Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-27T22:29:17.992Z Has data issue: false hasContentIssue false

A pilot study of the effects of early intervention on clinical symptoms and social functioning in psychiatric emergencies

Published online by Cambridge University Press:  13 June 2014

P Tyrer
Affiliation:
Early Intervention Service, St. Charles Hospital, London W10 6DZ.
S Merson
Affiliation:
Early Intervention Service, St. Charles Hospital, London W10 6DZ.
P Harrison-Read
Affiliation:
Early Intervention Service, St. Charles Hospital, London W10 6DZ.
S Lynch
Affiliation:
Early Intervention Service, St. Charles Hospital, London W10 6DZ.
P Birkett
Affiliation:
Early Intervention Service, St. Charles Hospital, London W10 6DZ.
S Onyett
Affiliation:
Early Intervention Service, St. Charles Hospital, London W10 6DZ.

Abstract

A pilot study of the effects of early intervention by a multidisciplinary community team in patients presenting as psychiatric emergencies to an inner London teaching hospital (St. Mary's) is described. Of 22 consecutive emergency referrals, 20 agreed to be formally assessed, 18 were successfully engaged and 16 had assessments of symptoms and social functioning assessed over a four week period. There was significant improvement in clinical symptoms but no important changes in social functioning. The discordance between improvement in social function and symptoms was unexpected and may reflect the unusual social circumstances of life in metropolitan London or be a consequence of the high proportion (55%) of patients seen with personality disorders.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Onyett, S, Tryer, P, Connolly, J, Malone, S, et al.The Early Intervention Service: the first eighteen months of an inner London demonstration project. Psychiatric Bulletin 1990; 14: 267269.CrossRefGoogle Scholar
2.Asberg, M, Montgomery, SA, Perris, C, Schalling, D, Sedvall, G. A comprehensive psychopathological rating scale. Acta Psychiatr Scand 1978; Supplementum 271: 529.Google Scholar
3.Montgomery, SA, Asberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382389.CrossRefGoogle ScholarPubMed
4.Tyrer, P, Owen, RT, Cicchetti, D. The Brief Scale for Anxiety: a subdivision of the Comprehensive Psychopathological Rating Scale. J Neurol Neurosurg Psychiatry 1984; 47: 970975.CrossRefGoogle ScholarPubMed
5.World health Organisation. International Classification of Diseases, draft for 10th revision. Geneva: WHO, 1988.Google Scholar
6.Tyrer, P, Alexander, J. Classification of personality disorder. Br J Psychiatry 1979; 135: 163167.CrossRefGoogle ScholarPubMed
7.Tyrer, P, Alexander, J, Ferguson, B. Personality assessment schedule. In: Tyrer, P, ed. Personality disorders: diagnosis, management and course. London: Wright, 1988: 140167.Google Scholar
8.Remington, M, Tyrer, P. The Social Functioning Schedule – a brief semi-structured interview. Soc Psychiatry 1979; 14: 151157.CrossRefGoogle Scholar
9.Tyrer, P. Personality disorder and social functioning. In: Peck, D, Shapiro, C, eds. Chichester: John Wiley and Sons (in press).Google Scholar
10.Anstee, BH. Psychiatry in the casualty department. Br J Psychiatry 1972; 120: 625629.CrossRefGoogle ScholarPubMed
11.Lim, MH. A psychiatric emergency clinic: a study of attendances over six months. Br J Psychiatry 1983; 143: 460466.CrossRefGoogle Scholar
12.Casey, PR, Tyrer, PJ, Dillon, S. The diagnostic status of patients with conspicuous psychiatric morbidity in primary care. Psychol Med 1984; 14: 673681.CrossRefGoogle ScholarPubMed
13.Tyrer, P, Casey, P, Gall, J. The relationship between neurosis and personality disorder. Br J Psychiatry 1983; 142: 404408.CrossRefGoogle ScholarPubMed
14.Cutting, J, Cowen, PJ, Mann, AH, Jenkins, R. Personality and psychosis: use of the Standardised Assessment of Personality. Acta Psychiatr Scand 1986; 73: 8792.CrossRefGoogle Scholar
15.Tyrer, P, Remington, M. Controlled comparison of day hospital and out-patient treatment for neurotic disorders. Lancet 1979; i: 10141016.CrossRefGoogle Scholar
16.Platt, S, Weyman, A, Hirsch, S, Hewett, S. The Social Behaviour Assessment Schedule (SBAS): rationale, contents, scoring and reliability of a new interview schedule. Soc Psychiatry 1980; 15: 4355.CrossRefGoogle Scholar
17.Casey, PR, Tyrer, PJ, Piatt, S. The relationship between social functioning and psychiatric symptomatology in primary care. Soc Psychiatry 1985; 20: 59.CrossRefGoogle ScholarPubMed
18.Weissman, MM, Klerman, GL, Paykel, ES, Prusoff, B, Hansen, B. Treatment effects on the social adjustment of depressed patients. Arch Gen Psychiatry 1974; 30: 771778.CrossRefGoogle ScholarPubMed
19.Goering, P, Wasylenki, D, Lancee, W, Freeman, SJ. Social support and post-hospital outcome for despressed women. Can J Psychiatry 1983; 28: 612623.CrossRefGoogle ScholarPubMed
20.Goering, P, Wasylenki, D, Lancee, W, Freeman, SJ. From hospital to community: six-month and two-year outcomes for 505 patients. J Nerv Ment Dis 1984; 172: 667–73.CrossRefGoogle ScholarPubMed
21.Leaf, PJ, Weisman, MM, Myers, JK. Social factors related to psychiatric disorder: the Yale epidemiologic catchment area study. Soc Psychiatry 1984; 19: 5361.CrossRefGoogle ScholarPubMed
22.Brugha, TS. Social support. Current Opinion in Psychiatry 1988; 1: 206–11.CrossRefGoogle Scholar