STEP-ED: Reducing Duration of Untreated Psychosis and Its Impact in the U.S.

Summary

The guiding questions for this study are: can a U.S. adaptation of a successful Scandinavian approach (TIPS) to early detection substantially reduce the duration of untreated psychosis (DUP) and improve outcomes beyond an established first-episode service (FES)?

The primary aim of this study is:

1. To determine whether an early detection intervention can reduce DUP in the US, as compared to usual detection. Early detection (ED) will be implemented in one US community (New Haven, CT), and usual detection efforts will continue in another (Boston, MA). DUP will be measured at admission to the corresponding first-episode services (STEP \& PREP) in each community, over one year before and throughout ED implementation. The investigators hypothesize that DUP will be reduced significantly in the early detection site compared to the usual detection site;
2. A secondary aim is to determine whether DUP reduction can augment the outcomes of established FES on outcomes in the U.S. The investigators will measure symptoms, functioning and engagement with treatment at entry and over 1 year at each site. The investigators hypothesize that shorter DUP at one FES (STEP) will predict reduced distress and illness severity at entry and better early outcomes at STEP compared to PREP.

Conditions

• Psychosis
• Schizophrenia

Interventions

BEHAVIORAL

Early Detection (ED)

This intervention consists of educational campaigns directed at patients \& families (who have yet to seek care) and professionals in educational and clinical settings to hasten referral of individuals with new onset psychosis to an established, best-practice first-episode service (i.e. STEP). Interleaved with this educational campaign will be procedures to make the STEP clinic more rapidly responsive to referrals to further shorten the duration of untreated psychosis

BEHAVIORAL

Usual Detection

This intervention will provide equivalent best practice care without the benefit of an early detection campaign

Sponsors & Collaborators

• Harvard University

  collaborator OTHER

• National Institute of Mental Health (NIMH)

  collaborator NIH

• Yale University

  lead OTHER

Principal Investigators

• Vinod Srihari, MD · Yale University

Study Design

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

16 Years

Max Age

35 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2014-02-01

Primary Completion

2020-02-27

Completion

2020-08-18

Countries

• United States

Study Locations