Understanding mental illness

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Understanding mental illness
http//earlypsychosis.ucdavis.edu
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New Opportunity

• Four Year Grant from Robert Wood Johnson
• One of 5 National EDIPPP Sites
• Goal to Identify and Treat 50 EP subjects/year
• Emphasis on Community Outreach in a
  Linguistically Culturally Competent Manner
• Emphasis on Youth schools, pediatricians, child
  adolescent mental health
• Outcome Assessed through Catchment -Comparison
  Area Contrast Regression - Discontinuity Design

The EDAPT Program
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impact
Sacramento City
The EDAPT Program
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Impact Reduction through Early Detection and
Treatment
The duration of untreated psychosis (DUP) in the
US and Europe is from 1-2 years. Research shows
that the DUP correlates with increased problems
with cognitive functioning impacting school,
vocational, and social success. Current
treatment waits for the acute stage of illness!
The EDAPT Program
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Functioning as an effect of psychotic episodes
The EDAPT Program
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EDAPT Clinic Rationale

• Duration of untreated psychosis is associated
  with poor outcome
• Early in illness treatment response is robust
• Loss of function and treatment resistance follow
  repeated relapses
• Early intervention can improve functional outcome
• Tailored treatment pathways and therapies for
  early treatment and rehabilitation

The EDAPT Program
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Key elements of treatment model

• Multidisciplinary treatment team
• Rapid response, extensive medical and psychiatric
  assessment
• Setting, may be better outside of CMH setting
• Medication management
• Individual and group therapy (psychoed,
  motivational, supportive)
• Advocacy (school, vocational, insurance, etc)
• Multifamily support group

The EDAPT Program
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Three Prodromal Risk State Categories

• Attenuated Positive Symptom State
• Onset or worsening in past year of (a) paranoid,
  grandiose, or referential ideas but without full
  conviction, (b) perceptual disturbances without
  certainty of an external source, or (c) vague,
  circumstantial or tangential communication that
  is coherent and structured under redirection
• Brief Intermittent Psychotic Symptom State
• Onset in the last month of transient
  hallucinations, delusions, and/or thought
  disorder, lasting less than one hour per day
• Genetic Risk and Deterioration State
• A decline of 30 or more on the GAF in the past
  12 months, AND patient either (a) has a
  first-degree relative with schizophrenia or (b)
  meets criteria for schizotypal PD

The EDAPT Program
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Very Early Intervention Ultra High Risk Cohort

• Ultra high risk criteria predict 20-40
  conversion to a psychotic disorder at 1-2 years
• Melbourne and Yale groups have shown that low
  dose antipsychotic treatment markedly reduces
  conversion but
• Treat to prevent ratio is 41
• APA treatment guidelines recommends careful
  monitoring

The EDAPT Program
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Ultra-High Risk Treatment

• Careful diagnostic assessment, SIPS interview,
  plus active diagnoses and comorbidities
• TARGETTED pharmacological therapies
• Psycho ed, supportive therapy, family support and
  therapy, testing and advocacy
• Research for enhanced risk prediction

The EDAPT Program
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EDAPT Offers

• Phone consultation
• Assessment and engagement
• Education
• Crisis management
• Individual, family, multifamily group, medication
  therapies dependent on treatment protocols
• Monitoring, problem-solving
• Supporting professionals like you!

The EDAPT Program
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Contact Information
EDAPT Hours 900am 500pm M-F To make a
referral, call 916-734-5331 http//earlypsychosi
s.ucdavis.edu
The EDAPT Program