Nidotherapy in the treatment of substance misuse, psychosis and personality disorder: secondary analysis of a controlled trial

Aims and method To examine the clinical outcome and bed usage in patients with comorbid substance misuse and psychosis. The patients were randomised to ordinary assertive outreach team care or to enhanced assertive outreach with nidotherapy. Ratings of clinical symptoms, social function, engagement with services, bed usage (primary outcome after 1 year) and economic costs were assessed at baseline and at 6 and 12 months after randomisation. Results Patients referred to nidotherapy had similar reduction in symptoms and engagement, with marginal superiority in social function ( P = 0.045). There was a 110% reduction in hospital bed use after 1 year compared with control assertive care ( P = 0.03). The mean cost savings for each patient allocated to nidotherapy was £14 705 per year, mainly as a consequence of reduced psychiatric bed use. Clinical implications Nidotherapy shows promise in the treatment of substance misuse and psychosis and may reduce hospital bed usage.