Wednesday, April 9, 2014
The “TIPS” Early Intervention in Psychosis Study
Outcome and Development of Evidence-Based Services
Jan Olav Johannessen, MD, and Inge Joa, PhD, Division of Psychiatry, Stavanger University, Norway
UCLA Faculty Center
4 – 5:30 pm
Wine reception to follow, 5:30 – 6:15 pm
Over the last decades there has been a growing interest in early detection and intervention in first episode psychosis (FEP). Over the years the question rose whether detecting psychosis earlier could improve prognosis. Perhaps “applying existing schizophrenia treatments as soon as possible in the course of the disorder may slow or stop deterioration” (McGlashan & Johannessen, 1996).
The Scandinavian early Treatment and Intervention in Psychosis Study (TIPS) engineered an early detection (ED) of psychosis programme that sought to reduce the duration of untreated psychosis (DUP) through early detection teams and extensive information campaigns. The ED programme has continued for over 17 years. A quasi-experimental study ran from 1997 through 2000, comparing an area practicing ED (ED area) to an area with usual detection (NoED area). In the ED area DUP was reduced from 26 to 4.5 weeks, median value. DUP in the NoED area was 16 weeks. Results indicate that well-planned and multi-level information campaigns repeated on a regular basis for the general public and other targeted groups (GPs, families, teachers and high school students) are indeed key components of detecting patients with first-episode psychosis at an early phase of theillness. Patients from the ED area had significantly lower overall symptom levels and and less suicidal behaviour at study inclusion, milder negative symptoms at one-year and milder negative and cognitive symptoms at two and five years follow-up, a favorable outcome for the ED patients were sustained up to ten year after study inclusion, with a significant higher full recovery rate in the ED sector at ten years (OR > 2.5).
The lecture will describe the rationale for the TIPS study, and will present examples of the different components of the ED system; the low threshold ED teams, the development and implementation of intensive information campaigns (in the period of 1997-2013) aimed at three target groups; the general public, healthcare personnel and school personnel and students. Outcome data and implications for clinical practise will be presented.