Age criteria in Early Intervention in Psychosis programs

Abstract

In the last decades the paradigm of the early intervention in the first psychotic episodes (FEP) has spread all over the world and the investigation has shown its benefits in terms of improvement in recovery rates, psychotic relapse and suicide.

Currently, a  criticism of this intervention model is its arbitrary age criterion that raises issues of potential age and gender discrimination. There are arguments for and against the expansion of the age limits of early intervention programs (EIPs), with most of the 'counter' arguments based on the premise that patients with younger FEP represent the vast majority of cases, have a greater disruption functionally, greater psychosocial needs and a worse prognosis in the long term. However, recent data challenge these conceptions and indicate that psychosis arises at any stage of life with marked impact and disruption, with the population experiencing late illnesses requiring treatment and intervention equivalent to or greater than younger patients. This debate is hampered by the relative lack of knowledge about late FEPs - the majority of EIPs are focused on youth, so the flow of research tends to follow this pattern. Thus, populations of late FEP are relatively neglected with little literature focusing on this topic.

Based on a non - systematic review of the literature, the authors intend to present the main arguments that have been raised in favor of and against the remodeling of the EIP, according to the age criterion, analyzing and comparing the international  scenario and the Portuguese reality in this scope.