Cognitive therapy may reduce psychotic symptom severity but not risk of transition to psychosis in young people at high risk

2013 ◽  
Vol 16 (3) ◽  
pp. 83-83
Keyword(s):  
High Risk ◽  
Young People ◽  
Psychotic Symptom ◽  
Cognitive Therapy ◽  
Symptom Severity

Randomized Controlled Trial of Interventions for Young People at Ultra-High Risk of Psychosis: Study Design and Baseline Characteristics

2009 ◽  
Vol 43 (9) ◽  
pp. 818-829 ◽  
Author(s):  
Lisa J. Phillips ◽  
Barnaby Nelson ◽  
Hok Pan Yuen ◽  
Shona M. Francey ◽  
Magenta Simmons ◽  
...  
Keyword(s):  
High Risk ◽  
Young People ◽  
Cognitive Therapy ◽  
Controlled Trial ◽  
Treatment Groups ◽  
Mixed Support ◽  
Ultra High Risk ◽  
Supportive Counselling ◽  
Baseline Characteristics ◽  
The Impact

Objective: Intervention during the pre-psychotic period of illness holds the potential of delaying or even preventing the onset of a full-threshold disorder, or at least of reducing the impact of such a disorder if it does develop. The first step in realizing this aim was achieved more than 10 years ago with the development and validation of criteria for the identification of young people at ultra-high risk (UHR) of psychosis. Results of three clinical trials have been published that provide mixed support for the effectiveness of psychological and pharmacological interventions in preventing the onset of psychotic disorder. Method: The present paper describes a fourth study that has now been undertaken in which young people who met UHR criteria were randomized to one of three treatment groups: cognitive therapy plus risperidone (CogTher + Risp: n = 43); cognitive therapy plus placebo (CogTher + Placebo: n = 44); and supportive counselling + placebo (Supp + Placebo; n = 28). A fourth group of young people who did not agree to randomization were also followed up (monitoring: n = 78). Baseline characteristics of participants are provided. Results and conclusion: The present study improves on the previous studies because treatment was provided for 12 months and the independent contributions of psychological and pharmacological treatments in preventing transition to psychosis in the UHR cohort and on levels of psychopathology and functioning can be directly compared. Issues associated with recruitment and randomization are discussed.

scholarly journals Could mindfulness-based cognitive therapy prevent a lifelong recurrent course of depression or anxiety by addressing key mechanisms of vulnerability in high-risk adolescents?

2019 ◽  
Vol 216 (4) ◽  
pp. 175-177 ◽  
Author(s):  
Tamsin Ford ◽  
Jessica Richardson ◽  
Kath Wilkinson ◽  
Patrick Smith ◽  
Vashti Berry ◽  
...  
Keyword(s):  
High Risk ◽  
Young People ◽  
Cognitive Therapy ◽  
Negative Mood ◽  
Adaptive Responses ◽  
First Line ◽  
Large Group ◽  
Course Of Depression

SummaryWe explore the potential of mindfulness-based cognitive therapy, a skills-based intervention that provides participants with sustainable tools for adaptive responses to stress and negative mood, for the large group of young people with depression or anxiety who only partially or briefly respond to currently available first-line interventions.

INTERNALISED STIGMA IN YOUNG PEOPLE AT HIGH RISK OF DEVELOPING PSYCHOSIS: FINDINGS FROM A COGNITIVE THERAPY TRIAL

2014 ◽  
Vol 153 ◽  
pp. S42 ◽  
Author(s):  
Anthony P. Morrison ◽  
Melissa Pyle ◽  
Suzanne L.K. Stewart ◽  
Paul French ◽  
Rory Byrne ◽  
...  
Keyword(s):  
High Risk ◽  
Young People ◽  
Cognitive Therapy ◽  
Therapy Trial

scholarly journals Treating sleep problems in young people at ultra-high-risk of psychosis: study protocol for a single-blind parallel group randomised controlled feasibility trial (SleepWell)

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e045235
Author(s):  
Felicity Waite ◽  
Thomas Kabir ◽  
Louise Johns ◽  
Jill Mollison ◽  
Apostolos Tsiachristas ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Young People ◽  
Sleep Problems ◽  
Qualitative Interviews ◽  
Feasibility Trial ◽  
Psychotic Experiences ◽  
Post Intervention ◽  
Ultra High Risk ◽  
Randomised Controlled

BackgroundEffective interventions, targeting key contributory causal factors, are needed to prevent the emergence of severe mental health problems in young people. Insomnia is a common clinical issue that is problematic in its own right but that also leads to the development and persistence of psychotic experiences. The implication is that treating sleep problems may prevent the onset of psychosis. We collected initial case series data with 12 young people at ultra-high-risk of psychosis. Post-intervention, there were improvements in sleep, depression and psychotic experiences. Now we test the feasibility of a randomised controlled trial, with a clinical aim to treat sleep problems and hence reduce depression, psychotic experiences, and prevent transition to psychosis.Methods and analysisA randomised controlled feasibility trial will be conducted. Forty patients aged 14 to 25 years who are at ultra-high-risk of psychosis and have sleep disturbance will be recruited from National Health Service (NHS) mental health services. Participants will be randomised to receive either a novel, targeted, youth-focussed sleep intervention in addition to usual care or usual care alone. Assessor-blinded assessments will be conducted at baseline, 3 months (post-intervention) and 9 months (follow-up). The eight-session psychological intervention will target the key mechanisms which disrupt sleep: circadian rhythm irregularities, low sleep pressure, and hyperarousal. To gain an in-depth understanding of participants’ views on the acceptability of the intervention and study procedures, 16 participants (n=10 intervention, n=6 control) will take part in qualitative interviews. Analyses will focus on feasibility outcomes (recruitment, retention, and treatment uptake rates) and provide initial CI estimates of intervention effects. Thematic analysis of the qualitative interviews will assess the acceptability of the intervention and trial procedures.Ethics and disseminationThe trial has received ethical approval from the NHS Health Research Authority. Findings will be disseminated through peer-reviewed publications, conference presentations, and lay networks.Trial registration numberISRCTN85601537.

scholarly journals DECRYPT trial: study protocol for a phase II randomised controlled trial of cognitive therapy for post-traumatic stress disorder (PTSD) in youth exposed to multiple traumatic stressors

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e047600
Author(s):  
Leila Allen ◽  
Polly-Anna Ashford ◽  
Ella Beeson ◽  
Sarah Byford ◽  
Jessica Chow ◽  
...  
Keyword(s):  
Young People ◽  
Cognitive Therapy ◽  
Multiple Trauma ◽  
Traumatic Stress ◽  
Controlled Trial ◽  
Post Traumatic Stress ◽  
Children And Young People ◽  
Post Traumatic ◽  
Randomised Controlled ◽  
Post Randomisation

BackgroundPost-traumatic stress disorder (PTSD) is a distressing and disabling condition that affects significant numbers of children and adolescents. Youth exposed to multiple traumas (eg, abuse, domestic violence) are at particular risk of developing PTSD. Cognitive therapy for PTSD (CT-PTSD), derived from adult work, is a theoretically informed, disorder-specific form of trauma-focused cognitive–behavioural therapy. While efficacious for child and adolescent single-event trauma samples, its effectiveness in routine settings with more complex, multiple trauma-exposed youth has not been established. The Delivery of Cognitive Therapy for Young People after Trauma randomised controlled trial (RCT) examines the effectiveness of CT-PTSD for treating PTSD following multiple trauma exposure in children and young people in comparison with treatment as usual (TAU).Methods/designThis protocol describes a two-arm, patient-level, single blind, superiority RCT comparing CT-PTSD (n=60) with TAU (n=60) in children and young people aged 8–17 years with a diagnosis of PTSD following multiple trauma exposure. The primary outcome is PTSD severity assessed using the Children’s Revised Impact of Event Scale (8-item version) at post-treatment (ie, approximately 5 months post-randomisation). Secondary outcomes include structured interview assessment for PTSD, complex PTSD symptoms, depression and anxiety, overall functioning and parent-rated mental health. Mid-treatment and 11-month and 29-month post-randomisation assessments will also be completed. Process–outcome evaluation will consider which mechanisms underpin or moderate recovery. Qualitative interviews with the young people, their families and their therapists will be undertaken. Cost-effectiveness of CT-PTSD relative to TAU will be also be assessed.Ethics and disseminationThis trial protocol has been approved by a UK Health Research Authority Research Ethics Committee (East of England–Cambridge South, 16/EE/0233). Findings will be disseminated broadly via peer-reviewed empirical journal articles, conference presentations and clinical workshops.Trial registrationISRCTN12077707. Registered 24 October 2016 (http://www.isrctn.com/ISRCTN12077707). Trial recruitment commenced on 1 February 2017. It is anticipated that recruitment will continue until June 2021, with 11-month assessments being concluded in May 2022.

WC1B WHO ARE THESE YOUNG PEOPLE AT HIGH-RISK OF DEVELOPING PSYCHOSIS?

2006 ◽  
Vol 86 ◽  
pp. S4
Author(s):  
P. Patterson ◽  
M. Birchwood ◽  
A. Skeate
Keyword(s):  
High Risk ◽  
Young People

scholarly journals Predictors of treatment response in young people at ultra-high risk for psychosis who received long-chain omega-3 fatty acids

2015 ◽  
Vol 5 (1) ◽  
pp. e495-e495 ◽  
Author(s):  
G P Amminger ◽  
A Mechelli ◽  
S Rice ◽  
S-W Kim ◽  
C M Klier ◽  
...  
Keyword(s):  
Fatty Acids ◽  
High Risk ◽  
Young People ◽  
Treatment Response ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Ultra High Risk ◽  
Long Chain

scholarly journals Cognitive Therapy for Social Anxiety Disorder in Adolescents: A Development Case Series

2015 ◽  
Vol 44 (1) ◽  
pp. 1-17 ◽  
Author(s):  
Eleanor Leigh ◽  
David M. Clark
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Young People ◽  
Cognitive Therapy ◽  
Social Anxiety Disorder ◽  
Case Series ◽  
Process Measures ◽  
General Anxiety ◽  
Differential Effectiveness ◽  
End Of Treatment

Background: Social anxiety disorder is common and typically starts in childhood or adolescence. Cognitive Therapy for Social Anxiety Disorder (CT-SAD) in adults is a well-established treatment that shows strong evidence of differential effectiveness when compared to other active treatments. In contrast, CBT approaches to social anxiety in young people have yet to demonstrate differential effectiveness and there is some evidence that young people with social anxiety disorder respond less well than those with other anxiety disorders. Aims: To adapt CT-SAD for use with adolescents and conduct a pilot case series. Method: Five adolescents, aged 11–17 years, with a primary DSM-5 diagnosis of social anxiety disorder received a course of CT-SAD adapted for adolescents. Standardized clinical interview and questionnaire assessments were conducted at pre and posttreatment, and 2 to 3-month follow-up. Results: All five participants reported severe social anxiety at baseline and achieved remission by the end of treatment. Significant improvements were also observed in general anxiety, depression, concentration in the classroom, and putative process measures (social anxiety related thoughts, beliefs and safety behaviours). Conclusions: An adapted form of CT-SAD shows promise as a treatment for adolescents.

scholarly journals Systematic review of economic evaluations of interventions for high risk young people

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Kim Edmunds ◽  
Rod Ling ◽  
Anthony Shakeshaft ◽  
Chris Doran ◽  
Andrew Searles
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Young People ◽  
Economic Evaluations
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