Transition rates from schizotypal disorder to psychotic disorder for first-contact patients included in the OPUS trial. A randomized clinical trial of integrated treatment and standard treatment.
BACKGROUND
Only a few randomized clinical trials have tested the effect on transition rates of intervention programs for patients with sub-threshold psychosis-like symptoms.


OBJECTIVE
To examine whether integrated treatment reduced transition to psychosis for first-contact patients diagnosed with schizotypal disorder.


METHODS
Seventy-nine patients were randomized to integrated treatment or standard treatment. Survival analysis with multivariate Cox-regression was used to identify factors determinant for transition to psychotic disorder.


RESULTS
In the multivariate model, male gender increased risk for transition to psychotic disorder (relative risk=4.47, (confidence interval 1.30-15.33)), while integrated treatment reduced the risk (relative risk=0.36 (confidence interval 0.16-0.85)). At two-year follow-up, the proportion diagnosed with a psychotic disorder was 25.0% for patients randomized to integrated treatment compared to 48.3% for patients randomized to standard treatment.


CONCLUSIONS
Integrated treatment postponed or inhibited onset of psychosis in significantly more cases than standard treatment.
Nordentoft
Merete
M
Bispebjerg Hospital, Department Psychiatry, Bispebjerg, Bakke 23, DK-2400 Copenhagen NV, Denmark. merete.nordentoft@dadlnet.dk
Thorup
Anne
A
Petersen
Lone
L
Ohlenschlaeger
Johan
J
Melau
Marianne
M
Christensen
Torben Østergaard
TØ
Krarup
Gertrud
G
Jørgensen
Per
P
Jeppesen
Pia
P
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003156:Community Mental Health Services / Q000458:organization & administration*; D003266:Continuity of Patient Care; D019033:Delivery of Health Care, Integrated; D003718:Denmark; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011613:Psychotherapy / Q000379:methods; D011618:Psychotic Disorders / Q000517:prevention & control*; D012559:Schizophrenia / Q000517:prevention & control*; D012569:Schizotypal Personality Disorder / Q000503:physiopathology / Q000628:therapy*
D014150:Antipsychotic Agents