Cognitive and clinical predictors of functional capacity in patients with first episode schizophrenia.

Background: The predictors of functional capacity in first episode schizophrenia among seven separable cognitive domains and clinical variables are unknown.

Aim: To investigate predictors of functional capacity in first episode schizophrenia and the associations between functional capacity and measures of real-world functioning.

Methods: Socio-demographic, clinical, and cognitive measures from a sample of patients with first episode schizophrenia spectrum disorders aged 18-34years (N=117) were examined at baseline, 4-month follow-up, and 10-month follow-up and used to predict concurrent and longitudinal functional capacity.

The effect of five years versus two years of specialised assertive intervention for first episode psychosis - OPUS II: study protocol for a randomized controlled trial.

Background: The Danish OPUS I trial randomized 547 patients with first-episode psychosis to a two-year early-specialised assertive treatment programme (OPUS) versus standard treatment. The two years OPUS treatment had significant positive effects on psychotic and negative symptoms, secondary substance abuse, treatment adherence, lower dosage of antipsychotic medication, and a higher treatment satisfaction. However, three years after end of the OPUS treatment, the positive clinical effects were not sustained, except that OPUS-treated patients were significantly less likely to be institutionalised compared with standard-treated patients.

Cognitive training plus a comprehensive psychosocial programme (OPUS) versus the comprehensive psychosocial programme alone for patients with first-episode schizophrenia (the NEUROCOM trial): a study protocol for a centrally randomised, observer-blinded multi-centre clinical trial.

Background: Up to 85% of patients with schizophrenia demonstrate cognitive dysfunction in at least one domain. Cognitive dysfunction plays a major role in functional outcome. It is hypothesized that addition of cognitive training to a comprehensive psychosocial programme (OPUS) enhances both cognitive and everyday functional capacity of patients more than the comprehensive psychosocial programme alone.

Predictors of recovery from psychosis Analyses of clinical and social factors associated with recovery among patients with first-episode psychosis after 5 years.

Introduction: This paper aims to investigate the predictors of good outcome after first-episode non-affective psychosis and the clinical and social trajectories of those that recover.

Methods: A cohort of 255 patients with first-episode non-affective psychosis was interviewed 5 years after first diagnosis and treatment. Recovery was defined as working or studying, having a GAF-function score of 60 or above, having remission of negative and psychotic symptoms, and not living in a supported housing facility or being hospitalized during the last 2 years before the five-year follow-up interview.

[First episode of psychosis intensive early intervention programme versus standard treatment--secondary publication].

A total of 547 patients with a first episode of psychosis were randomised to two years of intensive early intervention programme (OPUS) versus standard treatment. OPUS treatment consisted of Assertive Community Treatment (ACT) with manuals for family involvement and social skills training. Standard treatment comprised contact with a community mental health centre.

Predictors of poor adherence to medication among patients with first-episode schizophrenia-spectrum disorder.

Aim: This study sought to identify predictors for poor adherence to medication among patients with first-episode schizophrenia-spectrum disorder.

Methods: Medication adherence was measured 1 and 2 years after initiation of antipsychotic medication in a follow-up study of 547 patients. Relevant variables were systematically assessed at baseline, 1- and 2-year follow up.

[Psychotherapy for schizophrenia].

The article describes psychotherapy for schizophrenia. There is evidence for the effect of cognitive behavioural therapy in reducing persistent positive symptoms, improving social function, improving insight and reducing the time to remission. Personal therapy is a relatively new kind of psychotherapeutic intervention.

Course of illness in a sample of 265 patients with first-episode psychosis--five-year follow-up of the Danish OPUS trial.

There is an ongoing debate as to whether psychosis is a progressively deteriorating illness or one of progressive amelioration. This paper aims at investigating the rate of recovery and institutionalization and predicting a continuous illness course in a descriptive prospective study of a sub-sample of the OPUS trial of 265 first-episode psychotic patients after five years. Recovery, defined as no psychotic or negative symptoms, living independently, GAF (f)>59, working or studying, was reached for 18% after five years, whereas 13% were institutionalized either at hospital or supported housing after five years.

Predictors of remission and recovery in a first-episode schizophrenia spectrum disorder sample: 2-year follow-up of the OPUS trial.

Objective: To examine the frequency and predictors of good outcome for patients with first-episode schizophrenia spectrum disorder (SSD).

Method: We conducted a 2-year follow-up of a cohort of patients (n = 547) with first-episode SSD. We evaluated the patients on demographic variables, diagnosis, duration of untreated psychosis (DUP), premorbid functioning, psychotic and negative symptoms, substance abuse, adherence to medication, and service use.

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.

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.

Does a detection team shorten duration of untreated psychosis?

Introduction: Duration of untreated psychosis (DUP) is shown to be associated with poor outcome in many domains. It has been shown that it is possible to shorten DUP when combining a detection team and an information campaign. The aim of this study was to evaluate whether DUP was shortened during the first 3 years after establishing detection teams without a concomitant information campaign.

Effect of integrated treatment on the use of coercive measures in first-episode schizophrenia-spectrum disorder. A randomized clinical trial.

The effect of integrated treatment on the use of coercive measures in first-episode schizophrenia-spectrum disorder in Denmark is not known. A total of 328 patients were randomly assigned to integrated treatment (167 patients) or standard treatment (161 patients). Integrated treatment consisted of assertive community treatment, psycho-educational multi-family groups, and social skills training.

Gender differences in young adults with first-episode schizophrenia spectrum disorders at baseline in the Danish OPUS study.

Gender differences in age at first onset, duration of untreated psychosis, psychopathology, social functioning, and self-esteem were investigated in a group of 578 young adults with a first-episode schizophrenia spectrum disorder. The mean age at first-onset of symptoms, age at first contact, and duration of untreated psychosis were similar for men and women. Men had more severe negative symptoms, poorer premorbid functioning, and poorer social networks, whereas women had more severe hallucinations.

Substance abuse and first-episode schizophrenia-spectrum disorders. The Danish OPUS trial.

Aim: To evaluate whether integrated treatment (given by OPUS), in comparison with standard treatment, significantly reduced the number of patients with substance abuse and improved clinical and social outcome in the group of substance abusers after 2 years.

Methods: A total of 547 patients with first-episode schizophrenia-spectrum disorders were included in the study, 275 randomly assigned to OPUS treatment and 272 to standard treatment. OPUS treatment consisted of assertive community treatment with family involvement and social skills training.

Social network among young adults with first-episode schizophrenia spectrum disorders: results from the Danish OPUS trial.

Background: Social network has considerable impact on physical and mental health. Patients experiencing first-episode psychosis early in adult life may experience severe problems concerning development and maintenance of their social network.

Methods: A total of 547 first-episode psychotic patients (18-45) were randomised to standard or integrated treatment, (ACT, social skills training and family intervention), and followed up at 2 years.

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.

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.

[OPUS: a randomised multicenter trial of integrated versus standard treatment for patients with a first-episode psychosis--secondary publication].

A total of 547 patients with first-episode psychosis were included in a randomised clinical trial comparing integrated treatment with standard treatment. The integrated treatment consisted of assertive community treatment with programmes for family involvement and social skills training. Patients in integrated treatment had significantly fewer psychotic and negative symptoms, less comorbid substance abuse, better adherence to treatment and more satisfaction with treatment at one-year and two-year follow-ups.

A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness.

Objectives: To evaluate the effects of integrated treatment for patients with a first episode of psychotic illness.

Design: Randomised clinical trial.

Setting: Copenhagen Hospital Corporation and Psychiatric Hospital Aarhus, Denmark.

Improving 1-year outcome in first-episode psychosis: OPUS trial.

Background: Because early illness course and outcome may affect the long-term outcome of schizophrenia-spectrum disorders, it is especially important to address poor outcome in this early critical period.

Aims: To evaluate whether integrated treatment compared with standard treatment reduced the proportion of patients with poor clinical and social outcome after 1 year.

Method: A total of 547 patients with first-episode psychosis were included in the study, 275 randomly assigned to integrated treatment and 272 to standard treatment.

Integrated treatment of first-episode psychosis: effect of treatment on family burden: OPUS trial.

Background: The families of patients with first-episode psychosis often play a major role in care and often experience lack of support.

Aims: To determine the effect of integrated treatment v. standard treatment on subjective burden of illness, expressed emotion (EE), knowledge of illness and satisfaction with treatment in key relatives of patients with a first episode of schizophrenia-spectrum disorder.