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Well begun is half done:

Implementation and maintenance of early detection and intervention in mental health care for psychosis.

N. Duijnhouwer, B. Seelen-de Lang, K. Janssen & P. de Bont

The past decade mental health organizations worldwide implemented Early Detection and Intervention (EDI) teams for help-seeking non-psychotic patients with a high risk profile for psychosis. A growing body of evidence shows that EDI helps diminish the burden of the symptoms and problems associated with the risk profile,  substantially decreases the transition rate to first psychotic episodes and is cost effective. Nevertheless, to many professionals and organizations in mental health EDI is still unknown and implementation is not prioritized. In order to further help bridge the gap between scientifically proven guidelines and clinical practice this article evaluates the implementation of EDI in a mental health organization. To foster dissemination and implementation of EDI in clinical practice the authors present useful pitfalls and success factors.


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Afgelopen decennia zijn Early Detection and Intervention (edi) teams gestart voor niet-psychotische cliënten met een ultrahoog psychose-risicoprofiel. Studies tonen aan dat een edi-team problemen rond psychose effectief behandelt, het aantal nieuwe psychosen drastisch vermindert en kosteneffectief is. Toch worstelen ggz-organisaties met opzet en behoud van edi-teams. Om de kloof tussen klinische praktijk en evidence-based richtlijnen te verkleinen, wordt de implementatie en borging van een edi-team geëvalueerd.

Steeds meer GGZ-instellingen in Nederland en wereldwijd bieden een zorgaanbod van vroege opsporing en interventie aan voor hulpzoekende, niet-psychotische cliënten met een ultrahoog risicoprofiel (UHR) voor psychose. Deze aanpak, in Nederland vooral bekend als Early Detection and Intervention (EDI), is al jarenlang in Europese  en Nederlandse richtlijnen opgenomen (iepaw, 2005; nice, 2013; WerkgroepPsychose, 2017).

Recente reviews en meta-analyses onderstrepen met steeds robuustere evidentie het belang om EDI te implementeren in de GGZ (Bosnjak Kuharic et al., 2019; P. Fusar-Poli et al., 2020; Hutton & Taylor, 2014; Mei et al., 2021; Nelson et al., 2019; Stafford et al., 2013; van der Gaag et al., 2012; Zhang et al., 2020). Want EDI voor UHR reduceert klachten, verbetert de kwaliteit van leven, verkleint de kans op een transitie naar een eerste psychose en kost op termijn minder geld (Ising et al., 2017; Jin et al., 2020).

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