Objective: Early psychosis intervention (EPI) programs improve clinical and functional outcomes for people with first-episode psychosis. Less is known about the impact of these programs on the larger health care system. The authors sought to compare indicators of health service use, self-harm, suicide, and mortality between people with first-episode psychosis who were using EPI services and a propensity-matched group of concurrent control subjects who were not accessing EPI services.
Method: A retrospective cohort of incident cases of nonaffective psychosis in the catchment area of the Prevention and Early Intervention Program for Psychoses in London, Ontario, between 1997 and 2013 was constructed using health administrative data. This cohort was linked to primary data from the same program to identify people who used EPI services. Outcomes for people who used EPI services and those who did not were compared using Cox proportional hazards models.
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The participant will break down the ways in which early psychosis intervention services affect treatment for individuals with first-episode psychosis and how these services fit in the context of other medical care.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: May 1, 2018
End Date: April 30, 2020
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Title: Effectiveness of Early Psychosis Intervention: Comparison of Service Users and Nonusers in Population-Based Health Administrative Data
Authors: Kelly K. Anderson, Ph.D., Ross Norman, Ph.D., Arlene MacDougall, M.D., M.Sc., Jordan Edwards, M.Sc., Lena Palaniyappan, M.D., Ph.D., Cindy Lau, M.Sc., Paul Kurdyak, M.D., Ph.D.
Affiliations: From the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada (K.K.A., R.N., A.M.D., J.E.); the Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada (K.K.A., R.N., A.M.D., L.P.); the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (K.K.A., C.L., P.K.); the Centre for Addiction and Mental Health, Toronto, Ontario, Canada (K.K.A., P.K.); and the Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (P.K.).
Disclosures: Dr. Palaniyappan has received speaker’s fees from Otsuka Canada and an educational grant from Janssen Canada. All other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
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