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Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial.
Arch Gen Psychiatry. 2008 Jul; 65(7):762-71.AG

Abstract

CONTEXT

Intensive early treatment for first-episode psychosis has been shown to be effective. It is unknown if the positive effects are sustained for 5 years.

OBJECTIVE

To determine the long-term effects of an intensive early-intervention program (OPUS) for first-episode psychotic patients.

DESIGN

Single-blinded, randomized, controlled clinical trial of 2 years of an intensive early-intervention program vs standard treatment. Follow-up periods were 2 and 5 years.

SETTING

Copenhagen Hospital Corporation and Psychiatric Hospital, Aarhus, Denmark. Patients A total of 547 patients with a first episode of psychosis. Of these, 369 patients were participating in a 2-year follow-up, and 301 were participating in a 5-year follow-up. A total of 547 patients were followed for 5 years.

INTERVENTIONS

Two years of an intensive early-intervention program vs standard treatment. The intensive early-intervention treatment consisted of assertive community treatment, family involvement, and social skills training. Standard treatment offered contact with a community mental health center.

MAIN OUTCOME MEASURES

Psychotic and negative symptoms were recorded. Secondary outcome measures were use of services and social functioning.

RESULTS

Analysis was based on the principles of intention-to-treat. Assessment was blinded for previous treatment allocation. At the 5-year follow-up, the effect of treatment seen after 2 years (psychotic dimension odds ratio [OR], -0.32; 95% confidence interval [CI], -0.58 to -0.06; P = .02; negative dimension OR, -0.45; 95% CI, -0.67 to -0.22; P = .001) had equalized between the treatment groups. A significantly smaller percentage of patients from the experimental group were living in supported housing (4% vs 10%, respectively; OR, 2.3; 95% CI, 1.1-4.8; P = .02) and were hospitalized fewer days (mean, 149 vs 193 days; mean difference, 44 days; 95% CI, 0.15-88.12; P = .05) during the 5-year period.

CONCLUSIONS

The intensive early-intervention program improved clinical outcome after 2 years, but the effects were not sustainable up to 5 years later. Secondary outcome measures showed differences in the proportion of patients living in supported housing and days in hospital at the 5-year follow-up in favor of the intensive early-intervention program.

Authors+Show Affiliations

Bispebjerg Hospital, Department of Psychiatry, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark. mbe_76@yahoo.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18606949

Citation

Bertelsen, Mette, et al. "Five-year Follow-up of a Randomized Multicenter Trial of Intensive Early Intervention Vs Standard Treatment for Patients With a First Episode of Psychotic Illness: the OPUS Trial." Archives of General Psychiatry, vol. 65, no. 7, 2008, pp. 762-71.
Bertelsen M, Jeppesen P, Petersen L, et al. Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Arch Gen Psychiatry. 2008;65(7):762-71.
Bertelsen, M., Jeppesen, P., Petersen, L., Thorup, A., Øhlenschlaeger, J., le Quach, P., Christensen, T. Ø., Krarup, G., Jørgensen, P., & Nordentoft, M. (2008). Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Archives of General Psychiatry, 65(7), 762-71. https://doi.org/10.1001/archpsyc.65.7.762
Bertelsen M, et al. Five-year Follow-up of a Randomized Multicenter Trial of Intensive Early Intervention Vs Standard Treatment for Patients With a First Episode of Psychotic Illness: the OPUS Trial. Arch Gen Psychiatry. 2008;65(7):762-71. PubMed PMID: 18606949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. AU - Bertelsen,Mette, AU - Jeppesen,Pia, AU - Petersen,Lone, AU - Thorup,Anne, AU - Øhlenschlaeger,Johan, AU - le Quach,Phuong, AU - Christensen,Torben Østergaard, AU - Krarup,Gertrud, AU - Jørgensen,Per, AU - Nordentoft,Merete, PY - 2008/7/9/pubmed PY - 2008/9/5/medline PY - 2008/7/9/entrez SP - 762 EP - 71 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 65 IS - 7 N2 - CONTEXT: Intensive early treatment for first-episode psychosis has been shown to be effective. It is unknown if the positive effects are sustained for 5 years. OBJECTIVE: To determine the long-term effects of an intensive early-intervention program (OPUS) for first-episode psychotic patients. DESIGN: Single-blinded, randomized, controlled clinical trial of 2 years of an intensive early-intervention program vs standard treatment. Follow-up periods were 2 and 5 years. SETTING: Copenhagen Hospital Corporation and Psychiatric Hospital, Aarhus, Denmark. Patients A total of 547 patients with a first episode of psychosis. Of these, 369 patients were participating in a 2-year follow-up, and 301 were participating in a 5-year follow-up. A total of 547 patients were followed for 5 years. INTERVENTIONS: Two years of an intensive early-intervention program vs standard treatment. The intensive early-intervention treatment consisted of assertive community treatment, family involvement, and social skills training. Standard treatment offered contact with a community mental health center. MAIN OUTCOME MEASURES: Psychotic and negative symptoms were recorded. Secondary outcome measures were use of services and social functioning. RESULTS: Analysis was based on the principles of intention-to-treat. Assessment was blinded for previous treatment allocation. At the 5-year follow-up, the effect of treatment seen after 2 years (psychotic dimension odds ratio [OR], -0.32; 95% confidence interval [CI], -0.58 to -0.06; P = .02; negative dimension OR, -0.45; 95% CI, -0.67 to -0.22; P = .001) had equalized between the treatment groups. A significantly smaller percentage of patients from the experimental group were living in supported housing (4% vs 10%, respectively; OR, 2.3; 95% CI, 1.1-4.8; P = .02) and were hospitalized fewer days (mean, 149 vs 193 days; mean difference, 44 days; 95% CI, 0.15-88.12; P = .05) during the 5-year period. CONCLUSIONS: The intensive early-intervention program improved clinical outcome after 2 years, but the effects were not sustainable up to 5 years later. Secondary outcome measures showed differences in the proportion of patients living in supported housing and days in hospital at the 5-year follow-up in favor of the intensive early-intervention program. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/18606949/Five_year_follow_up_of_a_randomized_multicenter_trial_of_intensive_early_intervention_vs_standard_treatment_for_patients_with_a_first_episode_of_psychotic_illness:_the_OPUS_trial_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archpsyc.65.7.762 DB - PRIME DP - Unbound Medicine ER -