CoChat
Sign Up
Cited by 826Schizophrenia research and treatmentPsychiatric care and mental health servicesMental Health Treatment and Access

Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis: A Systematic Review, Meta-analysis, and Meta-regression

Open access
Correll, Christoph U., Galling, Britta, Pawar, Aditya, Krivko, Anastasia, Bonetto, Chiara, Ruggeri, Mirella, Craig, Thomas J., Nordentoft, Merete +18 more·2018·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2018.0623PMC PMC6137532
Open this paper in CoChat — free accountOpen PDF

Abstract

Importance: The value of early intervention in psychosis and allocation of public resources has long been debated because outcomes in people with schizophrenia spectrum disorders have remained suboptimal. Objective: To compare early intervention services (EIS) with treatment as usual (TAU) for early-phase psychosis. Data Sources: Systematic literature search of PubMed, PsycINFO, EMBASE, and ClinicalTrials.gov without language restrictions through June 6, 2017. Study Selection: Randomized trials comparing EIS vs TAU in first-episode psychosis or early-phase schizophrenia spectrum disorders. Data Extraction and Synthesis: This systematic review was conducted according to PRISMA guidelines. Three independent investigators extracted data for a random-effects meta-analysis and prespecified subgroup and meta-regression analyses. Main Outcomes and Measures: The coprimary outcomes were all-cause treatment discontinuation and at least 1 psychiatric hospitalization during the treatment period. Results: Across 10 randomized clinical trials (mean [SD] trial duration, 16.2 [7.4] months; range, 9-24 months) among 2176 patients (mean [SD] age, 27.5 [4.6] years; 1355 [62.3%] male), EIS was associated with better outcomes than TAU at the end of treatment for all 13 meta-analyzable outcomes. These outcomes included the following: all-cause treatment discontinuation (risk ratio [RR], 0.70; 95% CI, 0.61-0.80; P < .001), at least 1 psychiatric hospitalization (RR, 0.74; 95% CI, 0.61-0.90; P = .003), involvement in school or work (RR, 1.13; 95% CI, 1.03-1.24; P = .01), total symptom severity (standardized mean difference [SMD], -0.32; 95% CI, -0.47 to -0.17; P < .001), positive symptom severity (SMD, -0.22; 95% CI, -0.32 to -0.11; P < .001), and negative symptom severity (SMD, -0.28; 95% CI, -0.42 to -0.14; P < .001). Superiority of EIS regarding all outcomes was evident at 6, 9 to 12, and 18 to 24 months of treatment (except for general symptom severity and depressive symptom severity at 18-24 months). Conclusions and Relevance: In early-phase psychosis, EIS are superior to TAU across all meta-analyzable outcomes. These results support the need for funding and use of EIS in patients with early-phase psychosis.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1001/jamapsychiatry.2018.0623

Cites

63 of 64 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • PMI incorporates several components of multimodal early intervention programs with empirical support.

    “It incorporates several components of multimodal early intervention programs with empirical support, such as psychoeducation for patients and for their families, medication review, vocational and educational counselling, crisis management and relapse prevention [13].”

    From Mindfulness-based social cognition training (SocialMIND) versus psychoeducational multicomponent intervention for people with a first episode of psychosis: A study protocol for a randomised controlled trial (2019) · cites this paper as [13]

    The Study, Patient, and Treatment Characteristics section describes the reviewed early intervention programs as multicomponent and lists family psychoeducation, medication review, vocational and educational counseling, and crisis management. It does not identify patient psychoeducation or relapse prevention as program components; the Relapse, Remission, and Recovery section reports reduced relapse rates as an outcome, not a component. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Evidence from indicated prevention in FEP populations suggests that specialized psycho-social and pharmacological interventions can improve clinical outcomes compared to standard care.

    “Moreover, there is evidence from indicated prevention in FEP-populations [97], suggesting that specialized psycho-social and pharmacological interventions can improve clinical outcomes compared to standard care [97].”

    From Towards a youth mental health paradigm: a perspective and roadmap (2023) · cites this paper as [97]

  • The available evidence shows that early intervention is effective in psychosis as well as in other syndromes.

    “The available evidence that early intervention is effective in psychosis [97, 134] as well as in other syndromes [8]”

    From Towards a youth mental health paradigm: a perspective and roadmap (2023) · cites this paper as [97]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 66 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [24]24. Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA. 2000;283(15):2008-2012.

Cited by

Sorted by citations

Related

Authors
Correll, C. U., Galling, B., Pawar, A., Krivko, A., Bonetto, C., Ruggeri, M., Craig, T. J., Nordentoft, M., Srihari, V. H., Guloksuz, S., Hui, C. L. M., Chen, E. Y. H., Valencia, M., Juarez, F., Robinson, D. G., Schooler, N. R., Brunette, M. F., Mueser, K. T., Rosenheck, R. A., Marcy, P., Addington, J., Estroff, S. E., Robinson, J., Penn, D., Severe, J. B., & Kane, J. M.
Affiliations
  • Northwell Health (US)
  • University of Verona (IT)
  • Institute of Psychiatry, King’s College London, London, England
  • Copenhagen University Hospital (DK)
  • Yale University (US)
  • Department of Psychiatry, Yale University, New Haven, Connecticut
  • University of Hong Kong (HK)
  • Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
  • Division of Epidemiological and Psychosocial Research, National Institute of Psychiatry, Mexico City, Mexico
  • Dartmouth College (US)
  • Boston University (US)
  • University of Calgary (CA)
  • University of North Carolina at Chapel Hill (US)
  • Nathan Kline Institute for Psychiatric Research (US)
  • National Institute of Mental Health (US)
Corresponding author
Correll, Christoph U.
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2018-06-01
Volume
75
Issue
6
Pages
555
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2018.0623
PMC
PMC6137532
OpenAlex
W2799778639
Cited by
826
References
66
Citations by year
2026: 106 · 2025: 110 · 2024: 115 · 2023: 96 · 2022: 118 · 2021: 105 · 2020: 95 · 2019: 68 · 2018: 13
FWCI
55.28
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
  • Patrick and Catherine Weldon Donaghue Medical Research Foundation
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Sanofi
  • American Academy of Child and Adolescent Psychiatry
  • Sunovion
  • Wellcome Trust
  • National Institute for Health and Care Research
  • Lundbeckfonden (R155-2014-1724, R248‐2017‐2003)
  • Novo Nordisk
  • Allergan
  • National Institute of Mental Health (RC1MH088971, P30MH090590)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
early intervention services, first-episode psychosis, schizophrenia spectrum disorders, usual care, treatment discontinuation, psychiatric hospitalization, symptom severity, social functioning, public resource allocation, mental health services, randomized trial comparison, treatment duration
MeSH terms
Education, Employment, Hospitalization, Humans, Psychotic Disorders, Regression Analysis, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Randomized Controlled Trials as Topic, Early Medical Intervention

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review