Who gets evidence-based therapy for psychosis in the six months following a psychiatric hospital admission? Follow-up data from an inpatient randomised controlled trial

2020 ◽  
Author(s):  
Pamela Charlotte Jacobsen ◽  
Gemma Taylor ◽  
Maria Stefanova

A major barrier to clinicians referring service users with psychosis for psychological therapies is the belief that they will not engage. We investigated therapy receipt after discharge, in a sample of service users who had already demonstrated willingness to engage in psychological therapy during an inpatient admission. We found only one-third of service users (33%; 16/48) had received at least 1 session of evidence-based therapy at 6-month follow-up after discharge. We found that therapy receipt was more common for service users with i) lower delusional distress at discharge, ii) Black or minority ethnic (BME) background, and iii) discharged to an Early Intervention (EI) service.

2017 ◽  
Vol 48 (5) ◽  
pp. 751-764 ◽  
Author(s):  
G. Donohoe ◽  
R. Dillon ◽  
A. Hargreaves ◽  
O. Mothersill ◽  
M. Castorina ◽  
...  

BackgroundCognitive remediation (CR) training has emerged as a promising approach to improving cognitive deficits in schizophrenia and related psychosis. The limited availability of psychological services for psychosis is a major barrier to accessing this intervention however. This study investigated the effectiveness of a low support, remotely accessible, computerised working memory (WM) training programme in patients with psychosis.MethodsNinety patients were enrolled into a single blind randomised controlled trial of CR. Effectiveness of the intervention was assessed in terms of neuropsychological performance, social and occupational function, and functional MRI 2 weeks post-intervention, with neuropsychological and social function again assessed 3–6 months post-treatment.ResultsPatients who completed the intervention showed significant gains in both neuropsychological function (measured using both untrained WM and episodic task performance, and a measure of performance IQ), and social function at both 2-week follow-up and 3–6-month follow-up timepoints. Furthermore, patients who completed MRI scanning showed improved resting state functional connectivity relative to patients in the placebo condition.ConclusionsCR training has already been shown to improve cognitive and social function in patient with psychosis. This study demonstrates that, at least for some chronic but stable outpatients, a low support treatment was associated with gains that were comparable with those reported for CR delivered entirely on a 1:1 basis. We conclude that CR has potential to be delivered even in services in which psychological supports for patients with psychosis are limited.


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