Efficacy of the Integrated Long-term Program of Management of Patients After First Psychotic Episode in 5-Year Follow-up [PW03-05]

Abstract

The study was carried out as prospective, longitudinal investigation of first episode patients having been treated in the integrative program in first episode clinic (1^st group, 114 patients) and in routine care (2^nd group, 109 patients) during 5-year follow-up. The integrated program included management according to the following principles: decrease of duration of untreated psychosis; using of services with initial or early transition to day treatment and at the following outpatient treatment stages; primary use of atypical neuroleptics in combination with psychosocial interventions; long-term follow up with individualized case management; family involvement in treatment and rehabilitation process. The efficacy was evaluated according to the comparative pairwise analysis using initial demographical and clinical characteristics of patients (34 pairs).

Comparing to the routine care, patients who have been treated in first episode clinic were more adherent to therapy regimen during the follow-up period, more than half of patients maintained the condition of complete remission. Moreover, patients of the 1^st group were more likely to show help-seeking behavior and referred to services during the earlier stages of the exacerbation, therefore the relapse rates were decreased and 2/3 of patients were treated in outpatient settings. Symptomatic control of the illness contributed to social recovery in patients within integrated care. By the 5^th year, only 1/5 of the cases of the 1^st group were formally recognized as unemployable due to psychiatric disability. Significantly better clinical and psychosocial outcomes have been shown in comparison with the group of patients, treated in routine psychiatric services.