Are the routine early intervention services as effective as the randomised trials?

Presentation First Author: 
Max Birchwood

Early intervention in psychosis services (EIS) have been established in the UK for over 10 years and recommended in the UK NICE schizophrenia guidelines. How does the routine provision of EIS compare to these trials and what can we learn from them? We present results from the UK national evaluation of EIS, NATIONAL EDEN, a prospective study of 1027 individuals drawn from 5 sites and over 12 teams. We found that the level of engagement was uniformly high with drop out rate less than the RCTs. Using survival analysis, the rate of relapse over 12 months was less than 20% and well within the margin described in the UK LEO trial to maximise cost-efficacy. We conducted a prospective acceptability study of consumers and carers views of EIS. Consumers value these services highly, especially the community outreach aspect and the opportunity to access care in case of emerging crisis; however, a third of service users found that assertive outreach aspect too instrusive and controlling and at risk of disengagement. We conclude by describing what we argue should be the structure and focus of the 'second generation' of EIS.

Conference Name: 
Presentation Date: 
January, 2013
Additional Authors: 
Max Birchwood, Helen Lester
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