The Australian Clinical Guidelines for Early Psychosis were developed in response to growing research and clinical interest in a model of psychosis that challenged the pessimism prevailing at the time regarding the prognosis of people with psychosis. The model presented in these guidelines advocates that young people should receive timely and comprehensive intervention during the critical years following onset, and that ‘withholding treatment until severe and less reversible symptomatic and functional impairment have become entrenched represents a failure of care’. Specifically, the model proposed in the first edition of the guidelines suggested that intervening early in the course of acute psychosis is crucial for a number of reasons:
It enables timely reduction of distressing experiences
It was thought that early intervention would reduce the duration of untreated psychosis (DUP), one of the few obviously malleable candidate risk factors for poor outcome
It was proposed to be associated with better outcome in the short-term, perhaps because of an effect it may have on DUP
It was believed to be cost-effective, and in the case of the putative prodrome, it was thought early intervention might prevent onset of psychotic disorder.
The need for the second edition
Significant changes have occurred since the development of the initial guidelines. There is increasing evidence demonstrating the effectiveness of early intervention in psychotic disorders. These updated guidelines incorporate a signficant volume of additional evidence that has been developed around the world following the initial publication of the guidelines.