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Rationale and design

PRiSM Psychosis Study 1

Published online by Cambridge University Press:  02 January 2018

Graham Thornicroft
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Geraldine Strathdee
Oxleas NHS Trust, Laurel House, 2 Blean Grove, Penge
Michael Phelan
Charing Cross Hospital, Fulham Palace Road, London
Frank Holloway
Maudsley Hospital, Denmark Hill, London
Til Wykes
Department of Psychology, Institute of Psychiatry, London
Graham Dunn
University of Manchester, Oxford Road, Manchester
Paul McCrone
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Morven Leese
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Sonia Johnson
Department of Psychiatry & Behavioural Sciences, University College London Medical School, 48 Riding House Street, London
George Szmukler
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, De Crespigny Park, London



This paper sets out the rationale for the PRiSM Psychosis Study, and the research design used. Nine accompanying papers present the main results. The questions addressed by the PRiSM Psychosis Study are: can the gains of experimental studies which have demonstrated benefits arising from treatment by community mental health teams be translated to routine settings? If so, are the benefits diluted in ordinary clinical practice? What are the costs?


A prospective non-randomised controlled trial of two types of community mental health service, in two phases: case identification followed by patient interviews. For the case identification the research team conducted the complete ascertainment of all prevalent cases of psychosis in the two study catchment areas in the index year (1991–1992). From all 514 patients with psychotic disorders thus identified, 302 were randomly allocated for interview, along with a key informant clinician and a carer. Interviews were undertaken at two time points, two years apart.


This paper presents the socio-demographic, clinical and ethnic characteristics of the patients.


The people with psychosis interviewed for the PRiSM Psychosis Study are representative of the whole epidemiologically based patient population identified.

PRiSM Psychosis Study
Copyright © 1998 The Royal College of Psychiatrists 

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Declaration of interest

Funding provided by the Bethlem & Maudsley NHS Trust.


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