PMID- 25749390 OWN - NLM STAT- MEDLINE DCOM- 20160509 LR - 20220409 IS - 1778-3585 (Electronic) IS - 0924-9338 (Linking) VI - 30 IP - 3 DP - 2015 Mar TI - EPA guidance on the early intervention in clinical high risk states of psychoses. PG - 388-404 LID - S0924-9338(15)00057-7 [pii] LID - 10.1016/j.eurpsy.2015.01.013 [doi] AB - This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysis of current empirical evidence on the efficacy of psychological and pharmacological interventions in CHR samples. Eligible studies had to investigate conversion rate and/or functioning as a treatment outcome in CHR patients defined by the ultra-high risk and/or basic symptom criteria. Besides analyses on treatment effects on conversion rate and functional outcome, age and type of intervention were examined as potential moderators. Based on data from 15 studies (n=1394), early intervention generally produced significantly reduced conversion rates at 6- to 48-month follow-up compared to control conditions. However, early intervention failed to achieve significantly greater functional improvements because both early intervention and control conditions produced similar positive effects. With regard to the type of intervention, both psychological and pharmacological interventions produced significant effects on conversion rates, but not on functional outcome relative to the control conditions. Early intervention in youth samples was generally less effective than in predominantly adult samples. Seven evidence-based recommendations for early intervention in CHR samples could have been formulated, although more studies are needed to investigate the specificity of treatment effects and potential age effects in order to tailor interventions to the individual treatment needs and risk status. CI - Copyright (c) 2015 Elsevier Masson SAS. All rights reserved. FAU - Schmidt, S J AU - Schmidt SJ AD - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. FAU - Schultze-Lutter, F AU - Schultze-Lutter F AD - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. FAU - Schimmelmann, B G AU - Schimmelmann BG AD - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. FAU - Maric, N P AU - Maric NP AD - School of Medicine, University of Belgrade and Clinic of Psychiatry, Clinical Center of Serbia, Belgrade, Serbia. FAU - Salokangas, R K R AU - Salokangas RK AD - Department of Psychiatry, University of Turku, Turku, Finland. FAU - Riecher-Rossler, A AU - Riecher-Rossler A AD - Center for Gender Research and Early Detection, Psychiatric University Clinics of Basel, Basel, Switzerland. FAU - van der Gaag, M AU - van der Gaag M AD - Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Psychosis Research, Parnassia Psychiatric Institute, Hague, The Netherlands. FAU - Meneghelli, A AU - Meneghelli A AD - Dipartimento di Salute Mentale, Centro per l'Individuazione e l'Intervento Precoce nelle Psicosi-Programma 2000, Ospedale Niguarda Ca' Granda, Milan, Italy. FAU - Nordentoft, M AU - Nordentoft M AD - Mental Health Center of Copenhagen, University of Copenhagen, Copenhagen, Denmark. FAU - Marshall, M AU - Marshall M AD - School of Medicine, University of Manchester, Manchester, UK; LANTERN Center, Lancashire Care NHS Foundation Trust, Preston, UK. FAU - Morrison, A AU - Morrison A AD - School of Psychological Sciences, University of Manchester, Manchester, UK; Psychosis Research Unit, Greater Manchester West NHS Mental Health Trust, Manchester, UK. FAU - Raballo, A AU - Raballo A AD - Department of Mental Health, Reggio Emilia Public Health Center, Reggio Emilia, Italy; Regional Working Group on Early Detection of Psychosis, Emilia Romagna Regional Health Service, Bologna, Italy. FAU - Klosterkotter, J AU - Klosterkotter J AD - Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany. Electronic address: Joachim.klosterkotter@uk-koeln.de. FAU - Ruhrmann, S AU - Ruhrmann S AD - Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany. LA - eng PT - Journal Article DEP - 20150303 PL - England TA - Eur Psychiatry JT - European psychiatry : the journal of the Association of European Psychiatrists JID - 9111820 RN - 0 (Antipsychotic Agents) SB - IM MH - Adolescent MH - Adult MH - Antipsychotic Agents/therapeutic use MH - *Early Diagnosis MH - Early Medical Intervention/*statistics & numerical data MH - Humans MH - Male MH - Mood Disorders/diagnosis/therapy MH - *Practice Guidelines as Topic MH - Psychiatric Status Rating Scales MH - Psychotic Disorders/*diagnosis/*therapy MH - Risk Factors MH - Schizophrenia/diagnosis/therapy MH - Treatment Outcome OTO - NOTNLM OT - Adolescents OT - Antipsychotics OT - Cognitive-behavioral therapy OT - Early intervention in Europe OT - Meta-analysis OT - Neuroprotective OT - Prevention OT - Psychosis OT - Risk OT - Youth EDAT- 2015/03/10 06:00 MHDA- 2016/05/10 06:00 CRDT- 2015/03/10 06:00 PHST- 2014/11/10 00:00 [received] PHST- 2015/01/30 00:00 [revised] PHST- 2015/01/30 00:00 [accepted] PHST- 2015/03/10 06:00 [entrez] PHST- 2015/03/10 06:00 [pubmed] PHST- 2016/05/10 06:00 [medline] AID - S0924-9338(15)00057-7 [pii] AID - 10.1016/j.eurpsy.2015.01.013 [doi] PST - ppublish SO - Eur Psychiatry. 2015 Mar;30(3):388-404. doi: 10.1016/j.eurpsy.2015.01.013. Epub 2015 Mar 3.