title: A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness.
abstract: 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.
authors.affiliation: Bispebjerg Hospital, Department of Psychiatry, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark.
authors.forename: Lone
authors.initials: L
authors.lastname: Petersen
authors.forename: Pia
authors.initials: P
authors.lastname: Jeppesen
authors.forename: Anne
authors.initials: A
authors.lastname: Thorup
authors.forename: Maj-Britt
authors.initials: MB
authors.lastname: Abel
authors.forename: Johan
authors.initials: J
authors.lastname: Øhlenschlaeger
authors.forename: Torben Østergaard
authors.initials: TØ
authors.lastname: Christensen
authors.forename: Gertrud
authors.initials: G
authors.lastname: Krarup
authors.forename: Per
authors.initials: P
authors.lastname: Jørgensen
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
mesh_terms: 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