1

IRISInitiative to Reduce the Impact

of Schizophrenia

DON’T DELAY! IT’S TIME TO REDUCE THE IMPACT OF PSYCHOSIS

IN YOUNG PEOPLE……. NOW!

2

DID YOU KNOW?

• Early Diagnosis and treatment leads to significantly improved recovery and outcome in psychosis.

• The first few years of psychosis is a ‘critical period’ socially, psychologically and biologically - the earlier that treatment starts the better the long term outcome.

3

Consider psychosis when a young adult shows persistent changes in

functioning, behaviour or personality

• Physical e.g. sleep disturbance, loss of energy• Affect e.g. anxiety, irritability and depression• Cognitive difficulties e.g. poor concentration and

memory• Thought content e.g preoccupation with new ideas• Social difficulties and a tendency to become

isolated• Self harm

4

Why treat first-episode psychosis in a special way? 1.

• The prospects of recovery in this group are very good - 85% can remit within a few months.

• Relapse prevention is vital in the early years: each relapse increases the risk of further relapse.

• Early psychosis is a biologically ‘critical period’: most of the decline in cognition and function occurs in the first five years of psychosis

5

Why treat first-episode psychosis in a special way? 2.

• ‘critical period’ for suicide risk;10 - 15% of people with psychosis kill themselves within the first 10 years of illness, and two thirds of these within the first 6 years.

• Adverse outcomes from psychiatric hospitalisation -- 45% of people with first episode psychosis have clear evidence of post traumatic stress related to their illness and treatment

6

Effective responses-1.

• Improve collaboration between primary, secondary and a variety of community agencies

• Deliver in a range of low-stigma settings, sensitive to the needs of young people

• Facilitate medical treatment from GP with support of specialist care

7

Effective responses-2.

• Low dose neuroleptic drug therapy started within 6 months of onset of psychosis, with early review of treatment resistance

• Family interventions

• Support in vocational, educational recreational and social attainments

8

As GPs we need to raise our awareness

• Stay alert

• Be suspicious

• Ask about positive symptoms

• Be aware of risk factors like family history,

self-harm

9

And perhaps most important of all ….

Be Optimistic!!!

• Prompt diagnosis and treatment of first episode and early relapse significantly improves prospects for recovery in psychosis.