This review shows a beneficial effect of EWS in time to recurrence , percentage of people hospitalised and functioning in people with bipolar disorder .
BACKGROUND Recurrence rates for bipolar disorder are high despite effective treatments with mood stabiliser drugs .
Self-help treatments and psychological treatments that teach patients to recognise and manage early warning symptoms and signs ( EWS ) of impending manic or depressive episodes are popular with patients .
The main aim of such interventions is to intervene early and prevent bipolar episodes , thereby increasing the time to the next recurrence and preventing hospitalisation .
OBJECTIVES To compare the effectiveness of an EWS intervention plus treatment as usual ( TAU ) versus TAU ( involving and not involving a psychological therapy ) on time to manic , depressive and all bipolar episodes ( the primary outcome ) , hospitalisation , functioning , depressive and manic symptoms .
Early intervention in psychiatric emergencies: a controlled clinical trial
In the UK , psychiatric care of patients with acute and chronic disorders has increasingly moved from hospital to the community . We have evaluated in a controlled trial patients with severe mental illness , who were assigned to early intervention by community services or to st and ard hospital treatment .  100 patients aged 16 to 65 years presenting as psychiatric emergencies to an inner London teaching hospital were r and omly allocated to a multidisciplinary community-based team ( n = 48 ) or conventional hospital-based psychiatric services ( n = 52 ) and assessed over a 3-month period . Ratings of psychopathology and social functioning were made before treatment and after 2 , 4 , and 12 weeks by independent assessors . 85 patients completed all assessment s , and all patients had evaluable data beyond 2 weeks . 3 patients  died during the study , 2 from natural causes and 1 from an accident . Patients referred to the community service showed greater improvement in symptoms and were more satisfied with services than those in the hospital-based service . Patients treated in the hospital-based service spent eight times as many days as psychiatric in patients as those treated in the community-based service . Patients both prefer and seem to benefit from community-based psychiatric care , and our early-intervention community service might be a good model for such care
This review shows a beneficial effect of EWS in time to recurrence , percentage of people hospitalised and functioning in people with bipolar disorder .
BACKGROUND Recurrence rates for bipolar disorder are high despite effective treatments with mood stabiliser drugs .
Self-help treatments and psychological treatments that teach patients to recognise and manage early warning symptoms and signs ( EWS ) of impending manic or depressive episodes are popular with patients .
The main aim of such interventions is to intervene early and prevent bipolar episodes , thereby increasing the time to the next recurrence and preventing hospitalisation .
OBJECTIVES To compare the effectiveness of an EWS intervention plus treatment as usual ( TAU ) versus TAU ( involving and not involving a psychological therapy ) on time to manic , depressive and all bipolar episodes ( the primary outcome ) , hospitalisation , functioning , depressive and manic symptoms .