Public Documents and Research

EPI Evaluation Framework, British Columbia

The purpose of this EPI evaluation document is to guide and support the implementation of BC Standards and Guidelines for Early Psychosis Intervention Programs and facilitate continuous quality improvement in EPI services in British Columbia.

BC EPI Standards and Guidelines

This document identifies the minimum program requirements for evidence-based Early Psychosis Intervention (EPI) programs as well as guidelines to facilitate implementation and ongoing operations of these programs.

EPI Research in BC – A Partial Summary

Baitz, H.A., Thornton, A.E., Procyshyn, R.P., Smith, G.N., MacEwan, G.W., Kopala, L.C., Barr, A.M., Lang, D.L., & Honer, W.G. (2012). Antipsychotic medications: Linking receptor antagonism to neuropsychological functioning in first episode psychosis. Journal of the International Neuropsychological Society, 18, 717 – 727. doi:10.1017/S1355617712000343.

Ben‐David, S., Kealy, D., Hanson, J., & Ortiz, R. (2021). Perspectives on personal identity in the early stages of psychosis: A survey of Canadian clinicians. Early Intervention in Psychiatry15(4), 1038-104

Ehmann, T., Goldman, R., Yager, J., Xu, Y., & Macewan, G. (2007). Self-reported cognitive and everyday functioning in persons with psychosis: the Patient Perception of Functioning Scale. Comprehensive psychiatry, 48 6, 597-604

Ehmann, T., Tee, K., MacEwan, G., Dalzell, K.L., Hanson, L.A., Smith, G.N., Kopala, L., & Honer, W. (2014). Treatment delay and pathways to care in early psychosis. Early Intervention in Psychiatry, 8.

Ehmann, T.S. and Hanson L. Guide to Clinical Care in Early Psychosis. In Best Care in Early Psychosis: Global Perspectives (Eds. Ehmann, TS, MacEwan, GW and Honer, WG). Taylor & Francis Medical Books: London. 2004

Erickson DH, Roes MH, DiGiacomo A & Burns A (2020). “Individual Placement and Support” boosts employment for early psychosis clients, even when baseline rates are high.  Early Intervention in Psychiatry (2020, 1–7).doi.org/10.1111/eip.13005.

Erickson D(2010). CBT for medication-resistant positive symptoms in early psychosis:  A case series. Early Intervention in Psychiatry, 4, 251-256.

Erickson D, Beiser M, & Iacono W (1999).  Social support predicts 5-year outcome in first-episode schizophrenia.  Journal of Abnormal Psychology, 107, 681-685

Flynn SW, Lang DJ, MacKay AL, Goghari V, Vavasour IM, Whittall KP, Smith GN, Arango V, Mann JJ, Dwork AJ, Falkai P, Honer WG (2003) Abnormalities of myelination in schizophrenia detected in vivo with MRI, and postmortem with analysis of oligodendrocyte proteins. Molec Psychiatry 8:811-820. PMID: 12931208

Fredrikson DH, Boyda HN, Tse L, Whitney Z, Pattison MA, Ott FJ, Hansen L, Barr AM. (2014. Improving metabolic and cardiovascular health at an early psychosis intervention program in Vancouver, Canada. Front Psychiatry.). Sep 5;5:105

Goghari, V., Smith, G.N., Honer, W., Kopala, L., Thornton, A., Su, W., Macewan, G., & Lang, D. (2013). Effects of eight weeks of atypical antipsychotic treatment on middle frontal thickness in drug-naïve first-episode psychosis patients. Schizophrenia Research, 149, 149-155.

Goghari VM, Lang DJ, Flynn SW, Mackay AL and Honer WG. (Mar) 2005. Smaller corpus callosum sub-regions containing motor fibers in schizophrenia. Schizophrenia Research. Vol. 73: 59-68. 

Hanson, L.A., Grypma, M., Tee, K., & Macewan, G. (2006). Evaluation of a community mental health carepath for early psychosis. Journal of evaluation in clinical practice, 12 1, 112-9.

Honer, W., Lang, D., Kopala, L., Macewan, G., Smith, G.N., Chen, E., & Chan, R. (2011). First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment. Chinese Science Bulletin, 56, 3361-3371.

Honer WG (2021) Better evidence for pharmacological maintenance treatment in non-affective psychoses: implications for relapse prevention. Am J Psychiatry 178:369-371, PMID 33979537

Kim DD, Barr AM, Lian L, Yuen JWY, Fredrikson D,

Honer WG, Lang DJ, Kopala LC, MacEwan GW, Smith GN, Chen EYH, Chan RCK (2011) First episode psychosis with extrapyramidal signs prior to drug treatment. Chinese Science Bull 56:3361-3371.

Honer WG, Kopala LC, Rabinowitz J (2005) Extrapyramidal symptoms and signs in first-episode, neuroleptic exposed and non-exposed patients with schizophrenia or related psychotic illness. J Psychopharmacol 19:277-285.

Honer WG, Thornton AE, Procyshyn RM (2021) Efficacy and tolerability of aripiprazole versus D2 antagonists in the early course of schizophrenia: a systematic review and meta-analysis. npj Schizophrenia 7:29, PMID 34035313.

Keramatian K, Dhanoa T, McGirr A, Lang DJ, Honer WG, Lam RW, Yatham LN (2018) Structural brain changes in first episode mania with and without psychosis: Data from Systematic Treatment Optimization Program for Early Mania (STOP-EM). World J Biol Psychiatry 19(sup2):S30-S40, PMID: 27762161

Kim DD, Barr AM, Lian L, Yuen JWY, Fredrikson D, Honer WG, Thornton AE, Procyshyn RM. (2021). Efficacy and tolerability of aripiprazole versus D2 antagonists in the early course of schizophrenia: a systematic review and meta-analysis.

NPJ Schizophr. May 25;7(1):29.

Kopala LC, Good KP, Milliken H, Buiteman C, Woodley H, Rui Q, Whitehorn D, Love L, Balshaw R, Kiss I, Honer WG (2006) Treatment of a first episode of psychotic illness with quetiapine: an analysis of 2 year outcomes. Schizophrenia Res 81:29-39.

Lang, D. J., Khorram, B., Goghari, V. M., Kopala, L. C., Vandorpe, R. A., Rui, Q., Smith, G.N., & Honer, W. G. (2006). Reduced anterior internal capsule and thalamic volumes in first-episode psychosis. Schizophrenia Research, 87(1-3), 89-99.

Lang DJ, Kopala LC, Vandorpe RA, Rui Q, Smith GN, Goghari VM, and Honer WG.. (2001) An MRI study of basal ganglia volumes in first-episode schizophrenia patients treated with risperidone. American Journal of Psychiatry. Vol. 158: 625-631

Lang DJM, Yip E, MacKay AL, Thornton AE, Vila-Rodriguez F, MacEwan GW, Kopala LC, Smith GN, Laule C, MacRae CB, Honer WG (2014). 48 echo T2 myelin imaging of white matter in first-episode schizophrenia: evidence for aberrant myelination. Neuroimage: Clin 6:408-414, PMID: 25379454

Leavey, J.A, Flexhaug, M, Ehmann, T.S. (2008) A review of the literature regarding early intervention for children and adolescents aged 0 to 15 experiencing a first-episode psychiatric disturbance. Early Intervention in Psychiatry.  2, 212-224.

Lecomte, T., Mueser, K.T., MacEwan, G.W., Laferriere-Simard, M.C., Thornton, A.E., Buchanan, T., Goldner, E., Brink, J., Ehmann, T.S., Lang, D., Kang, S., Barr, A.M., & Honer, W.G. (2010). Profiles of individuals seeking psychiatric help for psychotic symptoms linked to methamphetamine abuse – Baseline results from the MAPS (methamphetamine and psychosis study) Mental Health Subst Abuse, 3, 168-181

Lecomte T, Spidel A, Leclerc C, MacEwan GW, Greaves C, Bentall RP. (2008). Predictors and profiles of treatment non-adherence and engagement in services problems in early psychosis. Schizophrenia Research. 102: 295-302. PMID 18295458 DOI: 10.1016/J.Schres.2008.01.024 

Lecomte T, Corbière M, Ehmann T, Addington J, Abdel-Baki A, MacEwan B. Development and preliminary validation of the First Episode Social Functioning Scale for early psychosis. Psychiatry research. 2014 May 30;216(3):412-7.

Lee, D., Smith, G., Su, W., Honer, W., Macewan, G., Lapointe, J.S., Vertinsky, A., Vila-Rodriguez, F., Kopala, L., & Lang, D. (2012). White matter tract abnormalities in first-episode psychosis. Schizophrenia Research, 141, 29-34.

Lian L, Kim DD, Procyshyn RM, Cazares D, Honer WG, Barr AM (2022) Long-acting injectable antipsychotic drugs for early psychosis: A comprehensive systematic review. PLoS ONE (in press).

Lian L, Kim DD, Procyshyn RM, Fredrikson DH, Cázares D, Honer WG, Barr AM. Early Interv Psychiatry. 2021 Jul 14. doi: 10.1111/eip.13202. Efficacy of long-acting injectable versus oral antipsychotic drugs in early psychosis: A systematic review and meta-analysis.

Smith GN, Thornton AE, Lang DJ, MacEwan GW, Kopala LC, Su W, Honer WG (2015) Cortical morphology and early adverse birth events in men with first-episode psychosis. Psychol Med 45:1825-1837, PMID: 25499574.

Smith GN, Lang DJ, Kopala LC, Lapointe JS, Falkai P, Honer WG (2003) Developmental abnormalities of the hippocampus in first-episode schizophrenia. Biol Psychiatry 53:555-561

Smith, G., Thornton, A., Lang, D., Macewan, G., Kopala, L., Su, W., & Honer, W. (2014). Cortical morphology and early adverse birth events in men with first-episode psychosis. Psychological Medicine, 45, 1825 – 1837.

Smith, G.N., Thornton, A.E., Lang, D.J., MacEwan, G.W., Ehmann, T.S., Kopala, L.C., Tee, K., Shiau, G., Voineskos, A.N. Kennedy, J.L., & Honer, W.G. (2012). Hippocampal volume and the brain-derived neurotrophic factor Val66Met polymorphism in first episode psychosis. Schizophrenia Research, 134, 253-259.

Smith, G.N., MacEwan, G.W., Kopala, Lang, D.J., Barr, A.M., Honer, W.G., Ehmann, T.S., Good, K., Thornton, A.E., & Neilson, H. (2010) Prenatal tobacco exposure in first-episode psychosis. Schizophrenia Research, 119(1-3), 271–272.

Smith, G.N., Wong, H., MacEwan, G.W., Kopala, L.C., Ehmann, T.S., Thornton, A.E., Lang, D.J., Barr, A.M., Procyshyn, R., Austin, J.C., Flynn, S.W., & Honer, W.G. (2009). Predictors of starting to smoke cigarettes in patients with first-episode psychosis. Schizophrenia Research, 108(1-3), 258-264.

Spidel A, Lecomte T, Greaves C, Sahlstrom, K, Yuille J. (2010).

Early psychosis and aggression: Predictors and prevalence of violent behaviour amongst individuals with early onset psychosis. International Journal of Law and Psychiatry,33:3, 171-176. doi.org/10.1016/j.ijlp.2010.03.007.

Tee, K., Ehmann, T., & Macewan, G. (2003). Early psychosis identification and intervention. Psychiatric services, 54 4, 573 .

Tee, K., Hanson, L., Krack, C., & Macewan, G. (2006). 0166 EARLY PSYCHOSIS AND SUBSTANCE ABUSE – A RETROSPECTIVE LOOK. Schizophrenia Research, 86.

Vila-Rodriguez, F., Lang, D., Baitz, H.A., Gicas, K., Thorton, A.E., Ehmann, T., Smith, G.N., Barr, A., Torres, I., Kopala, L., Macewan, G., Müller, D., Kennedy, J., & Honer, W. (2017). Verbal memory improvement in first-episode psychosis APOE-ε4 carriers: a pleiotropic effect? Neuropsychiatric Disease and Treatment, 13, 2945 – 2953

Voineskos, A.N., Lang, D.J., Zai, G., Bulgin, N., Shaikh, S., Su, W., Kopala, L.C., MacEwan, G.W., Thornton, A.E., Smith, G.N., Austin, J.C., Honer, W.G., & Kennedy, J.L. (2008). MAG gene variation and cortical gray matter volume in first episode schizophrenia. Brain Imaging & Behavior. Vol. 2(2): 117-122.

Voineskos AN, de Luca V, van Adrichem Q, Bulgin NL, Shaikh S, Lang D, Wong ACH, Honer WG, Kennedy JL (2008) A family-based association study of the myelin-associated glycoprotein and 2’,3’-cyclic nucleotide 3’-phosphodiesterase genes with schizophrenia Psychiatr Genet 18:143-146.

Yager, J, Ehmann, T.S. (2006) Untangling social cognition and social functioning in schizophrenia: Concepts and measurement. Psychiatry, 69, 47-68.

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