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Early detection strategies for untreated first-episode psychosis.

https://arctichealth.org/en/permalink/ahliterature71893
Source
Schizophr Res. 2001 Aug 1;51(1):39-46
Publication Type
Article
Date
Aug-1-2001
Author
J O Johannessen
T H McGlashan
T K Larsen
M. Horneland
I. Joa
S. Mardal
R. Kvebaek
S. Friis
I. Melle
S. Opjordsmoen
E. Simonsen
H. Ulrik
P. Vaglum
Author Affiliation
Rogaland Psychiatric Hospital, P.O. Box 1163, Hillevåg, 4095, Stavanger, Norway. joj@rps.no
Source
Schizophr Res. 2001 Aug 1;51(1):39-46
Date
Aug-1-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Comparative Study
Denmark
Ethics, Medical
Female
Health education
Health Services Accessibility
Humans
Male
Middle Aged
Norway
Outcome and Process Assessment (Health Care)
Psychotic Disorders - diagnosis - drug therapy
Referral and Consultation
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Schizophrenia - diagnosis - drug therapy
Schizotypal Personality Disorder - diagnosis - drug therapy
Abstract
Some studies in first-episode schizophrenia correlate shorter duration of untreated psychosis (DUP) with better prognosis, suggesting that timing of treatment may be important. A three-site prospective clinical trial in Norway and Denmark is underway to investigate the effect of the timing of treatment in first-episode psychosis. One health care sector (Rogaland, Norway) is experimental and has developed an early detection (ED) system to reduce DUP. Two other sectors (Ullevål, Norway, and Roskilde, Denmark) are comparison sectors and rely on existing detection and referral systems for first-episode cases. The study ultimately will compare early detected with usual detected patients. This paper describes the study's major independent intervention variable, i.e. a comprehensive education and detection system to change DUP in first onset psychosis.System variables and first results from the four-year inclusion period (1997-2000) are described. It includes targeted information towards the general public, health professionals and schools, and ED teams to recruit appropriate patients into treatment as soon as possible. This plus easy access to psychiatric services via ED teams systematically changed referral patterns of first-episode schizophrenia. DUP was reduced by 1.5 years (mean) from before the time the ED system was instituted (to 0.5 years). The ED strategies appear to be effective and to influence directly the community's help-seeking behaviour.
PubMed ID
11479064 View in PubMed
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The UllevÄl acute ward follow-up study: a personal 7-year follow-up of patients with functional psychosis admitted to the acute ward of a catchment area.

https://arctichealth.org/en/permalink/ahliterature68594
Source
Psychopathology. 1991;24(5):316-27
Publication Type
Article
Date
1991
Author
S. Friis
E. Hauff
T K Island
S. Lorentzen
I. Melle
P. Vaglum
Author Affiliation
Psychiatric Department B, Ullevål University Hospital, Norway.
Source
Psychopathology. 1991;24(5):316-27
Date
1991
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Catchment Area (Health)
Female
Follow-Up Studies
Hospitalization
Humans
Male
Middle Aged
Norway
Psychotic Disorders - diagnosis - psychology - therapy
Research Support, Non-U.S. Gov't
Sex Factors
Treatment Outcome
Abstract
Eighty-eight patients were admitted to the acute ward of a catchment area suffering from the following functional psychoses: schizophrenia (S; n = 41), affective disorder (AD; n = 22), other disorders (OD; n = 25). Follow-up data were obtained for 97%. Ten patients were dead at follow-up, 8 due to suicide. Sixty-five were personally interviewed. While nearly all the patients had only brief periods of rehospitalization, most had used neuroleptics during the follow-up period. Compared to other samples, functioning at follow-up was fairly good for the AD and OD patients, but rather poor for the S patients.
PubMed ID
1784708 View in PubMed
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The importance of ward atmosphere in inpatient treatment of schizophrenia on short-term units.

https://arctichealth.org/en/permalink/ahliterature211596
Source
Psychiatr Serv. 1996 Jul;47(7):721-6
Publication Type
Article
Date
Jul-1996
Author
I. Melle
S. Friis
E. Hauff
T K Island
S. Lorentzen
P. Vaglum
Author Affiliation
Department for clinical psychiatric research, Ullevål Hospital, Oslo, Norway.
Source
Psychiatr Serv. 1996 Jul;47(7):721-6
Date
Jul-1996
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adult
Female
Hospital Restructuring
Humans
Length of Stay
Male
Middle Aged
Norway
Patient Readmission
Schizophrenia - rehabilitation
Schizophrenic Psychology
Social Adjustment
Social Environment
Treatment Outcome
Abstract
The reorganization in 1981 of a general hospital psychiatric ward in Oslo, Norway, to achieve a more suitable treatment milieu for patients with schizophrenia resulted in a change in patients' perceptions of the ward atmosphere. Reduced group participation and increased individualized support from staff led patients to perceive of the ward as having a low level of anger and aggression and a high level of order and organization. This study examined whether the reorganization was associated with improved treatment outcome.
Psychiatrists retrospectively examined the charts of all patients with a DSM-III-R diagnosis of schizophrenia or schizophreniform disorder who were admitted to the ward the year before and the second year after the reorganization. Multiple regression analyses were used to examine treatment outcomes for both groups. Outcome was measured indirectly by length of stay, level of functioning at discharge, and whether the patient was rehospitalized during the following seven years.
Patients treated after the reorganization had significantly shorter stays with no reductions in either level of functioning at discharge or length of community tenure after discharge. Differences in demographic characteristics, illness history, or psychopharmacological treatment could not account for differences in outcome.
The results supported the hypothesis that the organization and milieu of brief-stay wards influence the short-term outcome of inpatient treatment of patients with schizophrenia.
PubMed ID
8807685 View in PubMed
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