Early intervention versus treatment as usual for adolescents with first-episode psychosis: Protocol for the randomized OPUS YOUNG trial

Mathilde S. Madsen*, Marianne Melau, Naja K. Andersen, Caroline Friis Nielsen, Natascha Larsen, Thomas Lind Andersen, Merete Nordentoft, Jens Richardt M. Jepsen, Anne A.E. Thorup, Pia Jeppesen, Birgitte Fagerlund, Martin Køster Rimvall, Patrick McGorry, Swaran Singh, Ditte Lammers Vernal, Lene Halling Hastrup, Lis Raabæk Olsen, Jacob Rydkjær, Christoph U. Correll, Robin ChristensenAnne Katrine Pagsberg

*Corresponding author af dette arbejde

Abstract

Background: The prognosis for early onset psychosis (EOP) is poor for a broad range of outcomes. Early intervention services (EIS) have proven beneficial for adult-onset first-episode psychosis, but no randomized trials have investigated EIS in samples of patients aged <18 years. We will examine benefits and harms of a new integrated intervention OPUS YOUNG for EOP. The primary objective is to compare the effect of the OPUS YOUNG intervention versus treatment as usual (TAU) on change in social functioning at end-of-treatment after two years. Methods: This investigator-initiated, single-center, pragmatic randomized clinical trial with blinded outcome assessment takes place in child- and adolescent mental health services in Copenhagen, Denmark. We randomize 290 participants aged 12 to 17 years with first-onset psychosis in a 1:1 ratio to a two-year intervention with OPUS YOUNG versus TAU. The OPUS YOUNG manual builds on the Danish evidence-based intervention for young adults (OPUS) adjusted to meet the specific needs of youths. The primary outcome is social functioning (Personal and Social Performance Scale [PSP] total score). Key secondary outcomes include measures of psychotic, negative, and disorganized symptom dimensions, client satisfaction, and health-related quality of life. Analyses will follow the intention-to-treat principle and use mixed-effects repeated measures models. Discussion: In a rigorous research design, we address the urgent need for evidence-based interventions integrating psychosocial and pharmacological treatments in an age-appropriate manualized program for EOP. The primary trial limitations are the risk of attrition during follow-up, and the inherent inability to mask for allocation in trials with psychosocial interventions. Trial registration: ClinicalTrials.gov: NCT04916626, registered June 2021. Protocol and modifications is presented here: https://classic.clinicaltrials.gov/ct2/show/NCT04916626

OriginalsprogEngelsk
Artikelnummer108253
TidsskriftContemporary Clinical Trials
Vol/bind162
ISSN1551-7144
DOI
StatusUdgivet - mar. 2026

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