OPUS treatment proven effective in first-episode psychosis

The Danish OPUS early intervention services for first-episode psychosis have not only maintained its efficacy following implementation as a standard treatment but have paralleled or even exceeded many of the effects noted during the randomized trial of the intervention, reports a study.

“The study results provide further evidence in support of implementation and funding of early intervention services worldwide,” the investigators said.

In this analysis, a team of investigators compared patients who received OPUS treatment as part of the original randomized trial to those who received standard treatment (control group) and those who received OPUS after its implementation in Denmark.

The investigators then examined whether the three groups differed on register-based outcomes, such as use of secondary healthcare, functional outcomes, and death. They also adjusted the analyses for relevant confounders.

Patients treated with OPUS after its implementation (n=3,328) appeared to have lower mortality (hazard ratio, 0.60, 95 percent confidence interval [CI], 0.33–1.09), fewer and shorter psychiatric admissions, and possibly fewer filled prescriptions of antipsychotic and psycholeptic medications after 4 or 5 years than trial study participants.

Patients who received postimplementation OPUS treatment were less likely to work or study at first, but they eventually had higher chances of working than did those in the trial (after 5 years: odds ratio, 1.49, 95 percent CI, 1.07–2.09).

The probability of being in a couple relationship was also higher among patients in the postimplementation group than those in the trial. For other outcomes, the associations with the OPUS treatment group were less clear.

Overall, individuals in the control group of the trial fared worse than their counterparts in both OPUS treatment groups.

“The Danish OPUS trial showed significant efficacy of early intervention services for first-episode schizophrenia spectrum disorders compared with standard treatment, leading to implementation of the OPUS intervention in clinical practice,” the investigators noted.