4.2 Improving Outcomes for Youth At-Risk for Psychosis or With First-Episode Psychosis

Objectives: Psychotic illnesses frequently begin during childhood or adolescence with profound consequences for one's functioning throughout life, often causing significant persistent disability. In the past 2 years, exciting studies have been done, suggesting ways to improve long-term outcomes for youth at risk for schizophrenia and related illnesses or affected by them. This presentation will inform participants about these important findings. Methods: Three key articles published in 2015-2016 will be reviewed. Their implications for clinical practice will be discussed. Results: The 7-year follow-up of 12weeks ofomega 3 treatment of youth at high risk for psychosis shows significantly improved quality of life, reduced rates of conversion to psychosis, reducedPANSS scores, and reduced incidence of other psychiatric disorders.TheRAISE (Recovery Afteran Initial SchizophreniaEpisode) Navigate study compared integrated care, including supported employment and education, with treatment as usual in real world settings for youth with firstepisode psychosis. Integrated care resulted in significantly better quality of life and lower total PANSS scores. The benefits were driven by results in youth with fewer than 74 weeks' duration of untreated psychosis. In partial response to these findings, the NIH NIMH has established the Early Psychosis Intervention Network (EPINET),which will collect data on outcomes fromrealworld settings to improve standard care in an iterative fashion similar to the Cancer Clinical Trials Network where almost all treatment involved participation in a clinical trial. Conclusions: Early identification of youth at risk for psychosis and with psychosis is essential. Treatment with omega 3 fatty acids may reduce the risk for developing psychosis, as well as other mental illnesses. Once psychosis is evident, an integrated treatment model that includes family psychoeducation and supported employment and education significantly improves quality of life and severity of psychotic symptoms.