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Citation |
Murphy BP, Brewer WJ. Adv. Psychiatr. Treat. 2011; 17(6): 408-416. |
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Copyright |
(Copyright © 2011, Royal College of Psychiatrists) |
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DOI |
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PMID |
unavailable |
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Abstract |
Engaging patients in first-episode psychosis services is critical in maximising the effect of early intervention and establishing a framework for longer-term treatment. Biopsychosocial assessments determine a working diagnosis and inform evidence-based treatment. Atypical antipsychotics should be used at doses that maximise therapeutic benefit and adherence while minimising side-effects. Patients are helped to construct a narrative of their illness, including a shared understanding of the contribution of biological and environmental risks, and early warning signs. Common comorbid conditions, including depression, suicidal ideation, substance misuse and anxiety, should be addressed. Management of comorbid borderline and antisocial personality disorders is difficult; their nexus with psychosis is discussed. Cognitive-behavioural therapy is a mainstay of treatment, with specific interventions developed for problems typical in first-episode presentations. Core psychosocial interventions include psychoeducation, vocational and educational support, family interventions and multimodal group programmes. Language: en |
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Keywords |
human; suicide; autism; suicidal ideation; depression; psychosis; comorbidity; clozapine; posttraumatic stress disorder; polypharmacy; psychoeducation; early intervention; review; substance abuse; neuroleptic agent; early diagnosis; high risk population; mental health service; cognitive therapy; social psychology; anxiety disorder; family therapy; psychosocial care; long term care; patient compliance; schizoidism; social phobia; benzodiazepine; attention deficit disorder; atypical antipsychotic agent; evidence based medicine; psychopathy; disease duration; mood stabilizer; intellectual impairment; treatment response; drug treatment failure; treatment duration; paranoid personality disorder; schizotypal personality disorder |