The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis
- PMID: 15485934
- PMCID: PMC526115
- DOI: 10.1136/bmj.38246.594873.7C
The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis
Abstract
Objective: To evaluate the effectiveness of a service for early psychosis.
Design: Randomised controlled clinical trial.
Setting: Community mental health teams in one London borough.
Participants: 144 people aged 16-40 years presenting to mental health services for the first or second time with non-organic, non-affective psychosis.
Interventions: Assertive outreach with evidence based biopsychosocial interventions (specialised care group) and standard care (control group) delivered by community mental health teams.
Primary outcome measures: Rates of relapse and readmission to hospital.
Results: Compared with patients in the standard care group, those in the specialised care group were less likely to relapse (odds ratio 0.46, 95% confidence interval 0.22 to 0.97), were readmitted fewer times (beta 0.39, 0.10 to 0.68), and were less likely to drop out of the study (odds ratio 0.35, 0.15 to 0.81). When rates were adjusted for sex, previous psychotic episode, and ethnicity, the difference in relapse was no longer significant (odds ratio 0.55, 0.24 to 1.26); only total number of readmissions (beta 0.36, 0.04 to 0.66) and dropout rates (beta 0.28, 0.12 to 0.73) remained significant.
Conclusions: Limited evidence shows that a team delivering specialised care for patients with early psychosis is superior to standard care for maintaining contact with professionals and for reducing readmissions to hospital. No firm conclusions can, however, be drawn owing to the modest sample size.
Comment in
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Specialised care for early psychosis: like was not compared with like.BMJ. 2005 Jan 22;330(7484):196-7; author reply 197. doi: 10.1136/bmj.330.7484.196-b. BMJ. 2005. PMID: 15661789 Free PMC article. No abstract available.
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Specialised care for early psychosis: more detail is needed.BMJ. 2005 Jan 22;330(7484):197; author reply 197. doi: 10.1136/bmj.330.7484.197. BMJ. 2005. PMID: 15661794 Free PMC article. No abstract available.
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Specialised care for early psychosis may reduce number of readmissions.Evid Based Ment Health. 2005 May;8(2):34. doi: 10.1136/ebmh.8.2.34. Evid Based Ment Health. 2005. PMID: 15851797 No abstract available.
References
-
- Department of Health. The NHS plan. A plan for investment. A plan for reform. London: DoH, 2000.
-
- Department of Health. The mental health policy implementation guide. London: DoH, 2001.
-
- Loebel AD, Lieberman JA, Alvir JM, Mayerhoff DI, Geisler SH, Symanski SR. Duration of untreated psychosis and cognitive functioning in first episode patients. Am J Psychiatry 1992;149: 1183-8. - PubMed
-
- McGorry PD, Edwards J, Mihalopoulos C, Harrigan SM, Jackson HJ. EPPIC: an evolving system of early detection and optimal management. Schizophr Bull 1996;22: 305-26. - PubMed
-
- Wyatt RJ, Green MF, Tuma AH. Long term morbidity associated with delayed treatment of first admission schizophrenic patients. Psychol Med 1997;27: 261-8. - PubMed
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