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S015-3

A Clinical Service for Ultra High-Risk – The Singapore Experience

Swapna Varma

Institute of Mental Health Singapore, Singapore

Background/Objective: The Support for Wellness Achievement Programme (SWAP) was
established in Singapore, in April 2008 within the remit of the Early Psychosis Intervention service
to provide a comprehensive and integrated assessment and treatment service for those experiencing
an At Risk Mental State (ARMS). Serving a population of 4.8 million in a 710 sq km area, SWAP
takes in help-seeking patients between the ages of 16-30years. The management of these
individuals with ARMS is done within a multidisciplinary framework with focus on psychosocial
interventions.

Method: From March 2008 to December 2014, 264 patients were accepted into the service. Socio
demographic information was taken at baseline and all patients were evaluated using the
Comprehensive Assessment of At Risk Mental State (CAARMS). In addition, severity of
psychopathology was assessed by Positive and Negative Scale for Schizophrenia (PANSS) and social
and occupational functioning was assessed using the Social and Occupational Functioning
Assessment Scale (SOFAS) and Global Assessment of Functioning Scale (GAF).

Result: The mean age of patients was 20.9 years (3.4) and 67.0 % were males. The majority of
patients (52.4%) belonged to the attenuated symptoms (APS) group. The mean total score at baseline
for PANSS was 50.6 (12.9) and GAF was 57.8 (8.0). Of the 264 patients, 50 (18.9%) made the
transition to psychosis.

Conclusion: Although the transition rates have been low and similar to other ARMS programmes
internationally, it is crucial that individuals with ARMS who are help-seeking, distressed or disabled
by their symptoms, have access to a service where assessment, monitoring and psychosocial
interventions are offered.