Early Intervention for Psychosis in Hong Kong: data and experience

Abstract

Early Intervention for psychosis has been propagated as a paradigm for service development in many locations in the last 20 years. It started with the realisation that despite good community services, there is still significant delays in the treatment of psychotic disorders, the delay being associated with a poorer long-term outcome. Ea rly psychosis programmes aim to improve the long-term outcome for psychotic disorders by (1) earlier detection; (2) focused intervention in the early course of the disorder (critical period) and (3) prevention in the pre-psychotic stage. Using reallife data of such an initiative in Hong Kong in the last 15 years, we review with a series of contro lled studies how this paradigm interacts with cultural and service delivery factors, and determined the extent to which outcome could be enhanced in a sustained manner. The result suggest that even with a relatively low-resource system, i t was possible to significantly reduce treatment delay, as well as improve function outcome in a sustained manner, suppo rting the critical period hypothesis. However there also appears to be a limit to which functional improvements can occur, beyond this limit, improvement has proven more difficult to sustain.