Initial outcomes of a community-based early intervention program: prevention and recovery in early psychosis (PREP)

Presentation First Author: 
Rachel L. Loewy

Increasing evidence suggests that early intervention can be effective and cost-effective in treating early psychosis. However, few intervention programs exist in the U.S. outside of academic medical centers. We present initial outcomes for PREP, a community-academic partnership program in San Francisco, CA serving adolescents and young adults with recent-onset psychosis (within 5 years of first psychotic episode) or at clinical-high-risk for psychosis. PREP provides an array of outpatient services tailored to the needs of each client/family in a community setting, including algorithm-based medication management, individual Cognitive Behavioral Therapy for psychosis, Psycho-Educational Multi-Family Groups, and vocational/educational support. Over 80 ethnically diverse clients (41% Caucasian, 24% Latino, 16% Asian-American and 15% African-American) entered PREP from 2008 to 2012. The majority of clients were male (70%), with a mean age of 21.7 years (± 4.1). Clients were assessed quarterly on the Quick Assessment of Negative Symptoms (QSANS), Quick Assessment of Positive Symptoms (QSAPS), PHQ-9, symptom distress, quality of life and functioning, as well as system use. Outcomes moved in the expected directions, with improvements in symptoms, related distress and quality of life over time. PREP clients were generally prescribed no more than one antipsychotic, at or less than the typical dose, as defined by the W.H.O. Additional data on functioning and service use for this ongoing program will also be discussed. Overall, preliminary within-subject analyses suggest that PREP clients experience a reduction in symptoms and improvement in quality of life while receiving psychosocial services and low-dose antipsychotic medications in a community-based program.

Conference Name: 
Presentation Date: 
January, 2013
Additional Authors: 
Rachel Loewy, Erika Van Buren, Kate Hardy, Melissa Moore, Demian Rose, Perry Olshan, Carletta Jackson-Lane, Michael Gause, Jessica Selvin, Alma Jackson, Bob Bennett
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