M Lambert1, D Schöttle1, F Ruppelt1, A Rohenkohl1, M Sengutta1, D Luedecke1,2, L A Nawara1, B Galling3, A-L Falk1, L Wittmann1, V Niehaus1, G Sarikaya1, L Rietschel4, C Gagern5, M Schulte-Markwort2, H-P Unger6, S Ott7, G Romer8, A Daubmann9, K Wegscheider9, C U Correll3, B G Schimmelmann2,4, K Wiedemann1, T Bock1, J Gallinat1, A Karow1,2. 1. Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany. 2. Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, UKE, Hamburg, Germany. 3. The Zucker Hillside Hospital, Psychiatry Research, Glen Oaks, NY, USA. 4. University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland. 5. Department of Clinical Psychology and Psychotherapy, University of Hamburg, Hamburg, Germany. 6. Center for Mental Health, Department of Psychiatry, Psychotherapy and Psychosomatics, Asklepios Hospital Harburg, Hamburg, Germany. 7. Center for Mental Health, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Asklepios Hospital Harburg, Hamburg, Germany. 8. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Muenster, Münster, Germany. 9. Department of Medical Biometry and Epidemiology, UKE, Hamburg, Germany.
Abstract
OBJECTIVE: The objective of the study was to investigate whether a combined intervention composed of early detection plus integrated care (EDIC) enhances outcomes in patients with early psychosis compared to standard care (SC). METHODS: ACCESS III is a prospective non-randomized historical control design 1-year study examining the efficacy of EDIC (n = 120) vs. SC (n = 105) in patients aged 12-29 years. Primary outcome was the rate of ≥6 months combined symptomatic and functional remission. Additional outcomes comprised the reduction of DUP and course of psychopathology, functioning, quality of life, and satisfaction with care. RESULTS: In observed cases, 48.9% in the EDIC and 15.2% in the SC group reached the primary endpoint. Remission was predicted by EDIC (OR = 6.8, CI: 3.15-14.53, P < 0.001); younger age predicted non-remission (OR = 1.1, CI: 1.01-1.19, P = 0.038). Linear regressions indicated a reduction of DUP in EDIC (P < 0.001), but not in SC (P = 0.41). MMRMs showed significantly larger improvements in PANSS positive (P < 0.001) and GAF (P < 0.01) scores in EDIC vs. SC, and in EDIC over time in CGI-Severity (P < 0.001) and numerically in Q-LES-Q-18 (P = 0.052). CONCLUSIONS: EDIC lead to significantly higher proportions of patients achieving combined remission. Moderating variables included a reduction of DUP and EDIC, offering psychotherapeutic interventions.
OBJECTIVE: The objective of the study was to investigate whether a combined intervention composed of early detection plus integrated care (EDIC) enhances outcomes in patients with early psychosis compared to standard care (SC). METHODS: ACCESS III is a prospective non-randomized historical control design 1-year study examining the efficacy of EDIC (n = 120) vs. SC (n = 105) in patients aged 12-29 years. Primary outcome was the rate of ≥6 months combined symptomatic and functional remission. Additional outcomes comprised the reduction of DUP and course of psychopathology, functioning, quality of life, and satisfaction with care. RESULTS: In observed cases, 48.9% in the EDIC and 15.2% in the SC group reached the primary endpoint. Remission was predicted by EDIC (OR = 6.8, CI: 3.15-14.53, P < 0.001); younger age predicted non-remission (OR = 1.1, CI: 1.01-1.19, P = 0.038). Linear regressions indicated a reduction of DUP in EDIC (P < 0.001), but not in SC (P = 0.41). MMRMs showed significantly larger improvements in PANSS positive (P < 0.001) and GAF (P < 0.01) scores in EDIC vs. SC, and in EDIC over time in CGI-Severity (P < 0.001) and numerically in Q-LES-Q-18 (P = 0.052). CONCLUSIONS:EDIC lead to significantly higher proportions of patients achieving combined remission. Moderating variables included a reduction of DUP and EDIC, offering psychotherapeutic interventions.
Authors: Christoph U Correll; Britta Galling; Aditya Pawar; Anastasia Krivko; Chiara Bonetto; Mirella Ruggeri; Thomas J Craig; Merete Nordentoft; Vinod H Srihari; Sinan Guloksuz; Christy L M Hui; Eric Y H Chen; Marcelo Valencia; Francisco Juarez; Delbert G Robinson; Nina R Schooler; Mary F Brunette; Kim T Mueser; Robert A Rosenheck; Patricia Marcy; Jean Addington; Sue E Estroff; James Robinson; David Penn; Joanne B Severe; John M Kane Journal: JAMA Psychiatry Date: 2018-06-01 Impact factor: 21.596
Authors: Daniel Schöttle; Friederike Ruppelt; Benno G Schimmelmann; Anne Karow; Alexandra Bussopulos; Jürgen Gallinat; Klaus Wiedemann; Daniel Luedecke; Anja Christine Rohenkohl; Christian G Huber; Thomas Bock; Martin Lambert Journal: Front Psychiatry Date: 2019-10-24 Impact factor: 4.157
Authors: Anja Christine Rohenkohl; Anne Daubmann; Jürgen Gallinat; Anne Karow; Vivien Kraft; Friederike Rühl; Daniel Schöttle; Martin Lambert; Romy Schröter Journal: Health Qual Life Outcomes Date: 2022-09-08 Impact factor: 3.077
Authors: Martin Lambert; Anne Karow; Jürgen Gallinat; Daniel Lüdecke; Vivien Kraft; Anja Rohenkohl; Romy Schröter; Constanze Finter; Anna-Katharina Siem; Lisa Tlach; Nathalie Werkle; Susann Bargel; Gunda Ohm; Martin Hoff; Helmut Peter; Martin Scherer; Claudia Mews; Susanne Pruskil; Johannes Lüke; Martin Härter; Jörg Dirmaier; Michael Schulte-Markwort; Bernd Löwe; Peer Briken; Heike Peper; Michael Schweiger; Mike Mösko; Thomas Bock; Martin Wittzack; Hans-Jochim Meyer; Arno Deister; Rolf Michels; Stephanie Herr; Alexander Konnopka; Hannah König; Karl Wegscheider; Anne Daubmann; Antonia Zapf; Judith Peth; Hans-Helmut König; Holger Schulz Journal: BMJ Open Date: 2020-05-04 Impact factor: 2.692