Transcript Early intervention in psychosis presentation

Early
Intervention
in
Psychosis
What is psychosis?
• Research has highlighted that psychotic disorders
rarely occur suddenly and that psychotic episodes
are generally preceded by a gradual change in the
person’s well being and psychosocial functioning,
often over a period of time
• This period, which precedes the onset of full-blown
psychotic symptoms, has been called the ‘prodromal’
phase.
• It may be possible to prevent psychosis from
occurring, or at least reduce the impact it may have
on the individual’s life through reducing the duration
of untreated psychosis.
Causes of Psychosis
• There are many different kinds of psychosis,
including
depressive psychosis
schizophrenia
puerperal psychosis
bipolar disorder
schizophreniform disorder
schizoaffective disorder
drug induced psychosis
organic psychosis
• In the last few decades, research has helped us in
understanding that this imbalance is most often
caused by a combination of genetic vulnerability and
environmental vulnerability.
Causes of Psychosis
• Environmental Vulnerability- Some types of street
drugs can trigger an episode of psychosis. Some
drugs like amphetamines and cocaine, can cause
drug-induced psychosis.
Causes of Psychosis
• Genetic Vulnerability: Since our DNA contains genes which
gives our bodies the instructions on how to make proteins,
wherever there is a mistake in a gene or mutation, this affect the
neurotransmitter to the brain and can cause psychosis which has
been linked to the chemical imbalance in the brain. The chances of
developing psychosis is believed to be higher for people who have a family member who is affected
Phases of Psychosis
There are three phases to a psychotic episode:1. Prodromal Phase :This is a period before the psychosis became evident and are
usually marked by changes in feelings, thoughts and behaviours.
Some prodromal symptoms may include; reduction in
concentration and attention, sleep disturbance, anxiety, social
withdrawal, suspiciousness or depressed mood
Phases of Psychosis contd.
2. Acute Phase :-
During the acute phase, typical psychotic symptoms emerge. The symptoms of psychosis are
frequently separated into “positive” and “negative’’ categories.
The Positive Symptoms includes:Delusions, Hallucinations and Disorganized speech Delusions (e.g. unusual beliefs that are not
shared by the majority of society and as such are considered as being out of touch with reality)
Hallucinations (e.g. hearing things that other people cannot hear, or seeing things that other
people cannot see)
Thought insertion (e.g. the person experiences thoughts as being put into their mind by an
external source)
Thought withdrawal (e.g. the person experiences thoughts as being removed by an external
source)
Thought broadcast (e.g. the person experiences thoughts as being spoken aloud or heard or read
by others)
Thought disorder (e.g. incoherent speech, pressure of speech and poverty of content and flight
of ideas). Acute phase cont.)
Phases of Psychosis contd.
The Negative symptoms includes:• Decrease in or loss of normal functions
• Decreased ability to initiate tasks
• Low level of motivation or drive
• Depression
• Suicidal thoughts or behaviour
3. Recovery Phase:The recovery process vary from person to person in duration and degree of
functional improvement. Whilst some recover from the psychosis very quickly
and be ready to return to life and their responsibilities, others will need
longer to respond to treatment and may need time to respond gradually.
Composition of Teams
There are two EIIP Teams covering the whole of Surrey and NE
Hants.
Our operational hours are 9 - 5pm, Monday to Friday
The EIiP teams are made up of professionals as follows:
• Consultant psychiatrists and Specialist doctors
• Psychologists
• Community Psychiatric Nurses
• Occupational Therapists
• Social workers
• Approved Mental Health Practitioners
• Support, Time and Recovery workers
• Enabling Independence workers
Purpose of EIiP Support
Our aim is to provide support to young people and their families to
reduce Stigma associated with psychosis through early assessment
thereby reduce the duration of untreated psychosis or (D.U.P.)
We aim to develop meaningful engagement, increased stability in
the lives of service users, facilitate development and help to
provide opportunities for personal fulfilment and promote
recovery during the early phase of recovery.
We provide interventions aimed at specific difficulties such as
anxiety, depression or substance misuse and help with
interpersonal, vocational and family issues where Psychoeducation and assistance to develop coping strategies for sub
threshold psychotic symptoms.
Support Provided by EIiP
We aim to help provide clear information about risks in relation to future
mental health issues, delivered in a careful and considered way.
The service works closely with partnership services:• Primary care
• Community Mental Health Recovery Services (CMHRS)
• Child and Adolescent Mental Health Service (CAMHS)
• Universities, Colleges, Schools
• Probation services
Support Provided by EIiP
•
Medical intervention aiming to provide optimal medical management including pharmacological
treatments aimed at minimising side effects and helps in symptom management.
•
Psychological Support including Psycho-education, cognitive behavioural therapies (CBT) and goal setting
•
Social aiming to promote inclusion into community environment and provide support with recovery
process, practical support with housing needs, benefits, youth & leisure services, Direct payments,
•
Vocational support as evidence has shown that young people with early onset psychosis benefit from
support to continue with their work or education
•
Family interventions aimed to support service users who have experienced psychosis and significant
others in their family to understand what has happened and how they may work at finding practical
solutions to day to day problems
In all, our focus lies with promoting a better well being to manage symptom's and be treated hence
preventing the acute phases of illness and admissions into hospital
Support Provided by EIiP
Throughout the year, we aim to run various group to
support our service users in promoting recovery.
These include:• Social group
• Social Confidence group
• Wellness & Recovery Action Planning (WRAP) group
• Recovery Workshop
• Carer’s group
Benefits of Treatment
•
In the prodromal stage, treatment usually ameliorates the presenting prodromal
symptoms and the associated distress and risk of self-harm. Most clients are able
to continue work or education, or return to this if they have dropped out. In the
longer term treatment significantly reduces the risk of the client developing a
psychotic illness in the next 2 years to 23%.
•
In the minority of clients who do become psychotic, the outcome appears to be
better than in patients who were not seen prior to the onset of illness. Thus they
are less likely to require hospital admission, compulsory treatment, or involvement
of the Police, and are more likely to adhere to subsequent treatment.