A European perspective on the early intervention of clinical high risk states of psychoses
Poster B130, Friday, October 21, 11:30 am - 1:00 pm, Le Baron
Stefanie J Schmidt1, Stephan Ruhrmann2, Frauke Schultze-Lutter1, Joachim Klosterkötter2; 1University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland, 2Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
As prevention of psychosis becomes more widely accepted, it seems necessary to provide guidance for early intervention, reflecting their current capabilities, but also their requirements and limitations. A meta-analysis was performed to inform the guidance project of the European Psychiatric Association. Eligible studies had to investigate conversion rate and/or psychosocial functioning as a treatment outcome in clinical high risk (CHR) patients defined by the ultra-high risk and/or basic symptom criteria. Besides analyses on treatment effects on conversion rate and functional outcome, age and type of intervention were examined as potential moderators. 15 studies were included into the meta-analysis on early intervention. The 12-month pooled risk ratio was 0.44, the NNT was 10. Psychosocial functioning seemed not to improve substantially more in the experimental condition compared to the control condition. However results were inconclusive due to methodological issues of the trials. With regard to the type of intervention, both psychological and pharmacological interventions produced significant effects on conversion rates, but not on functional outcome relative to the control conditions. Early intervention in adolescent samples was generally less effective than in predominantly adult samples. Seven recommendations were developed to guide early intervention, emphasizing the need for age-adapted strategies. More studies are needed to investigate the specificity of treatment effects and potential age effects in order to tailor interventions to the individual treatment needs and risk status. Furthermore, studies need to consider the fluid interplay of risk and resilience factors to advance early intervention significantly.
Topic Area: Psychosocial Interventions