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KMID : 1023220170070010006
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Mental Health
2017 Volume.7 No. 1 p.6 ~ p.13
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Follow-up Study on the High-risk Group for Psychosis, which was introduced in the Community Services
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Kang Yun-Ju
Seo Yong-Jin
Lee Myung-Soo
Lee Eun-Ji
Kim Eun-Hee
Jaw H.-S.
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Abstract
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Objective : This study is to follow the high-risk group, which was confirmed through the community-based intensive psychiatric assessment system, and to investigate its morbidity level to psychosis, symptoms, and changes in the social functioning levels. Those are to ultimately create the rational basis to further expand the early detection programs as well as the early intervention strategies for psychosis across the community-based mental health services.
Methods : This study evaluated the service inflow channels, demographic features, morbidity level to psychosis, symptoms, and social functioning levels of the psychiatrically high-risk group. The high-risk group was confirmed through the comprehensive assessment, such as ESI (Eppendorf Schizophrenia Inventory), SIPS (Structured Interview for Prodromal Syndromes), and in-depth interviews, among the clients, who had visited the Seoul Mental Health Center from January of 2012 to August of 2015.
Results : 170 subjects applied for the early psychiatric assessment system in total. Among them, 119 subjects (70%) were evaluated for the comprehensive assessment, such as ESI and SIPS, and 24 subjects (20%) were confirmed to be the high-risk group for psychosis. For the service inflow channels, 11 subjects (46%) were introduced through the Seoul Mental Health Center, 7 subjects (29%) through the Seoul Suicide Prevention Center (call no. at 82- 1577-0199), 1 subject (4%) through the mental health-related organization, and 5 subjects (21%) through voluntary inquiries. For the subjects, who agreed to the service contents, the intensive management services were provided, including supportive psychotherapy, cognitive counseling, mental health education, and family intervention. Among then, 11 subjects (46%) were transferred to the mental health-related organization for medication treatment, and 13 subjects (54%) were treated with psycho-social intervention without any medication.
The average service duration was 9.6 months, and there was no psychiatric morbidity during the follow-up study. The participation rates in the meaningful social activities, such as study, job searching, and examination preparation, had increased 79% (19 subjects) at the point of service registration to 96% (23 subjects) at the point of service termination. Meanwhile, the social functioning level at the point of service termination had also maintained or improved compared to the social functioning level at the point of service registration.
Conclusion : For the community-based early detection and early intervention programs for psychosis, the employees in the mental health field should be preferentially trained to be able to detect early warning signs of psychosis. Further, the training programs should be expanded to various counselling agencies, to which young people in the risky group can easily access. In addition, the early detection, assessment, and intensive intervention systems, which are being conducted as the metropolitan projects, should be settled as the community-based projects by co-establishing the early detection and intervention systems with the mental health centers in 25 districts in Seoul as well as with various community organizations. To this end, it requires constant political attentions and supports.
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KEYWORD
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Early psychosis, High-risk Group for Psychosis, Schizophrenia
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