Cognitively oriented psychotherapy for early psychosis (COPE): a 1-year follow-up.

Objectives: Cognitively oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode.

Design: A total of 80 people participated in the initial trial and completed assessments on a range of outcome measures. Post-treatment assessment results from a non-randomized controlled trial of COPE have been previously reported.

Facial affect and affective prosody recognition in first-episode schizophrenia.

Individuals with schizophrenia experience problems in the perception of emotional material; however, the specificity, extent, and nature of the deficits are unclear. Facial affect and affective prosody recognition were examined in representative samples of individuals with first-episode psychosis, assessed as outpatients during the early recovery phase of illness, and non-patients. Perception tasks were selected to allow examination of emotion category results across face and voice modalities.

Enduring negative symptoms in first-episode psychosis: comparison of six methods using follow-up data.

Targeted intervention in the early treatment of enduring positive and negative symptoms in first-episode psychosis is contingent on adequate case-identification procedures. Six methods of determining enduring negative symptoms in a sample of 238 individuals with first-episode psychosis who were assessed at three time points over a 12-month period are described. Results were examined at each of the seven combinations of follow-up points, revealing a highly fluid pattern.

Duration of untreated psychosis and 12-month outcome in first-episode psychosis: the impact of treatment approach.

Objective: Early intervention research is examining whether reducing the duration of untreated psychosis (DUP) leads to improved outcome from first-episode psychosis. Another key influence may be the quality of treatment after initiation of care. This study examined the effect of phase-specific treatment on 12-month outcome for different categories of DUP.

Is phase-specific, community-oriented treatment of early psychosis an economically viable method of improving outcome?

Objective: The Early Psychosis Prevention and Intervention Centre (EPPIC) provides a comprehensive 'real-world' model of early intervention to young people experiencing an emerging psychotic disorder. A prospective study has already provided evidence of improved clinical outcome at 12 months after entry. The present study examined whether the service was also cost-effective.

Analysis of the initial treatment phase in first-episode psychosis.

Background: The Early Psychosis Prevention and Intervention Centre (EPPIC) commenced operation in Melbourne, Australia, in 1992. It offers a model for management of first-episode psychosis, utilising principles of early detection, low-dose medication and comprehensive psychosocial interventions within the least restrictive setting.

Method: Data were examined from the first three months of treatment for all consecutive people with first-episode psychosis (n = 231) accepted in the programme in 1995-1996.

The prodromal phase of first-episode psychosis: past and current conceptualizations.

The initial prodrome in psychosis is potentially important for early intervention, identification of biological markers, and understanding the process of becoming psychotic. This article reviews the previous literature on prodrome, including descriptions of symptoms and signs, and patterns and durations of prodromes in both schizophrenic and affective psychoses. Early detailed descriptions, achieved through mainly anecdotal reports, are compared with current conceptualizations, such as the DSM-III-R checklist of mainly behavioral items, which seeks to enhance reliability of measurement but at the expense of adequately describing the full range of phenomena.

EPPIC: an evolving system of early detection and optimal management.

Early intervention at the onset of psychotic disorders is a highly attractive theoretical notion that is receiving increasing international interest. In practical terms, it amounts to first deciding when a psychotic disorder can be said to have commenced and then offering potentially effective treatment at the earliest possible point. A second element involves ensuring that this intervention constitutes best practice for this phase of illness and is not merely the translation of standard treatments developed for later stages and the more persistently ill subgroups of the disorder.

Monitoring and care of young people at incipient risk of psychosis.

This article describes the theoretical background, origins, and development of a new clinical service for intervention in the putatively prodromal phase of schizophrenia and other psychotic disorders. Establishing such a service required examination of conceptual issues such as the meaning of the prodrome in psychosis and its association with risk of subsequent psychosis, and of practical issues related to identifying prodromal patients in the community and engaging them in monitoring and treatment. Patients' needs, timing, and mode of treatment had to be considered.

The prevalence of prodromal features of schizophrenia in adolescence: a preliminary survey.

In most cases of schizophrenia the onset of frank psychosis is preceded by a period of prodromal features. This period has been relatively neglected by researchers and is potentially important in promoting early intervention. The prevalence of DSM-III-R schizophrenia prodrome symptoms was assessed as part (n = 657) of a large (n = 2525) questionnaire-based survey of high school students.

Spurious precision: procedural validity of diagnostic assessment in psychotic disorders.

Objective: Very few studies have quantified the level of agreement among alternative diagnostic procedures that use a common set of fixed operational criteria. The authors examined the procedural validity of four independent methods of assigning DSM-III-R diagnoses of psychotic disorders.

Method: The research was conducted as a satellite study to the DSM-IV Field Trial for Schizophrenia and Related Psychotic Disorders.