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Abstract
In recent years, early intervention is the paradigm in psychosis treatment. The logic of early intervention paradigm is based on the view that the earliest possible detection and intervention for psychosis will deliver the best outcome for patients. Therefore, in recent decades, most of studies focused on indentifying people with psychosis as early as possible, reducing the duration of untreated psychosis. However, while there are well documented and sometimes serious side effects associated with antipsychotic medication in the short-term, the iatrogenic risks of atypical antipsychotic medication are underscored. Furthermore, against this paradigm, the recent of longitudinal studies of schizophrenia suggest a new paradigm shift in treatment timing of psychosis. In this respect, this case which showed symptom remission after conversion into schizophrenia in early psychosis suggests wondering about the time of treatment. Similar cases have not been reported. And review of the effects of timing, in fact, has yet to be done. If similar cases would be reported in the future more, treatment timing may be the next paradigm shift in the therapeutics of early psychosis. (Korean J Schizophr Res 2016;19:89–93)
References
1. Almond S, Knapp M, Francois C, Toumi M, Brugha T. Relapse in schizophrenia: costs, clinical outcomes and quality of life. Br J Psychiatry. 2004; 184:346–351.
2. Chang SM, Cho SJ, Jeon HJ, Hahm BJ, Lee HJ, Park JI, et al. Economic burden of schizophrenia in South Korea. J Korean Med Sci. 2008; 23:167–175.
3. Thomas H. McGlashan and Jan Olav Johannessen, Early Detection and Intervention With Schizophrenia: Rationale. Schizophr Bull. 1996; 22:201–222.
4. Perkins DO, Gu H, Boteva K, Lieberman JA. Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and metaanalysis. Am J Psychiatry. 2005; 162:1785–1804.
5. Malla AK, Norman RM, Joober R. Firstepisode psychosis, early intervention, and outcome: What have we learned? Can J Psychiatry. 2005; 50:881–891.
6. Clarke M, Whitty P, Browne S, McTigue O, Kamali M, Gervin M, et al. Untreated illness and outcome of psychosis. Br J Psychiatry. 2006; 189:235–240.
7. Johannessen JO, McGlashan TH, Larsen TK, Horneland M, Joa I, Mardal S, et al. Early detection strategies for untreated first-episode psychosis. Schizophr Res. 2001; 51:39–46.
8. Klosterkötter J, Hellmich M, Steinmeyer EM, Schultze-Lutter F. Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatry. 2001; 58:158–164.
9. McGlashan. Thomas H. “Treatment Timing vs Treatment Type in Firstepisode psychosis: a paradigm Shift in Strategy and effectiveness.” Schizophrenia Bulletin. 2012. 38. .5: 902–903.
10. Bertelsen M, Jeppesen P, Petersen L, Thorup A, Øhlenschlaeger J, le Quach P, et al. Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Arch Gen Psychiatry. 2008; 65:762–171.
11. Llorca PM, Chereau I, Bayle FJ, Lancon C. Tardive dyskinesias and antipsychotics: a review. Eur Psychiatry. 2002; 17:129–138.
12. Tschoner A, Eng J, Laimer M, Kaser S, Rettenbacher M, Fleischhacker WW, et al. Metabolic side effects of antipsychotic medication. Int J Clin Pract. 2007; 61:1356–1370.
13. Francey SM, Nelson B, Thompson A, Parker AG, Kerr M, Macneil C, et al. Who needs antipsychotic medication in the earliest stages of psychosis? A reconsideration of benefits, risks, neurobiology and ethics in the era of early intervention. Schizophr Res. 2010; 119:1–10.
14. Shin YM, Jung HY, Kim SW, Lee SH, Shin SE, Park JI, et al. A descriptive study of pathways to care of high risk for psychosis adolescents in Korea. Early Interv Psychiatry. 2010; 4:119–123.
15. McGlashan TH. Early detection and intervention of schizophrenia: rationale and research. Br J Psychiatry. 1998; 172:3–6.
16. McGorry PD, Yung AR. Early intervention in psychosis: an overdue reform. Aust NZ J Psychiatry. 2003; 37:393–398.
17. McGorry PD. Issues for DSM-V: clinical staging: a heuristic pathway to valid nosology and safer, more effective treatment in psychiatry. Am J Psychiatry 2007a;164:. 859–860.
18. Edwards J, McGorry PD. Implementing Early Intervention in Psychosis: A Guide to Establishing Early Psychosis Services. Dunitz, London;2002.
19. Marshall M, Lewis S, Lockwood A, Drake R, Jones P, Croudace T. Association between duration of untreated psychosis and in cohorts of first-episode outcome patients-a systematic review. Arch Gen Psychiatry. 2005; 62:975–983.
20. Harrigan SM, McGorry PD, Krstev H. Does treatment delay in firstepisode psychosis really matter? Psychol Med. 2003; 33:97–110.
21. Perkins DO, Gu H, Boteva K, Lieberman JA. Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and metaanalysis. Am J Psychiatry. 2005; 162:1785–1804.
22. Marshall M, Lewis S, Lockwood A, Drake R, Jones P, Croudace T. Association between duration of untreated psychosis and in cohorts of first-episode outcome patients-a systematic review. Arch Gen Psychiatry. 2005; 62:975–983.
23. Keshavan MS, Amirsadri A. Early intervention in schizophrenia: current and future perspectives. Curr Psychiatry Rep. 2007; 9:325–328.
24. Allison DB, Casey DE. Antipsychotic-induced weight gain: a review of the literature. J Clin Psychiatry. 2001; 62:22–31.
25. Alvarez-Jimenez M, Gonzalez-Blanch C, Crespo-Facorro B, Het-rick S, Rodriguez-Sanchez JM, Perez-Iglesias R, et al. Antipsy-choticinduced weight gain in chronic and first-episode psychotic disorders: a systematic critical reappraisal. CNS Drugs. 2008; 22:547–562.
26. Muench J, Carey M. Diabetes mellitus associated with atypical antipsychotic medications: new case report and review of the literature. J Am Board Fam Pract. 2001; 14:278–282.
27. Tschoner A, Eng J, Laimer M, Kaser S, Rettenbacher M, Fleischhacker WW, et al. Metabolic side effects of antipsychotic medication. Int J Clin Pract. 2007; 61:1356–1370.
28. Stahl SM, Mignon L, Meyer JM. Which comes first: atypical antipsychotic treatment or cardiometabolic risk? Acta Psychiatr Scand. 2009; 119:171–179.
29. Bertelsen M, Jeppesen P, Petersen L, Thorup A, Øhlenschlaeger J, le Quach P, et al. Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Arch Gen Psychiatry. 2008; 65:762–771.
30. Keller MB, Lavori PW, Coryell W, Andreasen NC, Endicott J, Clayton PJ, et al. Differential outcome of pure manic, mixed/cycling, and pure depressive episodes in patients with bipolar illness. JAMA. 1986; 13::255:. 3138–3142.
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