Luis Alameda1, Philippe Golay2, Philipp Baumann3, Stéphane Morandi4, Carina Ferrari3, Philippe Conus5, Charles Bonsack4. 1. Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Switzerland; Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Switzerland. Electronic address: Luis.alameda-fernandez@chuv.ch. 2. Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Switzerland; Service of community Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Switzerland. 3. Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Switzerland; Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Switzerland. 4. Service of community Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Switzerland. 5. Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Switzerland.
Abstract
PURPOSE: Most specialized Early Psychosis (EP) programs include assertive outreach (AO) principles, either for all patients or as an intensive case management (ICM) subprogram in selected situations. The objective of this study is to examine prevalence, characteristics and outcomes of patients who needed additional ICM in a specialized EP program. METHODS: In a 3-year prospective naturalistic study of 229 consecutive EP patients treated at TIPP-Lausanne we compared characteristics of those who needed ICM and those who did not. RESULTS: 60 (26.2%) TIPP patients needed ICM. At baseline, ICM-patients showed a poorer academic premorbid functioning (p=0.019); lower level of insight (p<0.001); had a previous history of alcohol (p=0.043) and cannabis (p=0.040) use. ICM-patients were less likely to be adherent to medication during the early phase of treatment but differences disappeared during follow-up. ICM-patients showed globally a poorer functional level and higher level of positive and negative symptoms during the follow-up. CONCLUSIONS: About one quarter of EP patients needed a combination of ICM and assertive outreach. Despite the high treatment adherence in both groups, psychotic symptoms remained higher in ICM-patients. In a real live setting with limited resources, combination of ICM and AO in selected situations seems a valid solution.
PURPOSE: Most specialized Early Psychosis (EP) programs include assertive outreach (AO) principles, either for all patients or as an intensive case management (ICM) subprogram in selected situations. The objective of this study is to examine prevalence, characteristics and outcomes of patients who needed additional ICM in a specialized EP program. METHODS: In a 3-year prospective naturalistic study of 229 consecutive EP patients treated at TIPP-Lausanne we compared characteristics of those who needed ICM and those who did not. RESULTS: 60 (26.2%) TIPP patients needed ICM. At baseline, ICM-patients showed a poorer academic premorbid functioning (p=0.019); lower level of insight (p<0.001); had a previous history of alcohol (p=0.043) and cannabis (p=0.040) use. ICM-patients were less likely to be adherent to medication during the early phase of treatment but differences disappeared during follow-up. ICM-patients showed globally a poorer functional level and higher level of positive and negative symptoms during the follow-up. CONCLUSIONS: About one quarter of EP patients needed a combination of ICM and assertive outreach. Despite the high treatment adherence in both groups, psychotic symptoms remained higher in ICM-patients. In a real live setting with limited resources, combination of ICM and AO in selected situations seems a valid solution.
Authors: Valerie Moulin; Julie Palix; Luis Alameda; M Mehdi Gholamrezaee; Philipp S Baumann; Jacques Gasser; Julien Elowe; Alessandra Solida; Philippe Conus Journal: Can J Psychiatry Date: 2017-06-28 Impact factor: 4.356
Authors: Valerie Moulin; Philipp Baumann; Mehdi Gholamrezaee; Luis Alameda; Julie Palix; Jacques Gasser; Philippe Conus Journal: Front Psychiatry Date: 2018-07-04 Impact factor: 4.157
Authors: Luis Alameda; Axel Levier; Mehdi Gholam-Rezaee; Philippe Golay; Frederik Vandenberghe; Aurélie Delacretaz; Philipp Baumann; Anaïs Glatard; Céline Dubath; Andres Herane-Vives; Victoria Rodriguez; Alessandra Solida; Kim Q Do; Chin B Eap; Philippe Conus Journal: PLoS One Date: 2020-12-03 Impact factor: 3.240
Authors: Philippe Golay; Charles Bonsack; Benedetta Silva; Guillaume Pauli; Eva de Boer; Stéphane Morandi Journal: Adm Policy Ment Health Date: 2022-05-16
Authors: Margot Fournier; Martina Scolamiero; Mehdi M Gholam-Rezaee; Martine Cleusix; Raoul Jenni; Carina Ferrari; Philippe Golay; Philipp S Baumann; Michel Cuenod; Philippe Conus; Kim Q Do; Kathryn Hess Journal: Mol Psychiatry Date: 2020-07-06 Impact factor: 15.992