Nordentoft Merete, Melau Marianne, Iversen Tina, Petersen Lone, Jeppesen Pia, Thorup Anne, Bertelsen Mette, Hjorthøj Carsten Rygaard, Hastrup Lene Halling, Jørgensen Per
Mental Health Centre Copenhagen, Mental health Services Capital Region of Denmark, Risskov, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Risskov, Denmark.
Early Interv Psychiatry. 2015 Apr;9(2):156-62. doi: 10.1111/eip.12108. Epub 2013 Dec 5.
The early phases of psychosis have been hypothesized to constitute a critical period, a window of opportunity. At the same time, the early phases of psychosis are associated with increased risk of unwanted outcome, such as suicidal behaviour and social isolation. This was the background for the emergence of early intervention services, and in Denmark, the OPUS trial was initiated as part of that process.
Modified assertive community treatment, together with family involvement and social skills training, constituted the core elements in the original programme. A total of 547 patients with first-episode psychosis were included in the trial.
To summarize briefly the results of the OPUS trial: the OPUS treatment was superior to standard treatment in reducing psychotic and negative symptoms and substance abuse, in increasing user satisfaction and adherence to treatment, and in reducing use of bed days and days in supported housing. Moreover, relatives included in the OPUS treatment were less strained and had a higher level of knowledge about schizophrenia and higher user satisfaction.
The OPUS treatment was implemented throughout Denmark. Training courses were developed and manuals and books were published. Regional health authorities had access to national grants for implementing early intervention services; as a result, OPUS teams were disseminated throughout the country. The content of the treatment is now further developed, and new elements are being tried out - such as individual placement and support, lifestyle changes, cognitive remediation, specialized treatment for substance abuse and different kinds of user involvement.
精神病的早期阶段被假设为一个关键时期，一个机会之窗。与此同时，精神病的早期阶段与不良后果风险增加相关，如自杀行为和社会隔离。这就是早期干预服务出现的背景，在丹麦，OPUS试验作为该过程的一部分启动。
改良的积极社区治疗，连同家庭参与和社交技能训练，构成了原始项目的核心要素。共有547例首发精神病患者纳入该试验。
简要总结OPUS试验的结果：OPUS治疗在减轻精神病性和阴性症状以及药物滥用、提高用户满意度和治疗依从性、减少住院天数和支持性住房居住天数方面优于标准治疗。此外，纳入OPUS治疗的亲属压力较小，对精神分裂症的了解程度较高，用户满意度也较高。
OPUS治疗在丹麦全国实施。开发了培训课程，出版了手册和书籍。地区卫生当局有机会获得国家拨款以实施早期干预服务；结果，OPUS团队在全国范围内得到推广。现在治疗内容正在进一步发展，新的要素正在试验中——如个体安置与支持、生活方式改变、认知矫正、药物滥用的专门治疗以及不同类型的用户参与。
