title: Supportive psychodynamic psychotherapy versus treatment as usual for first-episode psychosis: two-year outcome.
abstract: During recent decades, the field of treatment of schizophrenia has lacked empirical, systematic outcome studies that support psychodynamic psychotherapy as an evidence-based intervention for patients with schizophrenia. The Danish schizophrenia project (DNS) compared psychodynamic psychotherapy for psychosis with standard treatment in patients with a first-episode schizophrenia spectrum disorder. The study was designed as a prospective, comparative, longitudinal multi-site investigation of consecutively referred patients who were included during two years. The patients were treated with either manualized individual supportive psychodynamic psychotherapy (SPP) in addition to treatment as usual or with treatment as usual alone (TaU). Symptoms and functional outcomes were measured using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning scale (GAF). The study included 269 consecutively admitted patients, age 18-35, of whom 79% remained in the study after two years. The intervention group improved significantly on measures of both PANSS and GAF scores, with large effect sizes at two years follow-up after inclusion. Further, improvement on GAF(function) (p = 0.000) and GAF(symptom) (p = 0.010) significantly favored SPP in combination with TaU over TaU alone. In spite of limitations, this study speaks in favor of including supportive psychodynamic psychotherapy in the treatment for patients with schizophrenic first-episode psychoses.
authors.affiliation: Mental Health Services, Department of Psychology, University of Copenhagen, Frederiksberg, Denmark. bent.rosenbaum@dadlnet.dk
authors.forename: Bent
authors.initials: B
authors.lastname: Rosenbaum
authors.forename: Susanne
authors.initials: S
authors.lastname: Harder
authors.forename: Per
authors.initials: P
authors.lastname: Knudsen
authors.forename: Anne
authors.initials: A
authors.lastname: Køster
authors.forename: Anne
authors.initials: A
authors.lastname: Lindhardt
authors.forename: Matilde
authors.initials: M
authors.lastname: Lajer
authors.forename: Kristian
authors.initials: K
authors.lastname: Valbak
authors.forename: Gerda
authors.initials: G
authors.lastname: Winther
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003718:Denmark; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D055815:Young Adult