8 April 2018
Dr.Atsushi Nishida, (Mental Health Promotion Project) published a paper on “A randomized controlled trial of comprehensive early intervention care in patients with first-episode psychosis in Japan: 1.5-year outcomes from the J-CAP study.” in Journal of Psychiatry Research.
In recent decades, many early intervention services have been established internationally to target young individuals with first-episode psychosis (FEP). Early intervention in psychosis (EIP) is based on the hypothesis that the initial years of psychosis represent a “critical period,” in which comprehensive early intervention care can alter the course of the illness. Yet, few randomized controlled trials have assessed the effects of comprehensive EIP care programs in individuals with FEP. The objective of this study was to conduct a single-blinded multicenter trial comparing comprehensive EIP care and standard care in young patients with first-episode psychosis (FEP) in Japan (J-CAP Study).
A total of 77 participants with FEP (aged 15-35 years) were randomized to receive standard care or specialized comprehensive EIP care and were followed up for 1.5 years (trial no.: UMIN000005092). Function (measured with the Global Assessment of Functioning) and clinical remission (defined by internationally standardized criteria proposed by the Remission in Schizophrenia Working Group) were evaluated by independent raters who were blinded to group assignment.
Dropout rate and other secondary outcomes were also examined. The specialized EIP care group had a higher clinical remission rate (odds ratio, 6.3; 95% confidence interval, 1.0-37.9) and lower treatment dropout rate (odds ratio, 0.038; 95% confidence interval, 0.002-0.923) than the standard care group, even after adjusting for baseline characteristics. Functional improvement in the specialized EIP care group was slightly higher than that in the standard care group, but this difference was not statistically significant (p = 0.195).
From the results, we conclude that comprehensive EIP care may provide advantages over standard care in patients with FEP.