Project 170515

The generally poor long term outcome in schizophrenia and related psychotic disorders is established relatively early in the first five "critical" years after onset. Specialized Early Intervention (SEI) service is a relatively new concept in mental health and is designed to improve outcome through provision of a comprehensive package of phase specific interventions provided early in the course of these disorders. While the results of this early intervention approach to treatment of a first episode of psychosis (FEP) for outcome in the first two years are encouraging, these benefits are not sustained over the subsequent three years if the person is transferred back to routine mental health care. We, therefore, propose to conduct a randomized controlled study of FEP patients who have already received two years of specialized treatment by comparing the effectiveness of extending the SEI service for another three years with patients who after the first two years of SEI are transferred to routine care which is what they would expect to receive under current circumstances. We will also assess the cost-effectiveness of this approach. This study would provide us answers to the question whether a specialized early intervention approach should extend to the entire risk period of the first five years.