Early detection and assertive community treatment of young psychotics: theOpus Study - Rationale and design of the trial

Background: Recent research indicates that early detection of young persons suffering from psychosis and subsequent intensive intervention enhances tr eatment response and prognosis, but the data are only preliminary and sugge stive. Method: We present the rationale and design of the largest study to date to evaluate two major issues in the field of secondary prevention: (1) Does education and intensified collaboration with general practice, social services etc. reduce the duration of untreated psychosis? and (2) Can modi fied assertive community treatment improve the course and outcome in young persons suffering from psychosis as compared to treatment in community ment al health centres? The article aims additionally to put the study in contex t and assist in designing future studies. Results: Preliminary experiences are described. The findings of the first 312 patients show that modified as sertive community treatment results in patients adhering to treatment signi ficantly better than standard treatment in community mental health centres. Conclusion: The surge of interest in preventively oriented detection and t reatment models for untreated psychosis in young people calls for research programmes and evidence. The obstacles to this are manifold. The initial fi ndings of the OPUS study suggest, however, that better adherence to treatme nt is possible.