1. ITAlian Partnership for Psychosis Prevention (ITAPP): improving the mental health of young people
- Author
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Paolo Fusar-Poli, Adele Ferro, Amedeo Minichino, Renato Borgatti, Andrea Raballo, Martina Maria Mensi, Silvana Galderisi, Paolo Brambilla, Alessandro Bertolino, Fusar-Poli, P., Minichino, A., Brambilla, P., Raballo, A., Bertolino, A., Borgatti, R., Mensi, M., Ferro, A., and Galderisi, S.
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Prognosi ,Psychological intervention ,psychosi ,Young Adult ,prevention ,Health care ,medicine ,Humans ,psychosis ,Young adult ,Descriptive statistics ,business.industry ,Clinical high risk ,Prognosis ,medicine.disease ,Mental health ,schizophrenia ,Outreach ,Substance abuse ,early intervention ,Psychiatry and Mental health ,Mental Health ,Clinical research ,Italy ,Psychotic Disorders ,Family medicine ,Female ,business ,Delivery of Health Care ,Human ,Research Article - Abstract
Background The European impact of the clinical high risk for psychosis (CHR-P) paradigm is constrained by the lack of critical mass (detection) to power prognostic and preventive interventions. Methods An ITAlian partnership for psychosis prevention (ITAPP) was created across CHR-P centers, which were surveyed to describe: (a) service, catchment area, and outreach; (b) service users; and (c) interventions and outcomes. Descriptive statistics and Kaplan-Meier failure function complemented the analyses. Results The ITAPP included five CHR-P clinical academic centers established from 2007 to 2018, serving about 13 million inhabitants, with a recruitment capacity of 277 CHR-P individuals (mean age: 18.7 years, SD: 4.8, range: 12-39 years; 53.1% females; 85.7% meeting attenuated psychotic symptoms; 85.8% without any substance abuse). All centers were multidisciplinary and included adolescents and young adults (transitional) primarily recruited through healthcare services. The comprehensive assessment of at-risk mental state was the most widely used instrument, while the duration of follow-up, type of outreach, and preventive interventions were heterogeneous. Across 205 CHR-P individuals with follow up (663.7 days ± 551.7), the cumulative risk of psychosis increased from 8.7% (95% CI 5.3-14.1) at 1 year to 15.9% (95% CI 10.6-23.3) at 2 years, 21.8% (95% CI 14.9-31.3) at 3 years, 34.8% (95% CI 24.5-47.9) at 4 years, and 51.9% (95% CI 36.3-69.6) at 5 years. Conclusions The ITAPP is one of the few CHR-P clinical research partnerships in Europe for fostering detection, prognosis, and preventive care, as well as for translating research innovations into practice.
- Published
- 2021