BACKGROUND: This study reports on a preliminary evaluation of a cognitive behavioural intervention to improve social recovery among young people in the early stages of psychosis showing persistent signs of poor social functioning and unemployment. The study was a single-blind randomized controlled trial (RCT) with two arms, 35 participants receiving cognitive behaviour therapy (CBT) plus treatment as usual (TAU), and 42 participants receiving TAU alone. Participants were assessed at baseline and post-treatment. METHOD: Seventy-seven participants were recruited from secondary mental health teams after presenting with a history of unemployment and poor social outcome. The cognitive behavioural intervention was delivered over a 9-month period with a mean of 12 sessions. The primary outcomes were weekly hours spent in constructive economic and structured activity. A range of secondary and tertiary outcomes were also assessed. RESULTS: Intention-to-treat analysis on the combined affective and non-affective psychosis sample showed no significant impact of treatment on primary or secondary outcomes. However, analysis of interactions by diagnostic subgroup was significant for secondary symptomatic outcomes on the Positive and Negative Syndrome Scale (PANSS) [F(1, 69)=3.99, p=0.05]. Subsequent exploratory analyses within diagnostic subgroups revealed clinically important and significant improvements in weekly hours in constructive and structured activity and PANSS scores among people with non-affective psychosis. CONCLUSIONS: The primary study comparison provided no clear evidence for the benefit of CBT in a combined sample of patients. However, planned analyses with diagnostic subgroups showed important benefits for CBT among people with non-affective psychosis who have social recovery problems. These promising results need to be independently replicated in a larger, multi-centre RCT.
RCT Entities:
BACKGROUND: This study reports on a preliminary evaluation of a cognitive behavioural intervention to improve social recovery among young people in the early stages of psychosis showing persistent signs of poor social functioning and unemployment. The study was a single-blind randomized controlled trial (RCT) with two arms, 35 participants receiving cognitive behaviour therapy (CBT) plus treatment as usual (TAU), and 42 participants receiving TAU alone. Participants were assessed at baseline and post-treatment. METHOD: Seventy-seven participants were recruited from secondary mental health teams after presenting with a history of unemployment and poor social outcome. The cognitive behavioural intervention was delivered over a 9-month period with a mean of 12 sessions. The primary outcomes were weekly hours spent in constructive economic and structured activity. A range of secondary and tertiary outcomes were also assessed. RESULTS: Intention-to-treat analysis on the combined affective and non-affective psychosis sample showed no significant impact of treatment on primary or secondary outcomes. However, analysis of interactions by diagnostic subgroup was significant for secondary symptomatic outcomes on the Positive and Negative Syndrome Scale (PANSS) [F(1, 69)=3.99, p=0.05]. Subsequent exploratory analyses within diagnostic subgroups revealed clinically important and significant improvements in weekly hours in constructive and structured activity and PANSS scores among people with non-affective psychosis. CONCLUSIONS: The primary study comparison provided no clear evidence for the benefit of CBT in a combined sample of patients. However, planned analyses with diagnostic subgroups showed important benefits for CBT among people with non-affective psychosis who have social recovery problems. These promising results need to be independently replicated in a larger, multi-centre RCT.
Authors: Frank Iorfino; Elizabeth M Scott; Joanne S Carpenter; Shane P Cross; Daniel F Hermens; Madhura Killedar; Alissa Nichles; Natalia Zmicerevska; Django White; Adam J Guastella; Jan Scott; Patrick D McGorry; Ian B Hickie Journal: JAMA Psychiatry Date: 2019-11-01 Impact factor: 21.596
Authors: David L Penn; Sarah R Uzenoff; Diana Perkins; Kim T Mueser; Robert Hamer; Evan Waldheter; Sylvia Saade; Liz Cook Journal: Schizophr Res Date: 2011-02 Impact factor: 4.939
Authors: Richie Poulton; Mark J Van Ryzin; Gordon T Harold; Patricia Chamberlain; David Fowler; Mary Cannon; Louise Arseneault; Leslie D Leve Journal: J Am Acad Child Adolesc Psychiatry Date: 2014-09-16 Impact factor: 8.829
Authors: Moogeh Baharnoori; Cali Bartholomeusz; Aurelie A Boucher; Lisa Buchy; Christopher Chaddock; Bonga Chiliza; Melanie Föcking; Alex Fornito; Juan A Gallego; Hiroaki Hori; Gisele Huf; Gul A Jabbar; Shi Hyun Kang; Yousri El Kissi; Jessica Merchán-Naranjo; Gemma Modinos; Nashaat A M Abdel-Fadeel; Anna-Karin Neubeck; Hsiao Piau Ng; Gabriela Novak; Olasunmbo O Owolabi; Diana P Prata; Naren P Rao; Igor Riecansky; Darryl C Smith; Renan P Souza; Renate Thienel; Hanan D Trotman; Hiroyuki Uchida; Kristen A Woodberry; Anne O'Shea; Lynn E DeLisi Journal: Schizophr Res Date: 2010-10-08 Impact factor: 4.939
Authors: Martine Vallarino; Chantal Henry; Bruno Etain; Lillian J Gehue; Craig Macneil; Elizabeth M Scott; Angelo Barbato; Philippe Conus; Stefanie A Hlastala; Mary Fristad; David J Miklowitz; Jan Scott Journal: Lancet Psychiatry Date: 2015-05-27 Impact factor: 27.083
Authors: Yvonne B Suijkerbuijk; Frederieke G Schaafsma; Joost C van Mechelen; Anneli Ojajärvi; Marc Corbière; Johannes R Anema Journal: Cochrane Database Syst Rev Date: 2017-09-12