Real-world effectiveness of a multicomponent early intervention program for first episode psychosis in Emilia Romagna (Italy): Timeliness, specificity and fairness

Résumé fourni par la source

BACKGROUND: This study provides a real-world evaluation of the multicomponent Emilia-Romagna First Episode Psychosis Program (RER-FEP) (2013-2019). It assesses how timeliness, treatment specificity, and socio-demographic factors related to fairness (including citizenship) are associated with clinical outcomes. METHOD: A naturalistic cohort of 1085 FEP patients (aged 18-35) was analyzed. Outcomes included recovery (Δ HoNOS) and remission (HoNOS score ≤ 8). Predictors included duration of untreated psychosis (DUP) as a measure of timeliness and the frequency of FEP-specific interventions (CBT/psychoeducation) as an indicator of treatment specificity. RESULTS: The 1085 participants (mean age 23.8 years; mean follow-up 2.5 years) showed significant improvements in HoNOS scores (p < 0.001), with the largest reduction observed in the first six months. Longer duration of untreated psychosis was associated with poorer recovery outcomes. Treatment specificity was associated with improved outcomes: exposure to more than 36 FEP-specific interventions was linked to higher odds of remission (OR = 1.74). Regarding fairness, single status and lower educational level were associated with lower likelihood of remission, while foreign citizenship was associated with higher baseline and follow-up severity. Substance use was associated with improvement in behavioral symptoms. CONCLUSION: This real-world study suggests that multicomponent early intervention programs are associated with continuous clinical improvement. Outcomes appear to be influenced by timeliness of access, delivery of specific interventions, and socio-demographic factors. These findings highlight the importance of integrating effectiveness and equity considerations within early psychosis services.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.