[The Cologne Early Recognition and Intervention Center for mental crises (FETZ). Evaluation of service use]

Abstract

Background and purpose: The Cologne Early Recognition and Intervention Center for mental crises (FETZ) was set up in late 1997 as the first European center dedicated to the early detection of psychosis prior to first episode. Following the German psychopathologic tradition, basic symptoms, especially cognitive-perceptive disturbances, are employed as a means to this aim in addition to the internationally established "ultra-high risk" (UHR) criteria.

Methods: Besides analyses of the service use of the first 6 years (1998-2003), sociodemographic data of the FETZ sample were compared with the Cologne demography to give an estimate of its representativeness.

Results: The number of first contacts steadily increased over the first 3 years - not least due to an awareness campaign that started in 2000. In all, 872 persons contacted the FETZ during the 6-year period, 326 of them (37.4%) already suffering from frank psychosis. Of the remaining 546 persons, 402 (73.6%) met at least one prodromal criterion, 94.0% by reporting predictive basic symptoms, 68.9% by attenuated and 20.6% by transient psychotic symptoms. The comparison with the Cologne demography revealed significant bias toward persons of German citizenship as well as those of higher education among the service users.

Conclusion: Although an early detection center is generally well received, findings indicate the necessity to develop and carry out custom-built public campaigns especially tailored to at-risk persons with migration background as well as those with lower graduation.