title: Substance abuse and first-episode schizophrenia-spectrum disorders. The Danish OPUS trial.
abstract: OBJECTIVE
  To evaluate whether integrated treatment (given by OPUS), in comparison with standard treatment, significantly reduced the number of patients with substance abuse and improved clinical and social outcome in the group of substance abusers after 2 years.
  
  
  METHODS
  A total of 547 patients with first-episode schizophrenia-spectrum disorders were included in the study, 275 randomly assigned to OPUS treatment and 272 to standard treatment. OPUS treatment consisted of assertive community treatment with family involvement and social skills training. Standard treatment offered contact with a community mental health centre. Main outcome measure was reduction in comorbid substance abuse.
  
  
  RESULTS
  At 2-year follow up, 42 (17.3%) patients from OPUS and 40 (20.7%) patients from standard treatment met criteria for substance abuse (odds ratio=0.5, 95% confidence interval 0.3-1.0). OPUS treatment compared with standard treatment significantly reduced negative and disorganized symptoms in the substance abuser group. Patients with substance abuse in the OPUS treatment spent significantly fewer days in hospital during the 2-year period than patients given standard treatment (109 days vs. 167 days) and adhered to treatment significantly more often.
  
  
  CONCLUSIONS
  Results from this trial indicate that integrated treatment given by OPUS reduced substance abuse and improved clinical outcome in the substance abuser group. Supplementing the OPUS treatment with therapeutic programmes for patients with a comorbid substance abuse would probably further improve outcome.
authors.affiliation: Department of Psychiatry E, Bispebjerg Hospital, Copenhagen, Sct Hans Hospital, Roskilde, and Psychiatric Hospital Risskov, Risskov, Denmark. lonepetersen@mail.dk
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: Johan
authors.initials: J
authors.lastname: Ohlenschlaeger
authors.forename: Gertrud
authors.initials: G
authors.lastname: Krarup
authors.forename: Torben
authors.initials: T
authors.lastname: Ostergård
authors.forename: Per
authors.initials: P
authors.lastname: Jørgensen
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
mesh_terms: D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services / Q000379:methods*; D003718:Denmark; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*