Specialized home treatment versus hospital-based outpatient treatment for first-episode psychosis: a randomized clinical trial.
OBJECTIVE
This pilot study compared the effectiveness of specialized care that was home based versus hospital based for individuals experiencing their first psychotic episode.


METHODS
A randomized controlled trial design was used. A total of 29 subjects were interviewed at baseline, 3 and 9 months. Repeated measures analysis of variance was employed to test for statistically significant changes over time within and between groups with regard to community psychosocial functioning and symptom severity.


RESULTS
Our findings indicate that subjects in both the home-based and hospital-based programmes significantly improved with regard to symptoms and community functioning over time. However, the rates of change over time were not significantly different between the two programmes. There was a statistically significant difference between programmes with regard to the proportion of subjects with less than two visits (i.e. either did not attend their first assessment or attended follow-up visits after their assessment).


CONCLUSIONS
This was a modest pilot study and the sample was too small to allow definitive conclusions to be drawn. However, the results raise questions about differences in initial treatment engagement. They suggest the need for additional research focusing on interventions that promote initial treatment seeking.
Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada. carolyn_dewa@camh.net
Carolyn S
CS
Dewa
Robert B
RB
Zipursky
Nancy
N
Chau
Ivana
I
Furimsky
April
A
Collins
Ofer
O
Agid
Paula
P
Goering
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002170:Canada; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006699:Home Care Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*