Extending the period of specialised early intervention is clinically desirable but may not be feasible in lower-income countries.

Evidence indicates that the positive effects of 2-year early intervention services for psychosis are not maintained after service withdrawal. Optimal duration of early intervention in sustaining initial improved outcomes remains to be determined.To examine the sustainability of the positive effects of an extended, 3-year, early intervention programme for patients with first-episode psychosis (FEP) after transition to standard care.A total of 160 patients, who had received a 2-year early intervention programme for FEP, were enrolled to a 12-month randomised-controlled trial (ClinicalTrials.gov: NCT01202357) comparing a 1-year extension of the early intervention (3-year specialised treatment) with step-down care (2-year specialised treatment). Participants were followed up and reassessed 2 and 3 years after inclusion to the trial.There were no significant differences between the treatment groups in outcomes on functioning, symptom severity and service use during the post-trial follow-up period.The therapeutic benefits achieved by the extended, 3-year early intervention were not sustainable after termination of the specialised service.

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