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Two-year outcome in first-episode psychosis treated according to an integrated model. Is immediate neuroleptisation always needed?

Published online by Cambridge University Press:  16 April 2020

V. Lehtinen ,
J. Aaltonen ,
T. Koffert ,
V. Räkköläinen  and
E. Syvälahti
V. Lehtinen*
Affiliation:
Mental Health R&D Group, the National Research and Development Centre for Welfare and Health, STAKES, Mestarinkatu 2 D, FIN-20810Turku, Finland
J. Aaltonen
Affiliation:
Department of Psychology, University of Jyväskylä,Jyväskylä, Finland
T. Koffert
Affiliation:
Mental Health R&D Group, the National Research and Development Centre for Welfare and Health, STAKES, Mestarinkatu 2 D, FIN-20810Turku, Finland
V. Räkköläinen
Affiliation:
Kupittaa Hospital,Turku, Finland
E. Syvälahti
Affiliation:
Department of Pharmacology and Clinical Pharmacology, University of Turku,Turku, Finland
*
*Correspondence and reprints
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Summary

In this multicentre study the two-year outcome of two groups of consecutive patients (total N = 106) with first-episode functional non-affective psychosis, both treated according to the ‘need-specific Finnish model’, which stresses teamwork, patient and family participation and basic psychotherapeutic attitudes, was compared. No alternative treatment facilities were available in the study sites. The two study groups differed in the use of neuroleptics: three of the sites (the experimental group) used a minimal neuroleptic regime whilst the other three (the control group) used neuroleptics according to the usual practice. Total time spent in hospital, occurrence of psychotic symptoms during the last follow-up year, employment, GAS score and the Grip on Life assessment were used as outcome measures. In the experimental group 42.9% of the patients did not receive neuroleptics at all during the whole two-year period, while the corresponding proportion in the control group was 5.9%. The overall outcome of the whole group could be seen as rather favourable. The main result was that the outcome of the experimental group was equal or even somewhat better than that of the control group, also after controlling for age, gender and diagnosis. This indicates that an integrated approach, stressing intensive psychosocial measures, is recommended in the treatment of acute first-episode psychosis.

Keywords

first-time psychosisfollow-up studyintegrated treatmentoutcomeuse of neuroleptics
Type
Original Article
Information
European Psychiatry , Volume 15 , Issue 5 , August 2000 , pp. 312 - 320
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2000

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