Benefits of enriched intervention compared with standard care for patients with recent-onset psychosis: a metaanalytic approach.
OBJECTIVE
To assess the effectiveness of enriched intervention (EI) on symptomatic and functional outcomes, compared with standard care (SC).


METHODS
Studies were retrieved from search engines and, using a metaanalytic approach, we compared El trials with SC trials. Eleven EI sample trials (1053 patients) and 6 SC sample trials (500 patients), totalling data from 1553 patients (69% male), were examined. We calculated the effect sizes (ESs) of both symptomatic and functional improvement over a follow-up period of about 1 year.


RESULTS
Significant differences between El and SC were observed at follow-up for the improvement of both positive and negative symptoms, respectively: positive, EI = -1.54 (95%CI, -1.63 to -1.45 ) and SC = -1.07 (95%CI, -1.19 to -0.94) (Qbetween = 40.3, df 1, P < 0.001); negative, EI= -0.44 (95%CI, -0.53 to -0.35) and SC = -0.18 (95%Cl, -0.31 to -0.05) (Qbetween = 10.6, df 1, P < 0.01). We also observed a significant difference between the El and the SC groups for functional improvement over the follow-up period with mean EI = 1.11 (95%CI, 0.99 to 1.23) and SC = 0.63 (95%CI, 0.49 to 0.77) (Qbetween = 24.5, df 1, P < 0.001).


CONCLUSIONS
There is now quantitative evidence across multiple studies and sites to indicate that Els for patients with recent-onset psychosis are significantly more effective than SC for symptomatic and functional improvement over a period of about 1 year.
Harvey
Philippe-Olivier
PO
Prevention and Early Intervention Program for Psychoses, Douglas Mental Health University Institute, Montreal, Quebec.
Lepage
Martin
M
Malla
Ashok
A
D005500:Follow-Up Studies; D006801:Humans; D005791:Patient Care / Q000592:standards*; D011618:Psychotic Disorders / Q000628:therapy*; D018570:Risk Assessment