Curriculum; Health Care Quality, Access, and Evaluation; Evidence-Based Medicine; Schizophrenia and Disorders with Psychotic Features
Psychiatry: Connecticut Mental Health Center | Psychosis Program at Yale | Specialized Treatment for Early Psychosis (STEP) Program
Dr. Srihari is seeking to determine how best to provide care to individuals who have recently experienced the onset of psychotic symptoms. He directs a research clinic that provides multi-disciplinary care to such individuals while also collecting outcomes to inform an assessment of the cost-effectiveness of such care. The overall goal is to articulate a model of care that can be implemented in community settings across the U.S. to promote the functional recovery of individuals with psychotic illnesses.
Extensive Research Description
The STEP research project is described in the Psychiatric Services 2009 Nov/Dec issue in the article titled: 'Public-Academic Collaboration: Early Intervention for Psychotic Disorders in a Community Mental Health Center.'
In addition to providing a package of empirically supported treatments, the clinic is intended to serve as a platform for translational research that can improve understanding of the pathophysiology and thereby the treatment of psychotic illnesses.
- Randomized controlled trial of specialized team based care vs. treatment as usual for early psychosis to determine effectiveness and costs of care.
- Study of barriers to care for serious mental illness.
- Mechanisms of normal belief formation as a context for understanding delusion formation and persistence.
- Assessing the skills of resident trainee physicians in the appraisal and application of scientific studies of groups to clinical practice.
- Reducing the duration of untreated psychosis and its impact in the U.S.: the STEP-ED study. BMC Psychiatry. 2014 Dec 4;14:335. doi: 10.1186/s12888-014-0335-3.
- First-Episode Services for Psychotic Disorders in the U.S. Public Sector: A Pragmatic Randomized Controlled Trial. Psychiatr Serv. 2015 Jul;66(7):705-12. doi: 10.1176/appi.ps.201400236. Epub 2015 Feb 2.
- Srihari VH, Shah J, Keshavan MS. Is Early Intervention for Psychosis Feasible and Effective? Psychiatr Clin N Am 35(2012) 613-631
- Phutane VH, Tek C, Chwastiak L, Ratliff JC, Ozyuksel B, Woods SW, Srihari VH. Cardiovascular risk in a first-episode psychosis sample: A ‘critical period’ for prevention? Schizophrenia Research 2011; 127: 257-261.
- Srihari VH, Breitborde NJK, Frisman L, Tek C, McGlashan TH, Jacobs S, Woods SW. Public-Academic Partnerships: Early Intervention for Psychotic Disorders in a Community Mental Health Center. Psychiatric Services. 2009 (Nov/Dec)
- Dodds TJ, Phutane VH, Stevens BJ, Woods SW, Sernyak MJ, Srihari VH. Who Is Paying the Price? Loss of Insurance Coverage Early in Psychosis. Psychiatric Services 2011; 62(8):878-881.
- Srihari VH. Evidence-Based Medicine (EBM) in the Education of Psychiatrists. Academic Psychiatry. 2008;32(6):463-9.