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Predicting Medication-Free Treatment Response in Acute Psychosis: Cross-Validation From the Finnish Need-Adapted Project

Bola, John Robert PhD*; Lehtinen, Klaus MD; Aaltonen, Jukka MD; Räkköläinen, Viljo MD§; Syvälahti, Erkka MD§; Lehtinen, Ville MD

The Journal of Nervous and Mental Disease: October 2006 - Volume 194 - Issue 10 - p 732-739
doi: 10.1097/01.nmd.0000243080.90255.88
Original Articles

This study tested predictors of 2-year antipsychotic-free response from the Soteria study (older, better social functioning, fewer cardinal symptoms) using data from the Finnish Acute Psychosis Integrated treatment study. The quasi-experimental study compared need-adapted family-oriented psychosocial intervention within a 3-week antipsychotic-free trial to psychosocial intervention plus antipsychotic medications. Forty-six percent of experimental completers (37% of intent-to-treat subjects) were successfully treated without antipsychotic medications for the entire 2-year study. The DSM-III-R diagnoses of schizophrenia and schizophreniform disorder and Soteria-suggested predictors were not related to antipsychotic-free response. Different variables within the same domains of good prognosis and fewer schizophrenia symptoms predicted antipsychotic-free response or nonresponse with 74% accuracy. The 6-month duration of symptom criterion distinguishing schizophrenia from schizophreniform disorder does not separate medication-free treatment responders from those requiring medications. Prognosis appears related to antipsychotic-free response and may be helpful in distinguishing schizophrenia from schizophreniform disorder in early episodes.

*School of Social Work, University of Southern California, Los Angeles, California; †Tampere University Hospital, Tampere, Finland; ‡University of Jyväskylä, Jyväskylä, Finland; §University of Turku, Turku, Finland; and ∥National Research and Development Centre for Welfare and Health, Helsinki, Finland.

Supported in part by awards to Dr. Bola from the Zumberge Fund at the University of Southern California and the Larson Fund of the Hamovitch Research Center, School of Social Work, University of Southern California.

Send reprint requests to John R. Bola, PhD, School of Social Work, 669 West 34th Street, University of Southern California, Los Angeles, CA 90089-0411.

© 2006 Lippincott Williams & Wilkins, Inc.