Toronto, June 6, 2008 Johan Cullberg MD PhD Ersta Sköndal University College, Stockholm

2jc

Every first episode psychotic patient from 17 clinics (appr 1.5 million inhabitants) Fullfilling criteria (incl non-congr. aff.ps) (SCID) 253 Incidence/ years24.5 Dropout (31%) more non-sz78 Research population year follow-up 154 Prospective comparison group 3 years 64 Historic comparison group (TAU) 5 years72 jc3

 Small scale (3-6 beds)  Non-institutional and personal setting  Non-invasive but empathic and stable staff  No high demands for common activities  Unlocked doors daytime  No chronic patients  Access to emergency ward when needed  Support from mobile psychosis team 4jc

Outcome: clinics with crisis home vs. only psychiatric ward Mean GAF- values, schizophrenic syndromes Baseline 1 year - p< 0,05 With Crisis home Only ps. ward 5jc

 “Recovered”54 %  On antipsychotic med. 48 %  Depot: 3 pats out of 69 4 %  Median dose(halop.eqv) 2 mg  Sick pension or sick leave 32 %  Suicide 1 %  In institution 5 % 6jc

7

Outcome level 5 years after first episode psychosis N=153 % 8jc

 The 7 ”need specific” principles are feasible and cost-effective with a large scale organisation  Effects better than TAU  There is no rational reason to hesitate in developing specific FEP care in all psychiatric clinics  Psychological and medical treatments must be individualised. There is no general rule how to treat a FEP patient! jc9