Transcript Does Primary Care have a role in Early Intervention?

IRIS
Initiative to Reduce the Impact
of Schizophrenia
DON’T DELAY! IT’S TIME TO
REDUCE THE IMPACT OF PSYCHOSIS
IN YOUNG PEOPLE…….
NOW!
1
DID YOU KNOW?
• Early Diagnosis and • The first few years of
treatment leads to
psychosis is a ‘critical
significantly
period’ socially,
improved recovery
psychologically and
and outcome in
biologically - the
psychosis.
earlier that treatment
starts the better the
long term outcome.
2
Consider psychosis when a young
adult shows persistent changes in
functioning, behaviour or personality
• Physical e.g. sleep disturbance, loss of energy
• Affect e.g. anxiety, irritability and depression
• Cognitive difficulties e.g. poor concentration and
memory
• Thought content e.g preoccupation with new ideas
• Social difficulties and a tendency to become
isolated
• Self harm
3
Why treat first-episode psychosis
in a special way? 1.
• The prospects of recovery in this group are very
good - 85% can remit within a few months.
• Relapse prevention is vital in the early years: each
relapse increases the risk of further relapse.
• Early psychosis is a biologically ‘critical period’:
most of the decline in cognition and function occurs in
the first five years of psychosis
4
Why treat first-episode psychosis
in a special way? 2.
• ‘critical period’ for suicide risk;10 - 15% of
people with psychosis kill themselves within
the first 10 years of illness, and two thirds of
these within the first 6 years.
• Adverse outcomes from psychiatric
hospitalisation -- 45% of people with first
episode psychosis have clear evidence of
post traumatic stress related to their illness
and treatment
5
Effective responses-1.
• Improve collaboration between primary,
secondary and a variety of community
agencies
• Deliver in a range of low-stigma settings,
sensitive to the needs of young people
• Facilitate medical treatment from GP with
support of specialist care
6
Effective responses-2.
• Low dose neuroleptic drug therapy started
within 6 months of onset of psychosis,
with early review of treatment resistance
• Family interventions
• Support in vocational, educational
recreational and social attainments
7
As GPs we need to raise our
awareness
• Stay alert
• Be suspicious
• Ask about positive symptoms
• Be aware of risk factors like family history,
self-harm
8
And perhaps most important of all ….
Be Optimistic!!!
• Prompt diagnosis and treatment of
first episode and early relapse
significantly improves prospects for
recovery in psychosis.
9