0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letters to the Editor   |    
Alternative Interpretation for the Early Detection of Psychosis Study
Andrew Amos, B.ARTS (HONS), M.B.B.S.
Am J Psychiatry 2012;169:992-992. doi:10.1176/appi.ajp.2012.12050578
View Author and Article Information

The author reports no financial relationships with commercial interests.

Brisbane, Australia

Accepted June , 2012.

To the Editor: In the April issue, the Treatment and Intervention in Psychosis (TIPS) early-detection study reports 10-year results in a manner that overstates the impact of reducing the duration of untreated psychosis (1). The authors dismissed a 50% increase in hospitalization in the treatment group after 5 years as the result of regional policy differences. They did not describe the policy differences or analyze the effects of this impressive confound on the small difference in symptoms, instead claiming to have demonstrated “positive effects on clinical and functional status” (2, 3). They omit hospitalization results altogether at 10 years, despite this being by far the most impressive result at 5 years (1).

Perhaps because at 5 years the researchers reported a nonsignificant advantage in remission for the control group (2), at 10 years they introduce a new recovery metric, based largely on work function, which showed a significant advantage for the treatment group (1). Although they acknowledge a significant attrition bias by 10 years, they do not report that at 5 years there was no difference in work function, or suggest how reducing the duration of untreated psychosis at baseline would not improve work function at 5 years but double work function at 10 years.

The authors reported that the control group achieved independent living significantly more often at the 10-year mark, but dismiss this evidence of worse function in the treatment group, suggesting that independent living is not evidence of recovery because it is not included in the new metric. They do not analyze the possibility that failure to achieve independent living is evidence of poor function (1).

Hegelstad  WTV;  Larsen  TK;  Auestad  B;  Evensen  J;  Haahr  U;  Joa  I;  Johannesen  JO;  Langeveld  J;  Melle  I;  Opjordsmoen  S;  Rossberg  JI;  Rund  BR;  Simonsen  E;  Sundet  K;  Vaglum  P;  Friis  S;  McGlashan  T:  Long-term follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome.  Am J Psychiatry 2012; 169:374–380
[CrossRef] | [PubMed]
 
Larsen  TK;  Melle  I;  Auestad  B;  Haahr  U;  Joa  I;  Johannessen  JO;  Opjordsmoen  S;  Rund  BR;  Rossberg  JI;  Simonsen  E;  Vaglum  P;  Friis  S;  McGlashan  TH:  Early detection of psychosis: positive effects on 5-year outcome.  Psychol Med 2011; 41:1461–1469
[CrossRef] | [PubMed]
 
Amos  A:  Early detection of psychosis: positive effects on 5-year outcome? (letter).  Psychol Med 2012; 42:669–670
[CrossRef] | [PubMed]
 
References Container
+

References

Hegelstad  WTV;  Larsen  TK;  Auestad  B;  Evensen  J;  Haahr  U;  Joa  I;  Johannesen  JO;  Langeveld  J;  Melle  I;  Opjordsmoen  S;  Rossberg  JI;  Rund  BR;  Simonsen  E;  Sundet  K;  Vaglum  P;  Friis  S;  McGlashan  T:  Long-term follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome.  Am J Psychiatry 2012; 169:374–380
[CrossRef] | [PubMed]
 
Larsen  TK;  Melle  I;  Auestad  B;  Haahr  U;  Joa  I;  Johannessen  JO;  Opjordsmoen  S;  Rund  BR;  Rossberg  JI;  Simonsen  E;  Vaglum  P;  Friis  S;  McGlashan  TH:  Early detection of psychosis: positive effects on 5-year outcome.  Psychol Med 2011; 41:1461–1469
[CrossRef] | [PubMed]
 
Amos  A:  Early detection of psychosis: positive effects on 5-year outcome? (letter).  Psychol Med 2012; 42:669–670
[CrossRef] | [PubMed]
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Web of Science® Times Cited: 1

Related Content
Books
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 1.  >
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 10.  >
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 10.  >
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 10.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 1.  >
Topic Collections
Psychiatric News
PubMed Articles