1. Objectifs

Intentions :
This study’s «primary objectives were to: 1. investigate the frequency of and time to patient-/family-initiated and clinician-supervised [antipsychotic] medication discontinuation within the first 2 years of early intervention services (EIS)] at both sites [Montreal and Chennai, India]; 2. compare the rates of remission of positive and negative symptoms at month 24 between patients who discontinued medication during the 2 years of treatment (the Off group) and those who continued medication throughout the 2 years (the On group); 3. determine whether medication continuation vs. discontinuation status is associated with variation in global social and occupational outcomes.» (p. 1330)

2. Méthode

Échantillon/Matériau :
«This was an observational 2-year study comparing outcomes in persons with previously untreated FEP [first-episode psychosis], receiving treatment and follow-up in early intervention services (EIS) in Montreal (Canada) and Chennai (India).» (p. 1330) In Montreal, 165 patients participated and in Chennai, 168.

Instruments :
Questionnaire

Type de traitement des données :
Analyse statistique

3. Résumé

The «results indicate that, within the first 2 years of EIS, a substantial proportion of FEP patients are able to sustain remission of positive and negative symptoms after discontinuing antipsychotic medication under clinical supervision. […] In general, family support is a buffer against relapse. Families are also often the first ones to notice early warning signs of relapses and initiate help-seeking. Knowing that families’ involvement and vigilance could be counted on, psychiatrists in Chennai may have been more comfortable with supporting patients’ and their families’ desires to discontinue medication. In Montreal, on the other hand, clinicians adhering more strictly to published guidelines for antipsychotic medication may have been hesitant to support the discontinuation of medication, especially in patients with limited or no involvement of families in their treatment. Increasing family participation in treatment of FEP through-out the duration of treatment may improve the chances of patients being able to discontinue medication with a relatively low risk of negative consequences.» (p. 1337)