Helen Wessels1, Michael Wagner2, Kathrin Kuhr3, Julia Berning2, Verena Pützfeld1, Birgit Janssen4, Ronald Bottlender5, Kurt Maurer6, Hans-Jürgen Möller7, Wolfgang Gaebel4, Heinz Häfner6, Wolfgang Maier2, Joachim Klosterkötter1, Andreas Bechdolf1,8. 1. Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany. 2. Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany. 3. Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany. 4. Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany. 5. Department of Psychiatry and Psychotherapy, Klinikum Lüdenscheid, Lüdenscheid, Germany. 6. Central Institute of Mental Health, Mannheim, Germany. 7. Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Munich, Germany. 8. Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Klinikum am Urban, Berlin, Germany.
Abstract
AIM: Psychological interventions, such as cognitive behavioural therapy (CBT) and supportive counselling (SC), are used to treat people with schizophrenia and people at clinical high risk (CHR) of psychosis. However, little information is available on predictors of treatment response. This study aims to identify such predictors of psychological interventions in CHR. METHODS:A total of 128 help-seeking CHR outpatients were randomized into two groups-integrated psychological intervention (IPI), including CBT, and SC-for 12 months. Multiple regression analysis was used to identify demographic, symptomatic and functional variables that predict improvement in positive (PANSS Positive), negative (PANSS Negative) and basic symptoms (Basic symptom total score) and improvement in functioning (GAF) at 1-year follow up. RESULTS: In the merged group (IPI + SC), people who lived independently, were younger and presented with higher baseline functioning showed more improvement in symptomatic outcomes at follow up. Negative symptoms at baseline predicted less improvement in positive and basic symptoms. Being married or cohabiting and living in the primary family were found to correlate with good functioning at 1-year follow up. CONCLUSIONS:Younger CHR individuals and those who are functioning well may particularly benefit from early intervention. Treatment might need to be modified for low-functioning CHR and those who already display higher scores of negative symptoms. Registration number: NCT00204087.
RCT Entities:
AIM: Psychological interventions, such as cognitive behavioural therapy (CBT) and supportive counselling (SC), are used to treat people with schizophrenia and people at clinical high risk (CHR) of psychosis. However, little information is available on predictors of treatment response. This study aims to identify such predictors of psychological interventions in CHR. METHODS: A total of 128 help-seeking CHR outpatients were randomized into two groups-integrated psychological intervention (IPI), including CBT, and SC-for 12 months. Multiple regression analysis was used to identify demographic, symptomatic and functional variables that predict improvement in positive (PANSS Positive), negative (PANSS Negative) and basic symptoms (Basic symptom total score) and improvement in functioning (GAF) at 1-year follow up. RESULTS: In the merged group (IPI + SC), people who lived independently, were younger and presented with higher baseline functioning showed more improvement in symptomatic outcomes at follow up. Negative symptoms at baseline predicted less improvement in positive and basic symptoms. Being married or cohabiting and living in the primary family were found to correlate with good functioning at 1-year follow up. CONCLUSIONS: Younger CHR individuals and those who are functioning well may particularly benefit from early intervention. Treatment might need to be modified for low-functioning CHR and those who already display higher scores of negative symptoms. Registration number: NCT00204087.