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Psychosis

Psychosis - when a person is unable to distinguish between what is real and what is not - is a serious mental illness that affects 1% of the population.

It often becomes a chronic condition, reducing life expectancy by up to 20 years.

Research at The University of Manchester from the late 1990s led to major changes in mental health policy and clinical guidelines and practice for the early treatment of psychosis in the UK and abroad.

Up until then, the provision of specialist mental health services for people early in the onset of their psychotic disorder had been a matter of considerable debate worldwide.

Individuals with psychosis sometimes had to wait up to two years before they and their families received appropriate help and treatment.

Professors Max Marshall, Shôn Lewis and their team conducted a systematic review and a meta-analysis of 26 prospective cohort studies involving nearly 5,000 first episode patients with schizophrenia.

Their studies demonstrated the shorter the period of time between the first appearance of psychosis and receiving adequate treatment (known as duration of untreated psychosis - DUP), the better the prognosis for the individual.

The NHS incorporated the ensuing recommendations into the NHS Plan 2000 and, as a result, the research contributed to a huge expansion in early intervention services (EIS) 2000-2008.

EIS is now a standard feature of mental health care and a key element of the NHS Plan.

In England alone in 2010-11, early intervention teams served over 10,300 cases of psychosis. This has resulted in a saving of £4,972 per year per person treated, due to better outcomes.

The Department of Health now requires the reporting of DUP as part of the National Mental Health Minimum Dataset for all NHS Mental Health Trusts.

The team's research has also had global impact - it is cited in a large number of international early intervention clinical policy documents and has fed into guidelines.

The work has also had a major influence on DUP policies in the USA, Canada and Australia.

“Studies demonstrated the shorter the period of time between the first appearance of psychosis and receiving adequate treatment, the better the prognosis for the individual.”

Max Marshall / Professor of Community Psychiatry