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Soc Psychiatry Psychiatr Epidemiol ; 43(12): 960-7, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18560782

RESUMO

BACKGROUND: Early intervention services (EIS) for psychosis are becoming widespread. Structured methods of assessment are advocated in these services, but a consensus is still needed on a package of measures with good psychometric properties that is feasible and reliable for routine use in this setting. METHODS: A computerised assessment package (MiData) was designed to provide clinicians with easy-to-understand feedback about clients' progress and to allow evaluation of the whole service for both audit and research purposes. Core areas include symptoms, duration of untreated psychosis (DUP), pathways into care, social functioning, and substance misuse at initial intake and annually thereafter. RESULTS: MiData has been adopted by EIS throughout London and in some other centres. Baseline data are now available regarding 533 first-episode psychosis patients who presented to 8 London teams. The completeness of the data varied across teams and measures, with fullest completion for sociodemographic data (99% on some measures) and poorest for DUP. The average London EIS client is male, single, unemployed and comes from Black or Minority Ethnic group. Most (70%) demonstrated poor social functioning at intake, over a third (38%) reported substance abuse problems and 23% had harmed themselves or others in the previous 6 months. CONCLUSIONS: MiData provides a clinician-friendly system of evaluating first-episode psychosis services but requires further refinement and dedicated resources to improve completion rates. This method of collecting routine data is of use to clinicians, managers, health service researchers and commissioners and potentially it may enable naturalistic comparisons between different models of care.


Assuntos
Auditoria Médica/métodos , Aplicações da Informática Médica , Serviços de Saúde Mental/normas , Avaliação de Resultados em Cuidados de Saúde/métodos , Transtornos Psicóticos , Adolescente , Adulto , Bases de Dados Factuais , Diagnóstico Duplo (Psiquiatria) , Diagnóstico Precoce , Feminino , Humanos , Londres , Masculino , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/psicologia , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
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