ECP05-02 - Early intervention in psychiatry: a waste of valuable resources?

Abstract

In this presentation I will make the following points. 1. Attempts by the early intervention movement to prevent the onset of psychotic illnesses using either psychological or pharmacological methods have been unsuccessful. This was entirely predictable 2. Efforts to identify vulnerable people before they develop a psychotic illness do more harm than good. This is because the positive predictive value of any test is dependant on the prevalence of the condition to which it is applied. 3. In the United Kingdom, early intervention for psychosis clinicians have been narrow minded and extremely selfish. Their recruitment raids have made it even more difficult for ordinary psychiatric teams to provide decent care to people with serious mental disorders 4. Early intervention teams have been described as jewels in the crown of psychiatric services in England. Their spectacular “success” and enviable public relations skills have tempted some clinical academic colleagues to apply their methods to other psychiatric disorders. Some of this work could be worthwhile but it must be informed by clinical experience and an understanding of epidemiological principles. References McGorry P, Pelosi AJ (2009). Is early intervention in the major psychiatric disorders justified? British Medical Journal, 338, 802–803 Malla A, Pelosi AJ (2010). Is treating patients with first-episode psychosis cost effective? Canadian Journal of Psychiatry, 55, 3–8