Evaluation of a multi-element treatment center for early psychosis: predictors of functional outcome at 1 Year Public Deposited

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  • March 20, 2019
Creator
  • Uzenoff, Sarah R.
    • Affiliation: College of Arts and Sciences, Department of Psychology and Neuroscience
Abstract
  • Background: A growing international body of research has demonstrated the potential for comprehensive, phase-specific care to improve clinical and functional outcomes in early psychosis. However there have been no evaluations of such treatment models in the United States (US). This study is a naturalistic, prospective one-year follow-up of an early psychosis cohort treated in one of the first US-based multi-element treatment centers. Method: Participants were 163 individuals treated at the Outreach and Support Intervention Services (OASIS) clinic, a multi-element treatment center for early psychosis. Data were collected as part of routine care at six-month intervals. Primary outcomes included role functioning, involvement in work or school, and subjective experiences of recovery. In addition, a novel definition of functional remission was proposed. Predictors of functional outcomes were examined using generalized estimating equations. Results: After one year of treatment, individuals experienced significant improvements in positive and negative symptoms, role functioning, and clinician- and patient-rated global functioning. Individuals were significantly more likely to achieve symptom remission, functional remission, and to be in school at one year than at baseline. There were also trend-level reductions in substance abuse. Symptom remission and age of referral emerged as significant predictors of role functioning across the first year of treatment. Individuals with active substance abuse over the course of treatment had poorer role functioning by one year than did individuals not abusing substances. Discussion: This study provides preliminary support for the efficacy of comprehensive early intervention services in the US. Limitations and implications for future research are discussed.
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  • In Copyright
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  • "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Psychology (Clinical Psychology)."
Advisor
  • Penn, David L.
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  • Chapel Hill, NC
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  • Open access
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