Early detection of psychosis – Establishing a service for persons at risk

An abstract published in the January 2009 edition of European Psychiatry:

By Frauke Schultze-Lutter, Stephan Ruhrmann, and Joachim Klosterkötter [pictured]

University of Cologne, Department of Psychiatry and Psychotherapy, Early Recognition and Intervention Centre for Mental Crises (FETZ), 50924 Cologne, Germany

Purpose

The establishment phase of an early detection centre for prodromal psychosis is introduced and characterised, along with its detaining and promoting factors within a universal multi-payer health care system.

Method

Across the first six years (1998–2003), users' characteristics are compared between different diagnostic groups and to the local population statistics; and, for an exemplary 12-months period (3-1-2002 to 2-28-2003), the characteristics of telephone contacts with the service are studied.

Results

Rising steadily in number across the first three years, 872 persons, predominately of German citizenship and higher education, consulted the service until 2003, 326 with first-episode psychosis and 144 not fulfilling criteria for a current or beginning psychosis. Of the 402 putatively prodromal patients, 94% reported predictive basic symptoms, 68.9% attenuated and 20.6% transient psychotic symptoms. Most contacts by persons meeting any prodromal criterion were initiated by mental health professionals (psychiatrists or psychologists) and counselling services.

Conclusion

Supported by public awareness campaigns, an early detection service is well received by its users and private practitioners as reflected by the large proportion of referrals from the latter. However, persons of non-German background as well as of lower education were underrepresented indicating that these sub-groups should be approached by tailored programmes.

Keywords: Psychosis; Early detection; Prodrome; Outpatient health services; Program evaluation

To download the entire article, click here (PDF).

Posting of this abstract is for the purposes of research into early psychosis.

Also see:

Early Detection Fact Sheet (PDF)

Nova Scotia Early Psychosis Program

Photograph of Joachim Klosterkötter courtesy of the University of Cologne.