Views on psychosis and judgment of appropriateness of early interventions in pre-psychotic phase: A survey of members of the International Early Psychosis Association

Abstract

Background: The evidence base for preventive interventions in psychosis during the pre-psychotic phase is still scarce. Professional views on this topic may be influenced by individual and professional background factors.

Aims: To study factors that possibly influence judgments made by mental health professionals dedicated to early psychosis on the appropriateness of early interventions during the pre-psychotic phase.

Method: Members of the International Early Psychosis Association (IEPA) were asked general questions about concepts of psychosis and about three case scenarios describing a client in the pre-psychotic phase.

Results: Views of 325 respondents were collected. About half the respondents thought that psychotic experiences exist on a continuum with normal experiences. Psychologists were more likely than other professional groups to endorse this view. A total of 52.6% of respondents (n = 171) believed that untreated psychotic episodes cause irreversible brain changes. Psychologists were less likely to endorse this view, which was associated with a willingness to offer pharmacologic interventions in pre-psychotic phases. More than 80% agreed, in most severe cases, on proposing lifestyle changes and psychological interventions.

Conclusions: When challenged with case scenarios, mental health professionals with clinical and research experience with patients with early psychosis expressed varied opinions on the appropriateness of pre-psychotic interventions, especially concerning pharmacologic treatment. Professional views on this topic were related not only to the level of symptoms and degree of active request for help from the client, but also to the professional's role and different conceptions of psychosis endorsed. These aspects warrant further study.

Declaration of interest: G. M. Galeazzi and K. Elkins are members of the IEPA. Funding is detailed in Acknowledgments.

Keywords:

• Psychosis prediction and prevention
• early intervention
• expert opinion
• evidence-based medicine