Early Intervention Services Evidence Profile

DescriptionStudy IdsQuality of included studiesConsistencyDirectnessOther factorsN treatment groupN controlEffect sizeLikelihood of clinically important effectOverall qualityImportance
01 Specific Prevention Intervention vs Needs Based Intervention
02 Psychotic (DSM) at end of treatmentMcCorry 2002SIGN: 1+ Insufficient details on randomisationN/AAt risk of progression to psychotic disorderSparse data (−1)3128RR= 0.27 (0.08, 0.89)Likely (favours specific intervention)ModerateCritical
03 Psychotic (DSM) at 12 monthsMcCorry 2002SIGN: 1+ Insufficient details on randomisationN/AAt risk of progression to psychotic disorderSparse/imprecise data (−1)3128RR= 0.54 (0.23, 1.3)InconclusiveLowCritical
04 General Psychiatric functioning: at end of treatmentMcCorry 2002SIGN: 1+ Insufficient details on randomisationN/AAt risk of progression to psychotic disorderSparse/imprecise data (−1)3128WMD= −1.3 (−6.28, 3.68)InconclusiveLow
05 General Psychiatric Functioning: at 12 monthsMcCorry 2002SIGN: 1+ Insufficient details on randomisationN/AAt risk of progression to psychotic disorderSparse/imprecise data (−1)3128WMD= 2 (−2.71, 6.71)InconclusiveLow
06 Depression mean: at end of treatmentMcCorry 2002SIGN: 1+ Insufficient details on randomisationN/AAt risk of progression to psychotic disorderSparse/imprecise data (−1)3128WMD= −0.2 (−4.77, 4.37)InconclusiveLow
07 Depression mean: at 12 monthsMcCorry 2002SIGN: 1+ Insufficient details on randomisationN/AAt risk of progression to psychotic disorderSparse/imprecise data (−1)3128WMD= 1.2 (−3.22, 5.62)InconclusiveLow
08 Mania mean: at end of treatmentMcCorry 2002SIGN: 1+ Insufficient details on randomisationN/AAt risk of progression to psychotic disorderSparse/imprecise data (−1)3128WMD= −0.7 (−2.54, 1.14)InconclusiveLow
09 Mania mean: at 12 monthsMcCorry 2002SIGN: 1+ Insufficient details on randomisationN/AAt risk of progression to psychotic disorderSparse/imprecise data (−1)3128WMD= 0 (−1.76, 1.76)InconclusiveLow
10 General functioning mean: at end of treatmentMcCorry 2002SIGN: 1+ Insufficient details on randomisationN/AAt risk of progression to psychotic disorderSparse/imprecise data (−1)3128WMD= 0 (−5.21, 5.21)InconclusiveLow
02 First Episode Family Intervention vs Standard care
01 Leaving the study early for any reasonZhang 1994SIGN: 1++NoneSchizophrenia; first episode (−1)Sparse data (−1); strong effect (+1)317313RR= 0.61 (0.45, 0.84)Very likely (favours family intervention)ModerateCritical
02 Re-admitted to hospital by 18 monthsZhang 1994SIGN: 1++N/ASchizophrenia; first episode (−1)Sparse data (−1); strong effect (+1)4241RR= 0.28 (0.13, 0.62)Very likely (favours family intervention)ModerateCritical
Death at end of follow up
01 Death (all causes)Jorgensen 2000 (OPUS)SIGN: 1++N/ASchizophrenia; first episode (−1)Sparse data (−1)275272RD = −0.02 (−0.04, 0)Likely (favours family intervention)ModerateCritical
02 Death due to suicideJorgensen 2000 (OPUS)SIGN: 1++N/ASchizophrenia; first episode (−1)Sparse data (−1)275272RD = −0.01 (−0.03, 0)Likely (favours family intervention)Moderate
04 Not living independently at end of studyJorgensen 2000 (OPUS)SIGN: 1++N/ASchizophrenia; first episode (−1)Sparse/imprecise data (−1)275272RR= 0.92 (0.44, 1.92)InconclusiveLow
Social functioning at about 12 months
05 GAF (Symptoms only) meanJorgensen 2000 (OPUS)SIGN: 1++N/ASchizophrenia; first episode (−1)Sparsee data (−1)227192SMD= 0.21 (0.02, 0.41)UnlikelyModerate
06 GAF (Functioning only) meanJorgensen 2000 (OPUS)SIGN: 1++N/ASchizophrenia; first episode (−1)Sparse data (−1)227192SMD= 0.15 (−0.04, 0.35)UnlikelyModerate
Social function at 24 months
02 GAF (Symptoms only) meanJorgensen 2000 (OPUS)SIGN: 1++N/ASchizophrenia; first episode (−1)Sparse/imprecise data (−1)205164WMD= 2.51 (−0.68, 5.7)InconclusiveLow
03 GAF (Functioning only) meanJorgensen 2000 (OPUS)SIGN: 1++N/ASchizophrenia; first episode (−1)Sparse/imprecise data (−1)205164WMD= 4.03 (0.83, 7.23)UnlikelyLow
Days in hospital: Mean at end of follow up
01 at 12 monthsJorgensen 2000 (OPUS)SIGN: 1++N/ASchizophrenia; first episode (−1)Sparse/imprecise data (−1)263244WMD= −16.7 (−34.05, 0.65)Likely (favours family intervention)Low
02 at 24 monthsJorgensen 2000 (OPUS)SIGN: 1++N/ASchizophrenia; first episode (−1)Sparse/imprecise data (−1)243193WMD= −8 (−22.52, 6.52)Likely (favours family intervention)Low
03 First Episode Family Intervention + Specialist Team vs Specialist Team
01 Relapse (BPRS) by end of treatmentLinszen 1996SIGN: 1+ Insufficient details on randomisationN/ASchizophrenia/related disorders or psychotic disorders; first episode (−1)Sparse/imprecise data (−1)3739RR= 1.05 (0.37, 2.98)InconclusiveLow
04 EIS (COAST) vs TAU
01 Leaving the study early for any reasonCraig 2005
Kuipers 2004
SIGN: 1++Significant heterogeneity: random effects usedSchizophrenia/ related disorders or psychotic disorders; first episode (−1)None103100RR (random effects) = 0.84 (0.61, 1.15)InconclusiveLow
02 Depression mean: at 6 monthKuipers 2004SIGN: 1++N/ASchizophrenia/ related disorders or psychotic disorders; first episode (−1)Sparse/ imprecise data (−1)148WMD= −5.8 (−14.35, 2.75)InconclusiveLow
03 Depression mean: at 9 monthsKuipers 2004SIGN: 1++N/ASchizophrenia/ related disorders or psychotic disorders; first episode (−1)Sparse/ imprecise data (−1)86WMD= −1 (−8.97, 6.97)InconclusiveLow
04 General Psychiatric functioning: at 6 monthsKuipers 2004SIGN: 1++N/ASchizophrenia/ related disorders or psychotic disorders; first episode (−1)Sparse/ imprecise data (−1)148WMD= 0.3 (−10.08, 10.68)InconclusiveLow
05 General Psychiatric functioning: at 9 monthsKuipers 2004SIGN: 1++N/ASchizophrenia/ related disorders or psychotic disorders; first episode (−1)Sparse/ imprecise data (−1)86WMD= 6.6 (−5.52, 18.72)InconclusiveLow
06 General functioning mean: at 6 monthsKuipers 2004SIGN: 1++N/ASchizophrenia/ related disorders or psychotic disorders; first episode (−1)Sparse data (−1)148WMD= 0.4 (0, 0.8)Likely (favours EIS)Low
07 General functioning mean: at 9 monthsKuipers 2004SIGN: 1++N/ASchizophrenia/ related disorders or psychotic disorders; first episode (−1)Sparse/ imprecise data (−1)86WMD= 0.5 (−0.36, 1.36)InconclusiveLow
08 Admitted to hospital during treatmentCraig 2005
Kuipers 2004
SIGN: 1++NoneSchizophrenia/ related disorders or psychotic disorders; first episode (−1)None103100RR= 0.63 (0.45, 0.89)Likely (favours EIS)Moderate
09 Remission at 18 months (ICD-10)Craig 2005SIGN: 1++N/ASchizophrenia/ related disorders or psychotic disorders; first episode (−1)Sparse/ imprecise data (−1)7173WMD= 1.21 (1.01, 1.45)UnlikelyModerate
10 No. of readmissions-mean at endpointCraig 2005SIGN: 1++N/ASchizophrenia/ related disorders or psychotic disorders; first episode (−1)Sparse/ imprecise data (−1)6967WMD= −0.4 (−0.69, −0.11)UnlikelyModerate
11 No. of Bed days - mean at endpointCraig 2005SIGN: 1++N/ASchizophrenia/ related disorders or psychotic disorders; first episode (−1)Sparse/ imprecise data (−1)6967WMD= −19.4 (−48.54, 9.74)InconclusiveLow

From: APPENDIX 23, EVIDENCE PROFILES

Cover of Bipolar Disorder
Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care.
NICE Clinical Guidelines, No. 38.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2006.
Copyright © 2006, The British Psychological Society & The Royal College of Psychiatrists.

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