Friday, October 26, 2012

Psychiatry EMR Reporting Prevents Future Psychosis in Adolescents

Schizophrenia and bi-polar-caused psychosis can be debilitating for those living with it.  Symptoms like delusions and hallucinations make sustaining a job or attending school very difficult, if not near impossible.  New research has proven that if addressed early enough, intervention can prevent the deterioration of educational, occupational and social abilities from psychosis in teenagers and young adults.

By recording young patients’ primary psychotic episodes in a psychiatry EMR, mental health professionals and pediatricians can detect those who might be at risk for developing a debilitating psychosis and create in intervention plan to prevent the condition from progressing.  According to a study by Columbia University in New York, early intervention during the critical period for teens and young adults (within two to five years of the initial psychotic episode) can decrease the chances of longer-term psychosis into adulthood.  
Columbia’s study included 20 participants aged 12-20 years of age and included 16 males and 4 females, all diagnosed with their first psychotic episode within the past five years.  Participants were evaluated using a scale based on levels of substance abuse, depression, disability and depression.  The study’s representative, Dr. Michael Birnbaum, defined psychosis as a process that starts in utero and progresses into the patient’s 20’s and 30’s until a psychotic episode occurs.  The research team took an approach by addressing mental illness as a progressive pathologic process; they believe there are stages of mental illness and different methods of intervention for each stage.

Using their PEER program (Prevention, Education, Evaluation, Rehabilitation), symptoms were managed through medication, individual and group intervention, help patients plan goals, provide education about their illness and prevent exacerbation.  Initially, participants reported baseline high levels of anxiety and depression and 70 percent were considered a suicide risk.  After 3 months of the intervention program, the participants reported a significant decline in their anxiety and depression.  Reported disruptions in work and school also declined – from a 75 percent baseline to 55 percent three months later.  The Columbia researchers plan on following the participants throughout their lives and monitoring their progress, building a model for the field of adolescent psychiatry. 

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