Treatment reluctance in first episode schizophrenia: Lack of insight, non-compliance and cannabis abuse predict bad outcome after eighteen months intervention

Early intervention for psychosis

“…Twelve trials were concerned with improving outcome in first-episode psychosis (Alvarez-Spain; Berger-Australia; Edwards-Australia; Jackson-Australia; Killackey-Australia; Leavey-UK; LEO-CAT-UK; LifeSPAN-Australia; Linszen-Amsterdam; OPUS-Scandinavia; Uzenoff-USA; Zhang-China).…”

“…Participants were aged 15 to 29 years, and were acutely suicidal. Linszen-Amsterdam recruited participants aged from 15 to 26 who were experiencing their first episode of schizophrenia and living in close contact with parents or relatives. All participants were recruited from an adolescent clinic and had to agree to an initial three months’ inpatient programme before randomisation.…”

“…OPUS-Scandinavia was the largest study, and had a sample size (n=547) which was arrived at using a pre-study power calculation. The other trials were small and, in ascending order of size, were:Uzenoff-USA (24), Killackey-Australia (41), Edwards-Australia (47), LifeSPAN-Australia (56), PACE-Australia (59), EDIE-UK (60), PRIME-USA (60), Alvarez-Spain (61), Jackson-Australia (62), Linszen-Amsterdam (76), Berger-Australia (80), Amminger-Austria (81), Zhang-China (83), Leavey-UK (106), LEO-CATUK (113), LIPS-Germany (124) and EIPS-Germany (128).…”

“…In Linszen-Amsterdam the intervention was behavioural family therapy for one year. Eighteen family therapy sessions were held over a 12-month period.…”

“…Four trials (Edwards-Australia; Killackey-Australia; LifeSPAN-Australia; Uzenoff-USA) reported data at six months. Linszen-Amsterdam reported at 12 months following an initial three-month inpatient admission and also reported a five-year follow-up, but data were provided for the whole sample only, not by group allocation. OPUS-Scandinavia reported data at 12 and 24 months, whereas Zhang-China reported at 18 months.…”