A randomised controlled trial (RCT) published in The Lancet Psychiatry has examined the effectiveness of Open Dialogue compared to standard NHS treatments for adults experiencing a mental health crisis. The study, known as the ODDESSI Trial, found that Open Dialogue did not reduce relapse, which was the primary outcome the study was designed to test.
However, the trial was associated with fewer hospital admissions and re-referrals. Participants in the Open Dialogue group also reported a more positive experience of care. Dr. Sameer Jauhar, Clinical Associate Professor at Imperial College London, noted that this combination of findings is of interest, but does not establish that Open Dialogue changes the underlying course of illness.
One important finding was that there was no significant improvement in the size or quality of participants' social networks, despite this being proposed as a fundamental component of Open Dialogue. Concerns were also raised about the interpretation of secondary outcomes due to clinicians and participants not being masked to treatment allocation, and the reporting of secondary-outcome results without adjustment for multiple comparisons.
Professor Richard Morriss of the University of Nottingham highlighted difficulties in interpreting the trial, noting that definitions of recovery from crisis and the timing of assessments were not clearly described. He also suggested that the decrease in hospital admissions might be driven by the triage process rather than therapeutic effects.