J Dubreucq1,2,3,4, M Faraldo5,6, M Abbes5,6, B Ycart7, H Richard-Lepouriel8, S Favre8, F Jermann8, J Attal9, M Bakri10, T Cohen5,6, C Cervello11,12, I Chereau6,13, C Cognard14, M De Clercq15, A Douasbin14, J Y Giordana16, E Giraud-Baro17, N Guillard-Bouhet18, E Legros-Lafarge19, M Polosan20, A Pouchon20, M Rolland11,12, N Rainteau9, C Roussel15, C Wangermez18, P T Yanos21, P H Lysaker22, N Franck23,11,12. 1. Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France. jdubreucq@ch-alpes-isere.fr. 2. Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, 1 place du Conseil National de la Résistance, 38400 Saint Martin d'Hères, Grenoble, France. jdubreucq@ch-alpes-isere.fr. 3. Fondation FondaMental, Créteil, France. jdubreucq@ch-alpes-isere.fr. 4. Réseau Handicap Psychique, Grenoble, France. jdubreucq@ch-alpes-isere.fr. 5. Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, 1 place du Conseil National de la Résistance, 38400 Saint Martin d'Hères, Grenoble, France. 6. Fondation FondaMental, Créteil, France. 7. Laboratoire Jean Kuntzmann, CNRS UMR 5224, Université Grenoble-Alpes, Grenoble, France. 8. Department of Psychiatry, Mood disorders Unit, Geneva University Hospital, 20bis rue de Lausanne, CH-1201, Geneva, Switzerland. 9. Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, 1061, Montpellier, France. 10. Centre de Réhabilitation Psychosociale et de Remédiation Cognitive (C2R), CH Drôme Vivarais, Montéléger, France. 11. Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Centre Hospitalier Le Vinatier, Bron, France. 12. Centre Référent Lyonnais de Réhabilitation Psychosociale et de Remédiation Cognitive (CL3R), Centre Hospitalier Le Vinatier, Bron, France. 13. CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France. 14. Unité Ariane de rehabilitation psychosociale, EPSM, Caen, France. 15. Centre Départemental de Réhabilitation Psychosociale des Glières, 219 chemin des bois des Fornets, 74800, La Roche sur Foron, France. 16. Centre Hospitalier Sainte Marie de Nice, 87 Avenue Joseph Raybaud, 06100, Nice, France. 17. Clinique du Dauphiné- Groupe Sinoué, 252 Route de Saint-Nizier, 38180, Seyssins, France. 18. CREATIV & URC Pierre Deniker, CH Laborit, Poitiers, France. 19. Centre Référent de Réhabilitation Psychosociale de Limoges C2RL, CH Esquirol, Limoges, France. 20. Centre Expert Troubles Bipolaires, Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes, CS10217, F-38043, Grenoble, France. 21. John Jay College of Criminal Justice, City University of New York, New York, USA. 22. Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, USA. 23. Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France.
Abstract
BACKGROUND: Self-stigma is highly prevalent in serious mental illness (SMI) and is associated with poorer clinical and functional outcomes. Narrative enhancement and cognitive therapy (NECT) is a group-based intervention combining psychoeducation, cognitive restructuring and story-telling exercises to reduce self-stigma and its impact on recovery-related outcomes. Despite evidence of its effectiveness on self-stigma in schizophrenia-related disorders, it is unclear whether NECT can impact social functioning. METHODS: This is a 12-centre stepped-wedge cluster randomized controlled trial of NECT effectiveness on social functioning in SMI, compared to treatment as usual. One hundred and twenty participants diagnosed with schizophrenia, bipolar disorder or borderline personality disorder will be recruited across the 12 sites. The 12 centres participating to the study will be randomized into two groups: one group (group 1) receiving the intervention at the beginning of the study (T0) and one group (group 2) being a control group for the first 6 months and receiving the intervention after (T1). Outcomes will be compared in both groups at T0 and T1, and 6-month and 12-month outcomes for groups 1 and 2 will be measured without a control group at T2 (to evaluate the stability of the effects over time). Evaluations will be conducted by assessors blind to treatment allocation. The primary outcome is personal and social performance compared across randomization groups. Secondary outcomes include self-stigma, self-esteem, wellbeing, quality of life, illness severity, depressive symptoms and personal recovery. DISCUSSION: NECT is a promising intervention for reducing self-stigma and improving recovery-related outcomes in SMI. If shown to be effective in this trial, it is likely that NECT will be implemented in psychiatric rehabilitation services with subsequent implications for routine clinical practice. TRIAL REGISTRATION: ClinicalTrials.gov NCT03972735 . Trial registration date 31 May 2019.
RCT Entities:
BACKGROUND: Self-stigma is highly prevalent in serious mental illness (SMI) and is associated with poorer clinical and functional outcomes. Narrative enhancement and cognitive therapy (NECT) is a group-based intervention combining psychoeducation, cognitive restructuring and story-telling exercises to reduce self-stigma and its impact on recovery-related outcomes. Despite evidence of its effectiveness on self-stigma in schizophrenia-related disorders, it is unclear whether NECT can impact social functioning. METHODS: This is a 12-centre stepped-wedge cluster randomized controlled trial of NECT effectiveness on social functioning in SMI, compared to treatment as usual. One hundred and twenty participants diagnosed with schizophrenia, bipolar disorder or borderline personality disorder will be recruited across the 12 sites. The 12 centres participating to the study will be randomized into two groups: one group (group 1) receiving the intervention at the beginning of the study (T0) and one group (group 2) being a control group for the first 6 months and receiving the intervention after (T1). Outcomes will be compared in both groups at T0 and T1, and 6-month and 12-month outcomes for groups 1 and 2 will be measured without a control group at T2 (to evaluate the stability of the effects over time). Evaluations will be conducted by assessors blind to treatment allocation. The primary outcome is personal and social performance compared across randomization groups. Secondary outcomes include self-stigma, self-esteem, wellbeing, quality of life, illness severity, depressive symptoms and personal recovery. DISCUSSION: NECT is a promising intervention for reducing self-stigma and improving recovery-related outcomes in SMI. If shown to be effective in this trial, it is likely that NECT will be implemented in psychiatric rehabilitation services with subsequent implications for routine clinical practice. TRIAL REGISTRATION: ClinicalTrials.gov NCT03972735 . Trial registration date 31 May 2019.
Authors: Ilanit Hasson-Ohayon; Michal Mashiach-Eizenberg; Noa Elhasid; Philip T Yanos; Paul H Lysaker; David Roe Journal: Compr Psychiatry Date: 2013-11-18 Impact factor: 3.735
Authors: John G Gunderson; Sabine C Herpertz; Andrew E Skodol; Svenn Torgersen; Mary C Zanarini Journal: Nat Rev Dis Primers Date: 2018-05-24 Impact factor: 52.329
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