The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis.
OBJECTIVE
To evaluate the effectiveness of a service for early psychosis.


METHODS
Randomised controlled clinical trial.


METHODS
Community mental health teams in one London borough.


METHODS
144 people aged 16-40 years presenting to mental health services for the first or second time with non-organic, non-affective psychosis.


METHODS
Assertive outreach with evidence based biopsychosocial interventions (specialised care group) and standard care (control group) delivered by community mental health teams.


METHODS
Rates of relapse and readmission to hospital.


RESULTS
Compared with patients in the standard care group, those in the specialised care group were less likely to relapse (odds ratio 0.46, 95% confidence interval 0.22 to 0.97), were readmitted fewer times (beta 0.39, 0.10 to 0.68), and were less likely to drop out of the study (odds ratio 0.35, 0.15 to 0.81). When rates were adjusted for sex, previous psychotic episode, and ethnicity, the difference in relapse was no longer significant (odds ratio 0.55, 0.24 to 1.26); only total number of readmissions (beta 0.36, 0.04 to 0.66) and dropout rates (beta 0.28, 0.12 to 0.73) remained significant.


CONCLUSIONS
Limited evidence shows that a team delivering specialised care for patients with early psychosis is superior to standard care for maintaining contact with professionals and for reducing readmissions to hospital. No firm conclusions can, however, be drawn owing to the modest sample size.
Institute of Psychiatry, De Crespigny Park, London SE5 8AF. t.craig@iop.kcl.ac.uk
Tom K J
TK
Craig
Philippa
P
Garety
Paddy
P
Power
Nikola
N
Rahaman
Susannah
S
Colbert
Miriam
M
Fornells-Ambrojo
Graham
G
Dunn
D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services; D006801:Humans; D008131:London; D010348:Patient Care Team; D010359:Patient Readmission / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000628:therapy*; D012008:Recurrence; D016896:Treatment Outcome