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

  • Peter Tyrer (a1), Katarina Milošeska (a2), Craig Whittington (a3), Maja Ranger (a2), Ibrahim Khaleel (a4), Mike Crawford (a1), Bernard North (a5) and Barbara Barrett (a6)...
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.


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 £14705 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.

Corresponding author
Peter Tyrer (
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Declaration of interest

P.T. has introduced nidotherapy to clinical practice and therefore has the natural bias of a product champion. No other author has any interests to declare.

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

  • Peter Tyrer (a1), Katarina Milošeska (a2), Craig Whittington (a3), Maja Ranger (a2), Ibrahim Khaleel (a4), Mike Crawford (a1), Bernard North (a5) and Barbara Barrett (a6)...
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