Indian Journal of PsychiatryIndian Journal of Psychiatry
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Year : 2010  |  Volume : 52  |  Issue : 7  |  Page : 153-158

Early intervention in psychotic disorders: Challenges and relevance in the Indian context


1 Department of Psychiatry, Harvard Medical School, Boston MA, USA
2 Lawson Health Research Institute, Consultant, Early Intervention of Psychosis Program, Regional Mental Health Care. Department of Psychiatry, The University of Western Ontario. London, Ontario, Canada
3 National Institute of Mental Health and Neurosciences, Bangalore, India

Correspondence Address:
Matcheri S Keshavan
Stanley R Cobb, 401 Park Drive Boston, MA 02215
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5545.69228

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Over the last two decades, there has been an increasing interest in the concept of early intervention (EI) in psychotic disorders, notably schizophrenia. Several lines of research underlie this emerging paradigm shift: (a) an increasingly well-established association between the duration of prolonged untreated illness and poor outcome; (b) evidence of progressive neurobiological changes in the early course of schizophrenia both in the pre-psychotic and psychotic phases, as evidenced by brain imaging studies in schizophrenia; and (c) emerging data, albeit preliminary, suggesting the efficacy and effectiveness of EI programs in improving the outcome in these patients. Mental health service systems across the globe, including Asian countries, have been incorporating specialized early intervention programs. However, literature on EI in the Indian setting is relatively sparse. In this article, we will review the rationale and approaches to EI and the application of these approaches to the Indian context, in light of the available literature. We also examine the constraints in the implementation of EI. Controlled data are needed to evaluate EI and the roadblocks to them, in order to implement EI in the resource-strapped mental health service settings in India.



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