A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness.
OBJECTIVE
To evaluate the effects of integrated treatment for patients with a first episode of psychotic illness.


METHODS
Randomised clinical trial.


METHODS
Copenhagen Hospital Corporation and Psychiatric Hospital Aarhus, Denmark.


METHODS
547 patients with first episode of schizophrenia spectrum disorder.


METHODS
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.


METHODS
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.


CONCLUSIONS
Integrated treatment improved clinical outcome and adherence to treatment. The improvement in clinical outcome was consistent at one year and two year follow-ups.
Petersen
Lone
L
Bispebjerg Hospital, Department of Psychiatry, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark.
Jeppesen
Pia
P
Thorup
Anne
A
Abel
Maj-Britt
MB
Øhlenschlaeger
Johan
J
Christensen
Torben Østergaard
TØ
Krarup
Gertrud
G
Jørgensen
Per
P
Nordentoft
Merete
M
D000293:Adolescent; D000328:Adult; D001242:Assertiveness; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010349:Patient Compliance; D017060:Patient Satisfaction; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D016896:Treatment Outcome