title: Predicting medication-free treatment response in acute psychosis: cross-validation from the Finnish Need-Adapted Project.
abstract: This study tested predictors of 2-year antipsychotic-free response from the Soteria study (older, better social functioning, fewer cardinal symptoms) using data from the Finnish Acute Psychosis Integrated treatment study. The quasi-experimental study compared need-adapted family-oriented psychosocial intervention within a 3-week antipsychotic-free trial to psychosocial intervention plus antipsychotic medications. Forty-six percent of experimental completers (37% of intent-to-treat subjects) were successfully treated without antipsychotic medications for the entire 2-year study. The DSM-III-R diagnoses of schizophrenia and schizophreniform disorder and Soteria-suggested predictors were not related to antipsychotic-free response. Different variables within the same domains of good prognosis and fewer schizophrenia symptoms predicted antipsychotic-free response or nonresponse with 74% accuracy. The 6-month duration of symptom criterion distinguishing schizophrenia from schizophreniform disorder does not separate medication-free treatment responders from those requiring medications. Prognosis appears related to antipsychotic-free response and may be helpful in distinguishing schizophrenia from schizophreniform disorder in early episodes.
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, California 90089-0411, USA.
authors.forename: John Robert
authors.initials: JR
authors.lastname: Bola
authors.forename: Klaus
authors.initials: K
authors.lastname: Lehtinen
authors.forename: Jukka
authors.initials: J
authors.lastname: Aaltonen
authors.forename: Viljo
authors.initials: V
authors.lastname: Räkköläinen
authors.forename: Erkka
authors.initials: E
authors.lastname: Syvälahti
authors.forename: Ville
authors.initials: V
authors.lastname: Lehtinen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005196:Family Therapy / Q000379:methods*; D005260:Female; D005387:Finland; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents