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Outcomes during and after early intervention services for first-episode psychosis : Results over 5 years from the RAISE-ETP site-randomized trial
Robinson, Delbert G. Schooler, Nina R. Marcy, Patricia Gibbons, Robert D. Hendricks Brown, C. John, Majnu Mueser, Kim T. Penn, David L. Rosenheck, Robert A. Addington, Jean
Robinson, Delbert G.
Schooler, Nina R.
Marcy, Patricia
Gibbons, Robert D.
Hendricks Brown, C.
John, Majnu
Mueser, Kim T.
Penn, David L.
Rosenheck, Robert A.
Addington, Jean
Author
Robinson, Delbert G.
Schooler, Nina R.
Marcy, Patricia
Gibbons, Robert D.
Hendricks Brown, C.
John, Majnu
Mueser, Kim T.
Penn, David L.
Rosenheck, Robert A.
Addington, Jean
Brunette, Mary F.
Correll, Christoph U.
Estroff, Sue E.
Mayer-Kalos, Piper S.
Gottlieb, Jennifer D.
Glynn, Shirley M.
Lynde, David W.
Gingerich, Susan
Pipes, Ronny
Miller, Alexander L.
Severe, Joanne B.
Kane, John M.
Schooler, Nina R.
Marcy, Patricia
Gibbons, Robert D.
Hendricks Brown, C.
John, Majnu
Mueser, Kim T.
Penn, David L.
Rosenheck, Robert A.
Addington, Jean
Brunette, Mary F.
Correll, Christoph U.
Estroff, Sue E.
Mayer-Kalos, Piper S.
Gottlieb, Jennifer D.
Glynn, Shirley M.
Lynde, David W.
Gingerich, Susan
Pipes, Ronny
Miller, Alexander L.
Severe, Joanne B.
Kane, John M.
Abstract
To examine long-term effects of early intervention services (EIS) for first-episode psychosis, we compared Heinrichs-Carpenter Quality of Life (QLS) and Positive and Negative Syndrome Scale (PANSS) scores and inpatient hospitalization days over 5 years with data from the site-randomized RAISE-ETP trial that compared the EIS NAVIGATE (17 sites; 223 participants) and community care (CC) (17 sites; 181 participants). Inclusion criteria were: age 15–40 years; DSM-IV diagnoses of schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, or psychotic disorder not otherwise specified; first psychotic episode; antipsychotic medication taken for ≤6 months. NAVIGATE-randomized participants could receive NAVIGATE from their study entry date until NAVIGATE ended when the last-enrolled NAVIGATE participant completed 2 years of treatment. Assessments occurred every 6 months. 61% of participants had assessments conducted ≥2 years; 31% at 5 years. Median follow-up length was CC 30 months and NAVIGATE 38 months. Primary analyses assumed data were not-missing-at-random (NMAR); sensitivity analyses assumed data were missing-at-random (MAR). MAR analyses found no significant treatment-by-time interactions for QLS or PANSS. NMAR analyses revealed that NAVIGATE was associated with a 13.14 (95%CI:6.92,19.37) unit QLS and 7.73 (95%CI:2.98,12.47) unit PANSS better improvement and 2.53 (95%CI:0.59,4.47) fewer inpatient days than CC (all comparisons significant). QLS and PANSS effect sizes were 0.856 and 0.70. NAVIGATE opportunity length (mean 33.8 (SD = 5.1) months) was not associated (P = .72) with QLS outcome; duration of untreated psychosis did not moderate (P = .32) differential QLS outcome. While conclusions are limited by the low rate of five-year follow-up, the data support long-term benefit of NAVIGATE compared to community care.
Keywords
coordinated specialty care, schizophrenia, follow-up, early intervention services, first episode psychosis
Date
2022
Type
Journal article
Journal
Schizophrenia Bulletin
Book
Volume
48
Issue
5
Page Range
1021-1031
Article Number
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled