Lorenzo Pelizza1,2, Silvia Azzali1, Federica Paterlini1, Sara Garlassi1, Ilaria Scazza1, Luigi R Chiri3, Michele Poletti1, Simona Pupo4, Andrea Raballo5. 1. Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy. 2. Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy. 3. Department of Primary Care, Azienda USL di Parma, Parma, Italy. 4. Anesthesia and Resuscitation Service, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. 5. Division of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation, Sant'Andrea University of Perugia, Perugia, Italy.
Abstract
AIM: From September 2012, the Reggio Emilia Department of Mental Health developed a specific program (the "Reggio Emilia At-Risk Mental States" [ReARMS] protocol) as a diffused, "liquid" infrastructure for early intervention in psychosis. Aims of the current study are (a) to describe the ReARMS macroscopic organization and (b) to examine specific process indicators during the first 5 years of clinical activity. METHODS: All participants (n = 300) were young help-seekers, aged 13 to 35 years, who completed the Comprehensive Assessment of At-Risk Mental States (CAARMS). RESULTS: At baseline, 95 (31.7%) participants did not meet CAARMS-defined criteria, while 205 (68.3%) were offered a dedicated protocol of care: 154 (75.1%) of them were enrolled in the program, 19 (9.3%) refused and 32 (15.6%) dropped out during the first year of treatment. Individuals enrolled in the ReARMS protocol were mainly referred by general practitioners (33.3%), emergency room/general hospital (24%) or they were self-referred (15%). In comparison with ultra-high risk individuals, patients with first episode psychosis showed significantly higher mean age at entry and preponderance of males, as well as higher percentages of history of substance abuse and previous hospitalization. CONCLUSIONS: An early intervention in psychosis service in Italian child/adolescent and adult mental health services are feasible and clinically relevant, also in adolescents, who have a high risk of falling through the child-adult service gap as they cross the transition boundary between services.
AIM: From September 2012, the Reggio Emilia Department of Mental Health developed a specific program (the "Reggio Emilia At-Risk Mental States" [ReARMS] protocol) as a diffused, "liquid" infrastructure for early intervention in psychosis. Aims of the current study are (a) to describe the ReARMS macroscopic organization and (b) to examine specific process indicators during the first 5 years of clinical activity. METHODS: All participants (n = 300) were young help-seekers, aged 13 to 35 years, who completed the Comprehensive Assessment of At-Risk Mental States (CAARMS). RESULTS: At baseline, 95 (31.7%) participants did not meet CAARMS-defined criteria, while 205 (68.3%) were offered a dedicated protocol of care: 154 (75.1%) of them were enrolled in the program, 19 (9.3%) refused and 32 (15.6%) dropped out during the first year of treatment. Individuals enrolled in the ReARMS protocol were mainly referred by general practitioners (33.3%), emergency room/general hospital (24%) or they were self-referred (15%). In comparison with ultra-high risk individuals, patients with first episode psychosis showed significantly higher mean age at entry and preponderance of males, as well as higher percentages of history of substance abuse and previous hospitalization. CONCLUSIONS: An early intervention in psychosis service in Italian child/adolescent and adult mental health services are feasible and clinically relevant, also in adolescents, who have a high risk of falling through the child-adult service gap as they cross the transition boundary between services.