Contemporary Perspectives in Schizophrenia Care
Early, Comprehensive Intervention

Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis: A Systematic Review, Meta-analysis, and Meta-regression

Correll CU, et al.  JAMA Psychiatry. 2018;75(6):555-565.
4 min

The Study

Comprehensive early intervention in psychosis remains an ongoing area of debate regarding both its clinical value and when/how to allocate public resources. This rigorous systematic review of 10 randomized clinical trials comprising 2,176 patients analyzed clinical outcomes among early-phase psychosis patients who received either early intervention services (EIS) or treatment as usual (TAU). EIS consisted of antipsychotic treatment and 4-6 evidence-based psychosocial interventions.

The Analysis

Six to 24 months of EIS was associated with superior outcomes vs TAU in all 13 meta-analyzable outcomes, including hospitalization risk, bed-days, symptom severity, global functioning, and all-cause treatment discontinuation. Importantly, duration of untreated psychosis did not appear to be predictive of the superior outcomes observed in the EIS group vs TAU.

The Reason It Matters

These results further reinforce the need for widespread funding and implementation of EIS among patients with early-phase psychosis. Critically, several lines of evidence indicate that gains made at Year 2 could be sustained or increased with EIS at a lower level for another 3 years, suggesting that the duration of EIS is an additional key factor to consider along the patient journey.

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