Journal List > Korean J Schizophr Res > v.16(1) > 1057788

Korean J Schizophr Res. 2013 Apr;16(1):32-37. Korean.
Published online April 30, 2013.  https://doi.org/10.16946/kjsr.2013.16.1.32
Copyright © 2013 Korean Society for Schizophrenia
The Analysis of Community-Based Identification, Assessment and Allocation System for Early Psychosis
Myung-Soo Lee, MD, MPH,1,2 and So-Ra Ahn, PRN, MPH1,2
1Seoul Mental Health Center, Seoul, Korea.
2Yongin Mental Hospital, Yongin, Korea.

Address for correspondence: Myung-Soo Lee, Seoul Mental Health Center, Yongin Mental Hospital, ilyang B/D 5F, 6 Bongeunsa-ro 21-gil, Gangnam-gu, Seoul 135-010, Korea. Tel: 02-3444-9934, Fax: 02-3444-9961, Email: mslee1010@hanmail.net
Received April 07, 2013; Revised April 17, 2013; Accepted April 19, 2013.

Abstract

Objectives

The purpose of this study was to make empirical evidence of community based detection, assessment and allocation system for early psychosis.

Methods

We analysed 222 youths who were referred to Seoul Early Management and Improvement Services (SEMIS) for early psychosis during six years from 2007 to 2012.

Results

44% of referrals were from suicide hotline, 23% from web-based SEMIS assessment program, 20% from other service areas such as military services and 11% were self referred. Among 222 youths, 139 (62.6%) were completed Structured Interview for Prodromal Syndrome (SIPS). After SIPS, 23% had untreated or early psychosis, another 17% were found to be at high risk of psychosis and 18% of completed SIPS were found to have other mental illness such as depression, yielding an efficiency ratio of 58%. 70% of youths who were categorized as psychosis or high risk of psychosis or other mental illness were referred to psychiatric hospital or case management services.

Conclusion

This study shows the effectiveness and limitations of community-based assessment and intervention system for early psychosis. Integrated community program is necessary to improve the efficiency of early intervention and for the better outcomes.

Keywords: Early psychosis; Community-based assessment and allocation

Figures


Fig. 1
Seoul mental health service spectrum of services for early psychosis.
Click for larger image


Fig. 2
Pathways and categorization after SIPS. CMHC : Community Mental Health Center, SEMIS : Seoul Early Management and Improvement System.
Click for larger image

Tables


Table 1
Referral outcomes of the patients
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References
1. Johnstone EC, Crow TJ, Johnson AL, MacMillan JF. The northwick park study of first episode of schizophrenia: presentation of the illness and problems relating to admission. Br J Psychiatry 1986;148:115–120.
2. Moscarelli M, Capri S, Neri L. Cost evaluation of chronic schizophrenia patients during the first 3 years after the first contact. Schizophr Bull 1991;17:421–426.
3. Wyatt RJ. Early intervention with neuroleptics may decrease the long-term morbidity of schizophrenia. Schizophr Res 1991;5:201–202.
4. McGlashan TH, Johannessen JO. Early detection and intervention with schizophrenia: rationale. Schizophr Bull 1996;22:201–222.
5. Lim HS, Choi JS, Shin YM, Jho KH. The impact of duration of untreated psychosis on clinical outcome in first-episode schizophrenia: retrospective study. Korean J Schizophr Res 2004;7:9–14.
6. Jung JC, Cho GH, Lee KH, Lee CR, Chung YC. Long-term outcomes of patients with first-episode schizophrenia spectrum disorder and effects of duration of untreated psychosis on them. Korean J Schizophr Res 2005;8:64–73.
7. Yung AR, McGorry PD, Francey SM, Melson BN, Baker K, Phillips LJ, et al. PACE: a specialised service for young people at risk of psychotic disorders. Med J Aust 2007;187:S43–S46.
8. Wong GH, Hui CLM, Wong DY, Tang JYM, Chang WC, Chan SKW, et al. Developments in early intervention for psychosis in hong kong. East Asian Arch Psychiatry 2012;22:100–104.
9. Yoo JM, Ahn SR, Cho YS, Lee MS. A study of duration of untreated psychosis (DUP) for first episode psychosis. Ment Health 2011;2:12–16.
10. Yoo SY, Lee KJ, Kang DH, Lee SJ, Ha TH, Wee W, et al. Characteristics of subjects at Clinical high risk for Schizophrenia: natural follow up study in 'seoul youth clinic'- pilot study. J Korean Neuropsychiatr Assoc 2007;46:19–28.
11. Lee SY, Kim KR, Kang JI, Kim BR, Choi SH, Park JY, et al. In: GRAPE Cognitive Therapy. Hakjisa; 2010.
12. Chung YC, Kang NI, Im YJ, Kim SW, Cho IH, Lee YM, et al. Validation of the korean version of the eppendorf schizophrenia inventory as a screening measure to detect adolescents at ultra-high risk for psychosis. Early Interv Psychiatry 2013;7:71–79.
13. Hahn HM, Yum TH, Shin YW, Kim KH, Yoon DJ, Chung KJ. A standardization study of beck depression inventory in korea. J Korean Neuropsychiatr Assoc 1986;25:487–500.
14. Jung MH, Jang JH, Kang DH, Choi JS, Shin NY, Kim HS, et al. The reliability and validity of the korean version of the structured interview for prodromal syndrome. Psychiatry Investig 2010;7:257–263.
15. Yung AR, Phillips LJ, Drew LT. Promoting access to care in early psychosis. In: McGorry PD, Fackson HJ, editors. Recognition and management of Early Psychosis:A Preventive Approach. New York: Cambridge University Press; 1999. pp. 80-114.
16. Upthegrove R, Birchwood M, Ross K, Brunett K, McCollum R, Jones L. The evolution of depression and suicidality in first episode psychosis. Acta Psychiatr Scand 2010;122:211–218.
17. Andriopoulos I, Ellul J, Skokou M, Beratis S. Suicidality in the "prodromal" phase of schizophrenia. Compr Psychiatry 2011;52:479–485.
18. McFarlane WR, Cook WL, Downing D, Verdi MB, Woodberry KA, Ruff A. Portland identification and early referral: a community-based system for identifying and treating youths at high risk of psychosis. Psychiatr Serv 2010;61:512–515.