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Conference Paper: A randomised controlled trial of extended 1-year specialised case management for patients presenting with first-episode psychosis to early intervention Programme in Hong Kong

TitleA randomised controlled trial of extended 1-year specialised case management for patients presenting with first-episode psychosis to early intervention Programme in Hong Kong
Authors
Issue Date2014
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://easap.asia/index.htm
Citation
The 2014 Regional Congress of the World Psychiatric Association (WPA), Hong Kong, 12-14 December 2014. In East Asian Archives of Psychiatry, 2014, v. 24 n. 4 suppl., p. 20, abstract RS2.2.2 How to Cite?
AbstractBACKGROUND: Specialised early intervention (EI) service has been shown to be effective in improving short-term outcome of psychosis but such initial therapeutic benefits could not be maintained after service termination. Most EI services offer 2-year treatment and there is a paucity of data regarding effectiveness of longer-term EI service for psychosis. METHODS: This randomised single-blind controlled trial (RCT) [trial registered with ClinicalTrials.gov: NCT01202357] aimed to compare extended 1-year EI service (EI group, i.e. 3-year EI service, n = 82) comprising continuing phase-specific case management with step-down standard care service (SC group, i.e. 2-year EI service, n = 78) in 160 Chinese patients who had received 2-year intensive EI service for first-episode psychosis in Hong Kong. Participants were assessed at study entry, and 6 and 12 months of follow-up. Primary outcome was functioning. Outcome analyses were performed on intention-to-treat basis. RESULTS: No significant between-group differences in socio-demographics, discontinuation rate, treatment characteristics, and baseline clinical and functional measures were noted. By the end of 12-month follow-up, EI group had significantly better outcomes than SC group in global functioning and various specific functional dimensions including work productivity, independent living skills, and social relationship. Participants in EI group had significantly fewer negative and depressive symptoms, and lower outpatient default rate than those in SC group. Longitudinal analyses revealed differential trajectories of functioning between treatment groups with EI but not SC group showing sustained and progressive functional improvement over 12 months. CONCLUSION: This study is the first to provide empirical supportive evidence to extending specialised EI service for psychosis beyond 2 years using RCT design. Further follow-up is required to clarify the sustainability of treatment effects of this extended 1-year early intervention.
DescriptionCongress Theme: Yin and Yang of Mental Health in Asia - Balancing Polarities
Regular Symposium 2.2 – Early Psychosis: no. RS2.2.2
Persistent Identifierhttp://hdl.handle.net/10722/214231
ISSN
2015 SCImago Journal Rankings: 0.331

 

DC FieldValueLanguage
dc.contributor.authorChang, WC-
dc.contributor.authorChan, GHK-
dc.contributor.authorJim, OTT-
dc.contributor.authorLau, ESK-
dc.contributor.authorHui, CLM-
dc.contributor.authorChan, SKW-
dc.contributor.authorLee, EHM-
dc.contributor.authorChen, EYH-
dc.date.accessioned2015-08-21T10:55:51Z-
dc.date.available2015-08-21T10:55:51Z-
dc.date.issued2014-
dc.identifier.citationThe 2014 Regional Congress of the World Psychiatric Association (WPA), Hong Kong, 12-14 December 2014. In East Asian Archives of Psychiatry, 2014, v. 24 n. 4 suppl., p. 20, abstract RS2.2.2-
dc.identifier.issn2078-9947-
dc.identifier.urihttp://hdl.handle.net/10722/214231-
dc.descriptionCongress Theme: Yin and Yang of Mental Health in Asia - Balancing Polarities-
dc.descriptionRegular Symposium 2.2 – Early Psychosis: no. RS2.2.2-
dc.description.abstractBACKGROUND: Specialised early intervention (EI) service has been shown to be effective in improving short-term outcome of psychosis but such initial therapeutic benefits could not be maintained after service termination. Most EI services offer 2-year treatment and there is a paucity of data regarding effectiveness of longer-term EI service for psychosis. METHODS: This randomised single-blind controlled trial (RCT) [trial registered with ClinicalTrials.gov: NCT01202357] aimed to compare extended 1-year EI service (EI group, i.e. 3-year EI service, n = 82) comprising continuing phase-specific case management with step-down standard care service (SC group, i.e. 2-year EI service, n = 78) in 160 Chinese patients who had received 2-year intensive EI service for first-episode psychosis in Hong Kong. Participants were assessed at study entry, and 6 and 12 months of follow-up. Primary outcome was functioning. Outcome analyses were performed on intention-to-treat basis. RESULTS: No significant between-group differences in socio-demographics, discontinuation rate, treatment characteristics, and baseline clinical and functional measures were noted. By the end of 12-month follow-up, EI group had significantly better outcomes than SC group in global functioning and various specific functional dimensions including work productivity, independent living skills, and social relationship. Participants in EI group had significantly fewer negative and depressive symptoms, and lower outpatient default rate than those in SC group. Longitudinal analyses revealed differential trajectories of functioning between treatment groups with EI but not SC group showing sustained and progressive functional improvement over 12 months. CONCLUSION: This study is the first to provide empirical supportive evidence to extending specialised EI service for psychosis beyond 2 years using RCT design. Further follow-up is required to clarify the sustainability of treatment effects of this extended 1-year early intervention.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://easap.asia/index.htm-
dc.relation.ispartofEast Asian Archives of Psychiatry-
dc.relation.ispartof東亞精神科學志-
dc.rightsEast Asian Archives of Psychiatry. Copyright © Hong Kong Academy of Medicine Press.-
dc.titleA randomised controlled trial of extended 1-year specialised case management for patients presenting with first-episode psychosis to early intervention Programme in Hong Kong-
dc.typeConference_Paper-
dc.identifier.emailChang, WC: changwc@hku.hk-
dc.identifier.emailHui, CLM: christyh@hkucc.hku.hk-
dc.identifier.emailChan, SKW: kwsherry@hku.hk-
dc.identifier.emailLee, EHM: edwinlhm@hku.hk-
dc.identifier.emailChen, EYH: eyhchen@hku.hk-
dc.identifier.authorityChang, WC=rp01465-
dc.identifier.authorityHui, CLM=rp01993-
dc.identifier.authorityChan, SKW=rp00539-
dc.identifier.authorityLee, EHM=rp01575-
dc.identifier.authorityChen, EYH=rp00392-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.hkuros249078-
dc.identifier.volume24-
dc.identifier.issue4 suppl.-
dc.identifier.spage20, abstract RS2.2.2-
dc.identifier.epage20, abstract RS2.2.2-
dc.publisher.placeHong Kong-

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