Reading the Signs
Early signs of serious mental illness can be subtle and hard to read, yet researchers theorize that the long-term outcome for those afflicted with schizophrenia and related disorders can be altered significantly if early identification, specialized treatment, and eventually, preventive interventions, are available.
After studying schizophrenia for 13 years, Dr. Ashok Malla turned his focus to the early stages of this and related illnesses. His new program expands that work, examining the predictors of short- and long-term multi-dimensional outcomes, especially potentially malleable predictors, such as treatment delay, cognition, and the nature and delivery of initial treatment.
Using his Prevention and Early Intervention for Psychosis Program model and results from his longitudinal study started in 1999 in London, Ontario, Dr. Malla will develop the necessary infrastructure at Montreal's Douglas Hospital Research Centre to establish a longitudinal database of new cases of first-episode psychosis and further investigate service models and new medical and psychosocial treatments for preventing relapses and improving long-term outcome. He will also compare the impact of different methods of early community case identification (identifying cases in a community rather than in a hospital or clinical setting) on outcome. Dr. Malla will collaborate with researchers at McGill to expand his research to include neurobiological and epidemiological methods in early psychosis and the pre-psychotic period.
Through longitudinal study of early psychosis, the role of malleable versus non-malleable predictors of outcome can be examined. The findings will help clinical investigators design various interventions for specific sub groups. The longitudinal nature of these studies will also allow researchers to examine patient and clinical characteristics that influence quality of life before and after treatment.
Other components of the program will evaluate specialized versus routine care, following the first two years of specialized treatment, to gauge the long-term impact of an early intervention approach on outcome, and measure the effectiveness of preventive interventions for people at risk of psychosis.