BRITISH JOURNAL OF (2005), 186, 394^399

The Danish National Schizophrenia Project: improve the course of illness compared with treatment as usual. We wanted to prospective, comparative longitudinal treatment explore whether the treatment methods in our investigation, including treatment as usual, would help patients to improve their study of first-episode psychosis psychic and social functioning, and whether the interventions would lead to greater BENT ROSENBAUM, KRISTIAN VALBAK, SUSANNE HARDER, PER KNUDSEN, improvement than usual treatment alone, ANNE KSTER, MATILDE LAJER, ANNE LINDHARDT, GERDA WINTHER, with respect to symptoms and social LONE PETERSEN, PER JRGENSEN, MERETE NORDENTOFT functioning. and ANNE HELMS ANDREASEN METHOD Background First-episode psychosis The first 2–3 years following a first episode Study design intervention mayimprove the course and of psychosis may represent a critical period during which crucial biological and psycho- outcome of schizophrenic disorders. The study was a prospective, comparative social changes are imprinted in the mind of longitudinal study with a minimum inter- Aims TodescribeTo describe the Danish National the patient, thus forming the predictors of vention period of 2 years and assessments thethelong-term outcome (Birchwood et aletal,, of participants at baseline and 1, 2 and 5 Schizophrenia Project and to measure the 1998). According to this theory, psycho- years after inclusion. Participants were allo- outcome of two different forms of social interventions counteracting the cated to three different treatments (Table 1). intervention after1year,after 1 year, compared with damaging effects of the negative predictors standard treatment. at this stage may have a disproportionate (a)(a) Treatment 1 ((nn¼119): patients were positive impact compared with inter- offered scheduled, manualised, suppor- MethodMethod AAprospective,longitudinal, prospective, longitudinal, ventions later in the course of the illness. tive individual psychotherapy (one multicentre investigationinvestigationincluded included 562 The basis for a lasting result is, however, 45-min session per week, for a period that the intervention is sustained for a patients, consecutivelyreferred over a of 1–3 years) and/or group psycho- period of years (Linszen et aletal, 2001). The therapy (one 60-min session per week 2-year period, with a firstepisode of Danish National Schizophrenia Project for a period of 1–3 years), in addition psychosis.Patients were allocated to investigates precisely the effects of early, to treatment as usual. Antipsychotic supportive psychodynamic rapid and year-long sustained intervention medication was given in doses based on individual needs. psychotherapy as a supplementtosupplement to after the first signs of psychosis. treatment as usual, an integrated, (b)(b) Treatment 2 ((nn¼139): patients were assertive, psychosocial and educational Background of the study offered an integrated treatment treatment programme or treatment as The Danish National Mental Health package – a scheduled, 2-year pro- usual.usual. Service has a long tradition of equal access gramme consisting of assertive com- to and free treatment for all inhabitants munity treatment, psycho-educational ResultsResults There was a non-significant regardless of their location, income, eth- multifamily treatment (according to McFarlaneMcFarlane et aletal (1995)), in which four tendency towardsgreaterimprovementin nicity or religion. Psychiatric treatment is organised according to sector, and there is to six families, including the patients, social functioning in the integrated meet for 11meetfor 11⁄⁄ h every second week for noprivate psychiatric in . 22 18 months), social skills training treatmentgroup and the supportive The National Mental Health Service has (concerning medication, self-manage- psychodynamic psychotherapygroup 4100 beds, approximately 105 co