Welcome to the EPA 2021 Interactive Programme

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Displaying One Session

Mental Health Policy
Date
Sun, 11.04.2021
Session Time
15:30 - 17:00
Room
Channel 6
Session Description
The Live Q&A of this session will take place in the Live Sessions auditorium. Please refer to the interactive programme for the exact time and channel.

Proposed by the EPA Section on Prevention of Mental Disorders. - Early intervention in Psychosis is one of the most dynamic and original areas in contemporary mental health for several interrelated reasons. Indeed, in the last two decades EIP has been a tremendous catalyzer for research, service-reform and concept-innovation in the broader field of psychiatry. However, as every innovative paradigm, EIP has entered a maturity phase in which reconceptualization of goals, strategies and opportunities to solve wide-scale, real-world problems are mandatory. This symposium will offer a critical, multilateral over-view of the EIP field, capitalizing on the contribution of leading international clinicians and researchers who have a direct, plurennial experience in the field. The symposium proposal is a collegial expression of the EPA Section of prevention of mental disorders.

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Pre-Recorded with Live Q&A, Section
Symposium: Preventing the "Hype, Hope and Disappointment" Cycle in Early Intervention of Psychosis (ID 319) No Topic Needed

S0029 - Early Intervention in Psychosis: An Innovation Trigger in a Challenging Environment

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Sun, 11.04.2021
Session Time
15:30 - 17:00
Room
Channel 6
Lecture Time
15:30 - 15:47
Presenter

ABSTRACT

Abstract Body

In theory and practice early intervention has an indisputable role in the treatment of patients with psychotic disorders, however modern psychiatrists face challenges in their clinical work to find the balance between the best practice and available treatment options in their environment. One of the biggest challenges remains the implementation of high-cost treatment approaches in healthcare systems of middle-income countries. Moreover, one very important aspect to consider when implementing early intervention is to prepare your team for resistance against the innovation. In countries where psychiatric treatment is more hospital-oriented and out-patient care is limited to short face-to-face visits with psychiatrists, the system is rigid and unwilling to step up to more expanded treatment option, such as a team approach of more than 6 members to treat one patient. In Latvia we started our early intervention programme in 2019 (LAT-EIP), 34 patients enrolled, and 27 finished the programme. When we compared results between standard treatment and LAT-EIP, psychiatrist out-patient visits were comparable to LAT-EIP, but the rate of rehospitalization and assigned disabilities at 12 months follow-up differ dramatically: in LAT-EIP 7.4% had been readmitted and 7.4% were assigned with disability vs 36.1% and 34.4% of patients in standard treatment group, respectively, p<0.05. Nevertheless, the only hospital which continues to provide early intervention is the one which first established it. This presentation will try to explain step-by-step what enhances and what holds back innovation in psychiatry in one middle-income countries.

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Symposium: Preventing the "Hype, Hope and Disappointment" Cycle in Early Intervention of Psychosis (ID 319) No Topic Needed

S0030 - The Trough of Disillusionment: A Critique of the “Transition” Paradigm

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Sun, 11.04.2021
Session Time
15:30 - 17:00
Room
Channel 6
Lecture Time
15:47 - 16:04

ABSTRACT

Abstract Body

I will attempt to address the issues surrounding the CHR concept in light of novel data and briefly discuss emerging alternatives. The root problem of the CHR early invention strategy is the exertion of reducing early nonspecific (pluripotent) psychopathology to a unidimensional model restricted only to positive psychotic symptoms, which define the binary categories of CHR and “transition” in help-seeking populations. This major conceptual handicap undermines the validity and clinical utility. The core predictor of the “transition” rate is the degree of the risk-enrichment and not the CHR status. Even with a significant pretest risk enrichment, the prognostic accuracy is mediocre. The incidence and “transition” rates of CHR in the community are very low; therefore, CHR does not represent a cost-effective clinical target—prevention paradox. CHR succeeding early pluripotent psychopathology is already late for intervention. “Transition” is not a categorical progression but a unidimensional shift in psychotic symptoms, and therefore, influenced by the fluctuation of psychotic symptoms, leading to both false positives and underestimation of nonpsychotic psychopathology. There exists no evidence for a specific effect of any intervention in preventing “transition”; therefore, CHR is not an ideal treatment target. Binary “transition” outcome does not represent a valid phenotype for research as “transition” rates are primarily driven by the sampling heterogeneity. The multidimensional psychopathology and functioning are more clinically relevant, overarching, and service-user-centered measures to define individual risk and outcome. Guided by the public health perspective, a universal early intervention framework, underscoring improved access to care, may represent a better strategy.

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Symposium: Preventing the "Hype, Hope and Disappointment" Cycle in Early Intervention of Psychosis (ID 319) No Topic Needed

S0031 - A Moderate Enlightenment: Between Economic Rationale, Clinical Challenges and Real-world Obstacles

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Pre-Recorded with Live Q&A, Section
Date
Sun, 11.04.2021
Session Time
15:30 - 17:00
Room
Channel 6
Lecture Time
16:04 - 16:21
Symposium: Preventing the "Hype, Hope and Disappointment" Cycle in Early Intervention of Psychosis (ID 319) No Topic Needed

S0032 - A Provisional Synthesis: Correcting the Blindspots and Roadmapping the Future of Early Intervention in Psychosis

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Sun, 11.04.2021
Session Time
15:30 - 17:00
Room
Channel 6
Lecture Time
16:21 - 16:38
Presenter
Symposium: Preventing the "Hype, Hope and Disappointment" Cycle in Early Intervention of Psychosis (ID 319) No Topic Needed

Live Q&A

Session Icon
Pre-Recorded with Live Q&A, Section
Date
Sun, 11.04.2021
Session Time
15:30 - 17:00
Room
Channel 6
Lecture Time
16:38 - 16:58