scholarly journals Social recovery therapy in combination with early intervention services for enhancement of social recovery in patients with first-episode psychosis (SUPEREDEN3): a single-blind, randomised controlled trial

2018 ◽  
Vol 5 (1) ◽  
pp. 41-50 ◽  
Author(s):  
David Fowler ◽  
Jo Hodgekins ◽  
Paul French ◽  
Max Marshall ◽  
Nick Freemantle ◽  
...  
Keyword(s):  
Early Intervention ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
First Episode Psychosis ◽  
First Episode ◽  
Early Intervention Services ◽  
Episode Psychosis ◽  
Randomised Controlled ◽  
Social Recovery ◽  
Single Blind

scholarly journals A Multicentre, Randomised, Controlled Trial of a Combined Clinical Treatment for First-Episode Psychosis

2021 ◽  
Vol 18 (14) ◽  
pp. 7239
Author(s):  
Itxaso González-Ortega ◽  
Patricia Vega ◽  
Enrique Echeburúa ◽  
Susana Alberich ◽  
Jessica Fernández-Sevillano ◽  
...  
Keyword(s):  
Early Intervention ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
First Episode Psychosis ◽  
Clinical Treatment ◽  
Post Treatment ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Episode Psychosis ◽  
Randomised Controlled

Introduction: There is evidence that early intervention contributes to improving the prognosis and course of first-episode psychosis (FEP). However, further randomised treatment clinical trials are needed. Objectives: The aim of this study was to compare the efficacy of a combined clinical treatment involving Cognitive Behavioural Therapy (CBT) as an adjunctive to treatment-as-usual (TAU) (CBT+TAU) versus TAU alone for FEP. Patients and methods: In this multicentre, single-blind, randomised controlled trial, 177 participants were randomly allocated to either CBT+TAU or TAU. The primary outcome was post-treatment patient functioning. Results: The CBT+TAU group showed a greater improvement in functioning, which was measured using the Global Assessment Functioning (GAF) and Functioning Assessment Short Test (FAST), compared to the TAU group post-treatment. The CBT+TAU participants exhibited a greater decline in depressive, negative, and general psychotic symptoms; a better awareness of the disease and treatment adherence; and a greater increase in brain-derived neurotrophic factor levels than TAU participants. Conclusions: Early intervention based on a combined clinical treatment involving CBT as an adjunctive to standard treatment may improve clinical and functional outcomes in FEP.

Suicide Prevention in First Episode Psychosis: The Development of a Randomised Controlled Trial of Cognitive Therapy for Acutely Suicidal Patients With Early Psychosis

2003 ◽  
Vol 37 (4) ◽  
pp. 414-420 ◽  
Author(s):  
P.J.R. Power ◽  
R.J. Bell ◽  
R. Mills ◽  
T. Herrman-Doig ◽  
M. Davern ◽  
...  
Keyword(s):  
Early Intervention ◽  
Treatment Group ◽  
Young People ◽  
Controlled Trial ◽  
First Episode Psychosis ◽  
Early Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Randomised Controlled ◽  
Suicidal Patients

Background: Young people with early psychosis are at particularly high risk of suicide. However, there is evidence that early intervention can reduce this risk. Despite these advances, first episode psychosis patients attending these new services still remain at risk. To address this concern, a program called LifeSPAN was established within the Early Psychosis Prevention and Intervention Centre (EPPIC). The program developed and evaluated a number of suicide prevention strategies within EPPIC and included a cognitively oriented therapy (LifeSPAN therapy) for acutely suicidal patients with psychosis. We describe the development of these interventions in this paper. Method: Clinical audit and surveys provided an indication of the prevalence of suicidality among first episode psychosis patients attending EPPIC. Second, staff focus groups and surveys identified gaps in service provision for suicidal young people attending the service. Third, a suicide risk monitoring system was introduced to identify those at highest risk. Finally, patients so identified were referred to and offered LifeSPAN therapy whose effectiveness was evaluated in a randomised controlled trial. Results: Fifty-six suicidal patients with first episode psychosis were randomly assigned to standard clinical care or standard care plus LifeSPAN therapy. Forty-two patients completed the intervention. Clinical ratings and measures of suicidality and risk were assessed before, immediately after the intervention, and 6 months later. Benefits were noted in the treatment group on indirect measures of suicidality, e.g., hopelessness. The treatment group showed a greater average improvement (though not significant) on a measure of suicide ideation. Conclusions: Early intervention in psychosis for young people reduces the risk of suicide. Augmenting early intervention with a suicide preventative therapy may further reduce this risk.

scholarly journals HORYZONS trial: protocol for a randomised controlled trial of a moderated online social therapy to maintain treatment effects from first-episode psychosis services

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024104 ◽  
Author(s):  
Mario Alvarez-Jimenez ◽  
Sarah Bendall ◽  
Peter Koval ◽  
Simon Rice ◽  
Daniela Cagliarini ◽  
...  
Keyword(s):  
Social Media ◽  
Randomised Controlled Trial ◽  
Social Functioning ◽  
Controlled Trial ◽  
First Episode Psychosis ◽  
First Episode ◽  
Online Social Media ◽  
Regular Care ◽  
Episode Psychosis ◽  
Randomised Controlled

IntroductionSpecialised early intervention services have demonstrated improved outcomes in first-episode psychosis (FEP); however, clinical gains may not be sustained after patients are transferred to regular care. Moreover, many patients with FEP remain socially isolated with poor functional outcomes. To address this, our multidisciplinary team has developed a moderated online social media therapy (HORYZONS) designed to enhance social functioning and maintain clinical gains from specialist FEP services. HORYZONS merges: (1) peer-to-peer social networking; (2) tailored therapeutic interventions; (3) expert and peer-moderation; and (4) new models of psychological therapy (strengths and mindfulness-based interventions) targeting social functioning. The aim of this trial is to determine whether following 2 years of specialised support and 18-month online social media-based intervention (HORYZONS) is superior to 18 months of regular care.Methods and analysisThis study is a single-blind randomised controlled trial. The treatment conditions include HORYZONS plus treatment as usual (TAU) or TAU alone. We recruited 170 young people with FEP, aged 16–27 years, in clinical remission and nearing discharge from Early Psychosis Prevention and Intervention Centre, Melbourne. The study includes four assessment time points, namely, baseline, 6-month, 12-month and 18-month follow-up. The study is due for completion in July 2018 and included a 40-month recruitment period and an 18-month treatment phase. The primary outcome is social functioning at 18 months. Secondary outcome measures include rate of hospital admissions, cost-effectiveness, vocational status, depression, social support, loneliness, self-esteem, self-efficacy, anxiety, psychological well-being, satisfaction with life, quality of life, positive and negative psychotic symptoms and substance use. Social functioning will be also assessed in real time through our Smartphone Ecological Momentary Assessment tool.Ethics and disseminationMelbourne Health Human Research Ethics Committee (2013.146) provided ethics approval for this study. Findings will be made available through scientific journals and forums and to the public via social media and the Orygen website.Trial registration numberACTRN12614000009617; Pre-results.

scholarly journals Cost-effectiveness of early intervention in first-episode psychosis: economic evaluation of a randomised controlled trial (the OPUS study)

2013 ◽  
Vol 202 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Lene Halling Hastrup ◽  
Christian Kronborg ◽  
Mette Bertelsen ◽  
Pia Jeppesen ◽  
Per Jorgensen ◽  
...  
Keyword(s):  
Early Intervention ◽  
Cost Effectiveness ◽  
Standard Treatment ◽  
Controlled Trial ◽  
Cost Effective ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
The Mean ◽  
Randomised Controlled

BackgroundInformation about the cost-effectiveness of early intervention programmes for first-episode psychosis is limited.AimsTo evaluate the cost-effectiveness of an intensive early-intervention programme (called OPUS) (trial registration NCT00157313) consisting of enriched assertive community treatment, psychoeducational family treatment and social skills training for individuals with first-episode psychosis compared with standard treatment.MethodAn incremental cost-effectiveness analysis of a randomised controlled trial, adopting a public sector perspective was undertaken.ResultsThe mean total costs of OPUS over 5 years (€123683, s.e. = 8970) were not significantly different from that of standard treatment (€148751, s.e. = 13073). At 2-year follow-up the mean Global Assessment of Functioning (GAF) score in the OPUS group (55.16, s.d. = 15.15) was significantly higher than in standard treatment group (51.13, s.d. = 15.92). However, the mean GAF did not differ significantly between the groups at 5-year follow-up (55.35 (s.d. = 18.28) and 54.16 (s.d. = 18.41), respectively). Cost-effectiveness planes based on non-parametric bootstrapping showed that OPUS was less costly and more effective in 70% of the replications. For a willingness-to-pay up to €50000 the probability that OPUS was cost-effective was more than 80%.ConclusionsThe incremental cost-effectiveness analysis showed that there was a high probability of OPUS being cost-effective compared with standard treatment.

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