1. The Pilot Project Soteria Berne Ciompi, L. British Journal of Psychiatry 161, suppl. 18, (1992):145-53.
Swedish researchers who opened a Soteria-style house in Berne reported that this approach produced good results. They noted that “patients who received no or very low-dosage medication demonstrated significantly better results.” (Page 148.)
2. Two-Year Outcome in First Episode Psychosis Treated According to an Integrated Model. Is Immediate Neuroleptisation Always Needed? Lehtinen, V. European Psychiatry 15 (2000):312-320.
In this study by Finnish investigators, 43% of the patients in the experimental group didn’t receive any antipsychotic medication, and overall, the outcomes for the experimental group “was equal or even somewhat better” than those treated conventionally with drugs.
3. Integrating Intensive Psychosocial Therapy and Low-Dose Medical Treatment in a Total Material of First Episode Psychotic Patients Compared to “Treatment as Usual. Cullberg, J. Acta Psychiatrica Scandinavica 83 (1991):363-72.
Swedish physicians sought to replicate the Finnish approach involving selective use of antipsychotic drugs. Only 45% of the patients in their experimental group were on antipsychotics at the end of three years, and those on the drugs were taking a very low dose of Thorazine. This experimental group had much lower hospital use than those treated conventionally with drugs during the three-year study.
4. Five-Year Experience of First-Episode Nonaffective Psychosis in Open-Dialogue Approach. Seikkula, J. Psychotherapy Research 16 (2006):214-228.
Finland’s Jaako Seikkula reports on his “open-dialogue” program in Western Lapland that involves minimizing the use of neuroleptics in patients diagnosed with schizophrenia and other psychotic disorders. At the end of five years, 82% of his patients did not have psychotic symptoms, 86% had returned to their studies or were working, and only 14% were on a disability allowance. Only 29% of his patients had ever been exposed to an antipsychotic drug during the five years, and only 17% were on antipsychotics at the end of five years.
5. The Open Dialogue Approach to Acute Psychosis.Seikkula, J. Family Process 42 (2003):403-18.
A review article about open-dialogue therapy in Western Lapland (in Finland.)
Mad in America Documents
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.