective psychosis and organic disorders like epilepsy and dementias. Written by an international roster of over seventy leading experts in the field, this volume comprehensively reviews, critiques, and integrates available knowledge on the etiology, mechanisms, and treatments of psychotic disorders, and outlines ways forward in both research and clinical practice towards more objective, mechanistically-based definitions of psychotic disorders. Chapters address topics such as psychosis phenomenology, biomarkers and treatments, the overlaps and interfaces between psychiatric disorders within the psychosis dimension, and novel disease definitions. Furthermore, the volume incorporates findings on potential mechanisms, bridges between various system levels (i.e., genetic, epigenetic, molecular and cellular, brain circuit and function, psychological, social, environmental and cultural) and their interactions, as well as the potential role in causation and/or mediation in psychotic disorders. Finally, the volume outlines a broad array of treatment approaches, from the readily available (e.g., psychopharmacology, various modalities of psychotherapy) to the experimental (e.g., cognitive interventions, neuromodulation). With a concluding section of forward perspectives conjecturing future directions and related challenges, this book aspires to stimulate new knowledge, generate novel frameworks, and carry new directions forward on psychotic disorders.
These guidelines from NICE set out clear recommendations, based on the best available evidence, for health care professionals on how to work with and implement physical, psychological and service-level interventions for people with various mental health conditions.The book contains the full guidelines that cannot be obtained in print anywhere else. It brings together all of the evidence that led to the recommendations made, detailed explanations of the methodology behind their preparation, plus an overview of the condition covering detection, diagnosis and assessment, and the full range of treatment and care approaches. There is a worse prognosis for psychosis and schizophrenia when onset is in childhood or adolescence, and this new NICE guideline puts much-needed emphasis on early recognition and assessment of possible psychotic symptoms. For the one-third of children and young people who go on to experience severe impairment as a result of psychosis or schizophrenia the guideline also offers comprehensive advice from assessment and treatment of the first episode through to promoting recovery.This guideline reviews the evidence for recognition and management of psychosis and schizophrenia in children and young people across the care pathway, encompassing access to and delivery of services, experience of care, recognition and management of at-risk mental states, psychological and pharmacological interventions, and improving cognition and enhancing engagement with education and employment.