Ten-year follow-up of the OPUS specialized early intervention trial for patients with a first episode of psychosis.
BACKGROUND
Specialized early intervention programs such as The Danish OPUS treatment are efficient in treating patients with a first episode of psychosis (FEP) at least after 2 and 5 years. Few studies have examined long-term outcomes of these interventions.


OBJECTIVE
To examine the effect of 2 years of OPUS vs treatment as usual (TAU) within an FEP cohort, 10 years after inclusion into the OPUS trial.


METHODS
From 1998 to 2000, participants were randomized to OPUS or TAU. Ten years later, we conducted comprehensive interviews and performed register-based follow-up on all participants in national Danish registers. We analyzed participants according to the intention-to-treat principle.


RESULTS
Of the 547 participants included in the study, 347 (63.4%) took part in this follow-up. While there was evidence of a differential 10-year course in the development of negative symptoms, psychiatric bed days, and possibly psychotic symptoms in favor of OPUS treatment, differences were driven by effects at earlier follow-ups and had diminished over time. Statistically significant differences in the course of use of supported housing were present even after 8-10 years. There were no differences between OPUS and TAU regarding income, work-related outcomes, or marital status.


CONCLUSIONS
Most of the positive short-term effects of the OPUS intervention had diminished or vanished at this long-term follow-up. We observed a clear tendency that OPUS treatment leads to fewer days in supported housing. There is a need for further studies investigating if extending the intervention will improve outcomes more markedly at long-term follow-ups.
Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark;
Rikke Gry
RG
Secher
Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus, Denmark; carsten.rygaard.hjorthoej@regionh.dk.
Carsten Rygaard
CR
Hjorthøj
Mental Health Center North Zealand, Copenhagen University Hospital, Copenhagen, Denmark;
Stephen F
SF
Austin
Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus, Denmark;
Anne
A
Thorup
Child & Adolescent Mental Health Center, Copenhagen University Hospital, Glostrup, Denmark;
Pia
P
Jeppesen
The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus, Denmark; Research Department P, Aarhus University Hospital, Risskov, Denmark.
Ole
O
Mors
Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus, Denmark;
Merete
M
Nordentoft
D000328:Adult; D003156:Community Mental Health Services / Q000379:methods*; D003718:Denmark; D061345:Early Medical Intervention / Q000379:methods* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011618:Psychotic Disorders / Q000188:drug therapy / Q000628:therapy*; D012042:Registries; D012559:Schizophrenia / Q000188:drug therapy / Q000628:therapy*; D013997:Time Factors
early intervention; long-term outcomes; randomized trial; schizophrenia