[OPUS: a randomised multicenter trial of integrated versus standard treatment for patients with a first-episode psychosis--secondary publication]. / OPUS: Randomiseret multicenterundersøgelse af integreret behandling sammenlignet med standardbehandling før første psykoseepisode--sekundaerpublikation.

A total of 547 patients with first-episode psychosis were included in a randomised clinical trial comparing integrated treatment with standard treatment. The integrated treatment consisted of assertive community treatment with programmes for family involvement and social skills training. Patients in integrated treatment had significantly fewer psychotic and negative symptoms, less comorbid substance abuse, better adherence to treatment and more satisfaction with treatment at one-year and two-year follow-ups.

A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness.

OBJECTIVES: To evaluate the effects of integrated treatment for patients with a first episode of psychotic illness. DESIGN: Randomised clinical trial. SETTING: Copenhagen Hospital Corporation and Psychiatric Hospital Aarhus, Denmark. PARTICIPANTS: 547 patients with first episode of schizophrenia spectrum disorder. INTERVENTIONS: Integrated treatment and standard treatment. The integrated treatment lasted for two years and consisted of assertive community treatment with programmes for family involvement and social skills training. Standard treatment offered contact with a community mental health centre. MAIN OUTCOME MEASURES: Psychotic and negative symptoms (each scored from 0 to a maximum of 5) at one and two years' follow-up. RESULTS: At one year's follow-up, psychotic symptoms changed favourably to a mean of 1.09 (standard deviation 1.27) with an estimated mean difference between groups of -0.31 (95% confidence interval -0.55 to -0.07, P = 0.02) in favour of integrated treatment. Negative symptoms changed favourably with an estimated difference between groups of -0.36 (-0.54 to -0.17, P < 0.001) in favour of integrated treatment. At two years' follow-up the estimated mean difference between groups in psychotic symptoms was -0.32 (-0.58 to -0.06, P = 0.02) and in negative symptoms was -0.45 (-0.67 to -0.22, P < 0.001), both in favour of integrated treatment. Patients who received integrated treatment had significantly less comorbid substance misuse, better adherence to treatment, and more satisfaction with treatment. CONCLUSION: Integrated treatment improved clinical outcome and adherence to treatment. The improvement in clinical outcome was consistent at one year and two year follow-ups.

Integrated treatment of first-episode psychosis: effect of treatment on family burden: OPUS trial.

BACKGROUND: The families of patients with first-episode psychosis often play a major role in care and often experience lack of support. AIMS: To determine the effect of integrated treatment v. standard treatment on subjective burden of illness, expressed emotion (EE), knowledge of illness and satisfaction with treatment in key relatives of patients with a first episode of schizophrenia-spectrum disorder. METHOD: Patients with ICD-10 schizophrenia-spectrum disorders (first episode) were randomly assigned to integrated treatment or to standard treatment. Integrated treatment consisted of assertive community treatment, psychoeducational multi-family groups and social skills training. Key relatives were assessed with the Social Behaviour Assessment Schedule (SBAS, burden of illness), the 5-min speech sample (EE), and a multiple choice questionnaire at entry and after 1 year. RESULTS: Relatives in integrated treatment felt less burdened and were significantly more satisfied with treatment than relatives in standard treatment. There were no significant effects of intervention groups on knowledge of illness and EE. CONCLUSIONS: The integrated treatment reduced family burden of illness and improved satisfaction with treatment.