Transition rates from schizotypal disorder to psychotic disorder for first-contact patients included in the OPUS trial. A randomized clinical trial of integrated treatment and standard treatment

Schizophr Res. 2006 Mar;83(1):29-40. doi: 10.1016/j.schres.2006.01.002. Epub 2006 Feb 28.

Abstract

Background: Only a few randomized clinical trials have tested the effect on transition rates of intervention programs for patients with sub-threshold psychosis-like symptoms.

Aim: To examine whether integrated treatment reduced transition to psychosis for first-contact patients diagnosed with schizotypal disorder.

Methods: Seventy-nine patients were randomized to integrated treatment or standard treatment. Survival analysis with multivariate Cox-regression was used to identify factors determinant for transition to psychotic disorder.

Results: In the multivariate model, male gender increased risk for transition to psychotic disorder (relative risk=4.47, (confidence interval 1.30-15.33)), while integrated treatment reduced the risk (relative risk=0.36 (confidence interval 0.16-0.85)). At two-year follow-up, the proportion diagnosed with a psychotic disorder was 25.0% for patients randomized to integrated treatment compared to 48.3% for patients randomized to standard treatment.

Conclusion: Integrated treatment postponed or inhibited onset of psychosis in significantly more cases than standard treatment.

Publication types

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

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use
  • Combined Modality Therapy
  • Community Mental Health Services / organization & administration*
  • Continuity of Patient Care*
  • Delivery of Health Care, Integrated*
  • Denmark
  • Disease Progression
  • Female
  • Humans
  • Male
  • Multivariate Analysis
  • Proportional Hazards Models
  • Prospective Studies
  • Psychotherapy / methods
  • Psychotic Disorders / prevention & control*
  • Schizophrenia / prevention & control*
  • Schizotypal Personality Disorder / physiopathology
  • Schizotypal Personality Disorder / therapy*

Substances

  • Antipsychotic Agents