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    The Early Psychosis Intervention Center (EPICENTER): development and six-month outcomes of an American first-episode psychosis clinical service

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    Author
    Breitborde, Nicholas JK
    Bell, Emily K.
    Dawley, David
    Woolverton, Cindy
    Ceaser, Alan
    Waters, Allison C.
    Dawson, Spencer C.
    Bismark, Andrew W.
    Polsinelli, Angelina J.
    Bartolomeo, Lisa
    Simmons, Jessica
    Bernstein, Beth
    Harrison-Monroe, Patricia
    Show allShow less
    Affiliation
    Department of Psychiatry and Behavioral Health, The Ohio State University
    Department of Psychiatry, The University of Arizona
    Department of Psychology, The University of Arizona
    Department of Psychiatry and Behavioral Sciences, Stanford University
    Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
    VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System
    Department of Education, The University of Arizona
    Issue Date
    2015
    Keywords
    First-episode psychosis
    Treatment
    Cognitive behavioral therapy
    Family psychoeducation
    Cognitive remediation
    Cost-effectiveness
    
    Metadata
    Show full item record
    Publisher
    BioMed Central Ltd
    Citation
    Breitborde et al. BMC Psychiatry (2015) 15:266 DOI 10.1186/s12888-015-0650-3
    Journal
    BMC Psychiatry
    Rights
    © 2015 Breitborde et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)
    Collection Information
    This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
    Abstract
    BACKGROUND: There is growing evidence that specialized clinical services targeted toward individuals early in the course of a psychotic illness may be effective in reducing both the clinical and economic burden associated with these illnesses. Unfortunately, the United States has lagged behind other countries in the delivery of specialized, multi-component care to individuals early in the course of a psychotic illness. A key factor contributing to this lag is the limited available data demonstrating the clinical benefits and cost-effectiveness of early intervention for psychosis among individuals served by the American mental health system. Thus, the goal of this study is to present clinical and cost outcome data with regard to a first-episode psychosis treatment center within the American mental health system: the Early Psychosis Intervention Center (EPICENTER). METHODS: Sixty-eight consecutively enrolled individuals with first-episode psychosis completed assessments of symptomatology, social functioning, educational/vocational functioning, cognitive functioning, substance use, and service utilization upon enrollment in EPICENTER and after 6 months of EPICENTER care. All participants were provided with access to a multi-component treatment package comprised of cognitive behavioral therapy, family psychoeducation, and metacognitive remediation. RESULTS: Over the first 6 months of EPICENTER care, participants experienced improvements in symptomatology, social functioning, educational/vocational functioning, cognitive functioning, and substance abuse. The average cost of care during the first 6 months of EPICENTER participation was lower than the average cost during the 6-months prior to joining EPICENTER. These savings occurred despite the additional costs associated with the receipt of EPICENTER care and were driven primarily by reductions in the utilization of inpatient psychiatric services and contacts with the legal system. CONCLUSIONS: The results of our study suggest that multi-component interventions for first-episode psychosis provided in the US mental health system may be both clinically-beneficial and cost-effective. Although additional research is needed, these findings provide preliminary support for the growing delivery of specialized multi-component interventions for first-episode psychosis within the United States. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01570972; Date of Trial Registration: November 7, 2011
    EISSN
    1471-244X
    DOI
    10.1186/s12888-015-0650-3
    Version
    Final published version
    Additional Links
    http://www.biomedcentral.com/1471-244X/15/266
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12888-015-0650-3
    Scopus Count
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    UA Faculty Publications

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