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

Persistent Link:
http://hdl.handle.net/10150/610297
Title:
The Early Psychosis Intervention Center (EPICENTER): development and six-month outcomes of an American first-episode psychosis clinical service
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
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
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
Keywords:
First-episode psychosis; Treatment; Cognitive behavioral therapy; Family psychoeducation; Cognitive remediation; Cost-effectiveness
Version:
Final published version
Additional Links:
http://www.biomedcentral.com/1471-244X/15/266

Full metadata record

DC FieldValue Language
dc.contributor.authorBreitborde, Nicholas JKen
dc.contributor.authorBell, Emily K.en
dc.contributor.authorDawley, Daviden
dc.contributor.authorWoolverton, Cindyen
dc.contributor.authorCeaser, Alanen
dc.contributor.authorWaters, Allison C.en
dc.contributor.authorDawson, Spencer C.en
dc.contributor.authorBismark, Andrew W.en
dc.contributor.authorPolsinelli, Angelina J.en
dc.contributor.authorBartolomeo, Lisaen
dc.contributor.authorSimmons, Jessicaen
dc.contributor.authorBernstein, Bethen
dc.contributor.authorHarrison-Monroe, Patriciaen
dc.date.accessioned2016-05-20T09:03:33Z-
dc.date.available2016-05-20T09:03:33Z-
dc.date.issued2015en
dc.identifier.citationBreitborde et al. BMC Psychiatry (2015) 15:266 DOI 10.1186/s12888-015-0650-3en
dc.identifier.doi10.1186/s12888-015-0650-3en
dc.identifier.urihttp://hdl.handle.net/10150/610297-
dc.description.abstractBACKGROUND: 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, 2011en
dc.language.isoenen
dc.publisherBioMed Central Ltden
dc.relation.urlhttp://www.biomedcentral.com/1471-244X/15/266en
dc.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/)en
dc.subjectFirst-episode psychosisen
dc.subjectTreatmenten
dc.subjectCognitive behavioral therapyen
dc.subjectFamily psychoeducationen
dc.subjectCognitive remediationen
dc.subjectCost-effectivenessen
dc.titleThe Early Psychosis Intervention Center (EPICENTER): development and six-month outcomes of an American first-episode psychosis clinical serviceen
dc.typeArticleen
dc.identifier.eissn1471-244Xen
dc.contributor.departmentDepartment of Psychiatry and Behavioral Health, The Ohio State Universityen
dc.contributor.departmentDepartment of Psychiatry, The University of Arizonaen
dc.contributor.departmentDepartment of Psychology, The University of Arizonaen
dc.contributor.departmentDepartment of Psychiatry and Behavioral Sciences, Stanford Universityen
dc.contributor.departmentDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicineen
dc.contributor.departmentVISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare Systemen
dc.contributor.departmentDepartment of Education, The University of Arizonaen
dc.identifier.journalBMC Psychiatryen
dc.description.collectioninformationThis 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.en
dc.eprint.versionFinal published versionen
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