T33. EARLY INTERVENTION FOR EARLY PSYCHOSIS IN FRANCE, MAPPING OF PROGRAMS
Notice bibliographique
Résumé
Early intervention programs (EIP) have been developed in many countries (United States, Europe, Canada, Australia) and are now widely considered effective in the treatment of early psychosis. In France, current national policies in the field of mental health promote the development of early intervention but France has not yet met national standards of care for EIP. A recent report from the London School of Economics (2016) comparing different European countries even mentioned the delay of France in this area, referring to only one EIP in the country. However, different early intervention initiatives have emerged in France during the last decade without such information being centralized and therefore with no visibility on the current situation over the whole territory. The aims of this study were to draw up a comprehensive inventory of existing or planned programs (in metropolitan France and in the overseas territories) in 2017 and to describe how they operate in 2016. This was a two-phase study; phase one was to identify and create an inventory of existing initiatives, and phase two was to describe and conduct an analysis of each initiative. To be included, identified initiatives had to offer an early, intensive and multidisciplinary approach with at least 0.5 dedicated full-time equivalent staff. A secondary inclusion criterion concerned the out-patient setting of the initiative. Inventory was achieved through many contacts across the country, among physicians/psychiatrists, healthcare facilities (hospitals, clinics, adolescent centers…) or administrative institutions (Health Regional Agencies…) which may either provide this kind of care or know of such initiatives. An online declarative survey was administered between March and July 2017 to the identified psychiatrists with questions that covered administrative and clinical topics: structure of attachment, dedicated team, funding, targeted population, activity in 2016, partners of the program, difficulties encountered and prospects. Between March and July 2017, 37 EIP for management of early psychosis were identified in France: 18 were operational, 8 were being established, and discussions were under way for the remaining 11. The 18 identified operational programs were located throughout the country with a few regional disparities. All programs operated with multidisciplinary teams, including at least one psychiatrist and one nurse, and with a mean of 4.3 dedicated full-time equivalents healthcare workers (median: 3.7). Most programs offered case management (12/18), with caseloads ranging from 4:1 to 22:1. The mean caseload was 10:1 (standard deviation 8:1). All programs included 15 to 35 year-old early psychosis patients. Four programs also included patients at ultra-high risk for psychosis (UHR), while 4 others continued patient management during the chronic stages; 4 initiatives included all these stages of the disease. Half of the programs had been existing for 2 to 5 years (50%); 89% were created less than 5 years ago. The surveyed professionals described an increasing number of patients under their care. Numerous projects and discussions appear to be under way (some programs should open very soon). A real dynamic has been launched in France with an increasing focus and this evaluation will help to improve visibility of the identified programs and promote the development of new programs.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».