Supportive Psychodynamic Psychotherapy versus Treatment as Usual for First-Episode Psychosis: Two-Year Outcome

Psychiatry ◽  
2012 ◽  
Vol 75 (4) ◽  
pp. 331-341 ◽  
Author(s):  
Bent Rosenbaum ◽  
Susanne Harder ◽  
Per Knudsen ◽  
Anne Køster ◽  
Anne Lindhardt ◽  
...  
Keyword(s):  
Psychodynamic Psychotherapy ◽  
First Episode Psychosis ◽  
First Episode ◽  
Treatment As Usual ◽  
Episode Psychosis ◽  
Versus Treatment

scholarly journals The Danish National Schizophrenia Project: prospective, comparative longitudinal treatment study of first-episode psychosis

2005 ◽  
Vol 186 (5) ◽  
pp. 394-399 ◽  
Author(s):  
Bent Rosenbaum ◽  
Kristian Valbak ◽  
Susanne Harder ◽  
Per Knudsen ◽  
Anne Køster ◽  
...  
Keyword(s):  
Psychodynamic Psychotherapy ◽  
First Episode Psychosis ◽  
Integrated Treatment ◽  
First Episode ◽  
Treatment As Usual ◽  
Episode Psychosis ◽  
Educational Treatment ◽  
Prospective Longitudinal ◽  
Drug And Alcohol ◽  
Longitudinal Treatment

BackgroundFirst-episode psychosis intervention may improve the course and outcome of schizophrenic disorders.AimsTo describe the Danish National Schizophrenia Project and to measure the outcome of two different forms of intervention after 1 year, compared with standard treatment.MethodA prospective, longitudinal, multicentre investigation included 562 patients, consecutively referred over a 2-year period, with a first episode of psychosis. Patients were allocated to supportive psychodynamic psychotherapy as a supplement to treatment as usual, an integrated, assertive, psychosocial and educational treatment programme or treatment as usual.ResultsThere was a non-significant tendency towards greater improvement in social functioning in the integrated treatment group and the supportive psychodynamic psychotherapy group compared with the treatment as usual group. Significance was reached for some measures when the confounding effect of drug and alcohol misuse was included.ConclusionsIntegrated treatment and supportive psychodynamic psychotherapy in addition to treatment as usual may improve outcome after 1 year of treatment for people with first-episode psychosis, compared with treatment as usual alone.

scholarly journals OPUS study: Suicidal behaviour, suicidal ideation and hopelessness among patients with first-episode psychosis

2002 ◽  
Vol 181 (S43) ◽  
pp. s98-s106 ◽  
Author(s):  
M. Nordentoft ◽  
P. Jeppesen ◽  
M. Abel ◽  
P. Kassow ◽  
L. Petersen ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behaviour ◽  
Female Gender ◽  
First Episode Psychosis ◽  
Integrated Treatment ◽  
High Risk Group ◽  
First Episode ◽  
Treatment As Usual ◽  
Episode Psychosis

BackgroundPatients with first-episode psychosis comprise a high-risk group in terms of suicide.AimsTo identify predictive factors for suicidal behaviour and to examine the effect of integrated treatment on suicidal behaviour and hopelessness.MethodA total of 341 patients with a first-episode schizophrenia-spectrum disorder were randomised to integrated treatment or treatment as usual.ResultsDuring the 1-year follow-up period, 11% attempted suicide. This was associated with female gender, hopelessness, hallucinations and suicide attempt reported at baseline, with the two latter variables being the only significant ones in the final multivariate model. The integrated treatment reduced hopelessness.ConclusionsHallucinations and suicide attempt before inclusion in the study were the most significant predictors of suicide attempt in the follow-up period.

scholarly journals S107. RANDOMIZED CONTROL TRIAL OF A MOBILE APP-BASED INTERVENTION FOR ADOLESCENTS WITH FIRST-EPISODE PSYCHOSIS: THE THINK APP

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S75-S75
Author(s):  
Ana Calvo ◽  
Teresa Sanchez-Gutierrez ◽  
Sara Barbeito ◽  
Maria Mayoral ◽  
Miguel Moreno ◽  
...  
Keyword(s):  
New Technologies ◽  
Psychiatric Treatment ◽  
Psychological Intervention ◽  
Intervention Group ◽  
First Episode Psychosis ◽  
Mobile App ◽  
First Episode ◽  
Control Group ◽  
Treatment As Usual ◽  
Episode Psychosis

Abstract Background Technological advances in psychiatric treatment is relatively recent. Previous studies have shown an improvement, in the access to treatment, for patients with first-episode psychosis (FEP). This new therapeutic approach may provide patients with personalized, flexible, and evidence-based interventions in their communities and even in their own homes. The aim of this study is to develop and test the effectiveness of a mobile app–based intervention to improve community functioning in adolescents with FEP. Methods We designed a single-blind randomized clinical trial (RCT) to study the effectiveness of a mobile app–based intervention for adolescents with FEP aged 14–19 years recruited from Gregorio Marañón Hospital, Madrid, Spain. Patients were randomly assigned to an intervention group, which received treatment as usual plus five modules of a psychological intervention through the mobile app (psychoeducation, recognition of symptoms and prevention of relapses, problem solving, mindfulness, and contact wall), or to a control group (standard care). Results The effectiveness of the intervention were assessed by means of an extensive battery of clinical tests at baseline and at 3 months of follow-up. The primary outcome was reduction in psychotic and depressive symptoms; secondary outcomes comprise adherence, awareness, use of drugs, and quality of life. Also, will report the usefulness, user experience (UX) and security perceived by adolescents with a PEP: frequency of application use, average time of use, quantitative use, etc. Discussion To our knowledge, this is the first randomized online treatment for adolescent with early psychosis comparison with treatment as usual. The main novelty of our approach is the integration of new technologies with traditional psychoeducation, cognitive behavioral therapy techniques, mindfulness and social skills development.

scholarly journals Individual placement and support for vocational recovery in first-episode psychosis: randomised controlled trial

2018 ◽  
Vol 214 (2) ◽  
pp. 76-82 ◽  
Author(s):  
Eóin Killackey ◽  
Kelly Allott ◽  
Henry J. Jackson ◽  
Rosanna Scutella ◽  
Yi-Ping Tseng ◽  
...  
Keyword(s):  
Young People ◽  
Controlled Trial ◽  
First Episode Psychosis ◽  
High Rate ◽  
First Episode ◽  
Control Group ◽  
Individual Placement And Support ◽  
Treatment As Usual ◽  
Episode Psychosis ◽  
Individual Placement

BackgroundHigh unemployment is a hallmark of psychotic illness. Individual placement and support (IPS) may be effective at assisting the vocational recoveries of young people with first-episode psychosis (FEP).AimsTo examine the effectiveness of IPS at assisting young people with FEP to gain employment (Australian and Clinical Trials Registry ACTRN12608000094370).MethodYoung people with FEP (n = 146) who were interested in vocational recovery were randomised using computer-generated random permuted blocks on a 1:1 ratio to: (a) 6 months of IPS in addition to treatment as usual (TAU) or (b) TAU alone. Assessments were conducted at baseline, 6 months (end of intervention), 12 months and 18 months post-baseline by research assistants who were masked to the treatment allocations.ResultsAt the end of the intervention the IPS group had a significantly higher rate of having been employed (71.2%) than the TAU group (48.0%), odds ratio 3.40 (95% CI 1.17–9.91, z = 2.25, P = 0.025). However, this difference was not seen at 12- and 18-month follow-up points. There was no difference at any time point on educational outcomes.ConclusionsThis is the largest trial to our knowledge on the effectiveness of IPS in FEP. The IPS group achieved a very high employment rate during the 6 months of the intervention. However, the advantage of IPS was not maintained in the long term. This seems to be related more to an unusually high rate of employment being achieved in the control group rather than a gross reduction in employment among the IPS group.Declaration of interestNone.

scholarly journals Evaluating the feasibility of a decision aid to promote shared decision making among young adults with first-episode psychosis: protocol for a pilot study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yaara Zisman-Ilani ◽  
Irene Hurford ◽  
Andrea Bowen ◽  
Mark Salzer ◽  
Elizabeth C. Thomas
Keyword(s):  
Decision Making ◽  
Young Adults ◽  
Antipsychotic Medication ◽  
Decision Aid ◽  
First Episode Psychosis ◽  
First Episode ◽  
Shared Decision ◽  
Treatment As Usual ◽  
Episode Psychosis ◽  
Service Engagement

Abstract Background Young adults ages 18 to 25 with first episode psychosis (FEP) have an increased risk of discontinuation antipsychotic medications and psychiatric service disengagement that lead to symptom exacerbation and deterioration. We seek to (1) examine the feasibility, usability, and potential impact of a Shared Decision Making (SDM) Antipsychotic Medication Decision Aid (DA) on decision-making, adherence to the decision made, and service engagement among young adults with FEP and (2) understand the role of additional patient-level factors on SDM. Methods A randomized controlled trial is being conducted in a coordinated specialty care community program for FEP in an urban setting. Eligible patients are randomly assigned to receive an intervention, the Antipsychotic Medication Decision Aid, or treatment as usual. Patients receive their assigned intervention before their medication appointment with the psychiatrist and complete four interviews: before the appointment (T0), after the appointment (T1), and at 3- and 6-month follow-ups (T2 and T3). The study staff and participating psychiatrists are not blinded to the intervention. The data are de-identified to maintain blinding during the analysis process. The primary aims are feasibility of intervention delivery and research procedures and preliminary impact of the intervention on SDM-related outcomes, medication adherence, and service engagement. As a secondary aim, we will explore the contribution of personality and motivation variables, clinical relationships, cognitive functioning, and mental-health-related stigma to SDM. If the sample size permits, we plan to conduct parametric tests such as independent-samples t tests at T1 to compare differences in SDM, adherence, and engagement scales. In the case of a small sample size, we will use non-parametric tests and descriptive statistics. Discussion This protocol outlines the methodology for a feasibility pilot comparing the effect of a novel SDM Antipsychotic Medication encounter DA with treatment as usual on SDM, medication adherence, and service engagement in FEP care. SDM is endorsed as a framework for use in FEP and antipsychotic pharmacotherapy, but its impact on adherence and health outcomes is unclear. Understanding the potential contribution of an SDM Antipsychotic Medication DA compared with usual care in psychosis pharmacotherapy is critical. The study will help answer several key questions new to SDM research, including the contribution of personality and clinical relationships to SDM in mental health and psychosis in particular. The study will serve to gather feasibility data to inform future studies and scale-up. Trial registration Ethics approval was obtained through Temple University’s institutional review board (IRB) and the City of Philadelphia’s Department of Public Health IRB. The study has been retrospectively registered with ClinicalTrials.gov as NCT04373590 on 29 April 2020. https://clinicaltrials.gov/ct2/show/NCT04373590?term=NCT04373590&draw=2&rank=1

scholarly journals Vocational intervention in first-episode psychosis: Individual placement and support v. treatment as usual

2008 ◽  
Vol 193 (2) ◽  
pp. 114-120 ◽  
Author(s):  
Eóin Killackey ◽  
Henry J. Jackson ◽  
Patrick D. McGorry
Keyword(s):  
Chronic Schizophrenia ◽  
First Episode Psychosis ◽  
First Episode ◽  
Individual Placement And Support ◽  
Treatment As Usual ◽  
Welfare Benefits ◽  
Episode Psychosis ◽  
Good Potential ◽  
To Receive ◽  
Individual Placement

BackgroundUnemployment is a major problem for people with first-episode psychosis and schizophrenia. This has repercussions for the economy, social functioning and illness prognosis.AimsTo examine whether a vocational intervention - individual placement and support (IPS) - which has been found to be beneficial in populations with chronic schizophrenia, was a useful intervention for those with first-episode psychosis.MethodA total of 41 people with first-episode psychosis were randomised to receive either 6 months of IPS + treatment as usual (TAU) (n=20) or TAU alone (n=21).ResultsThe IPS group had significantly better outcomes on level of employment (13 v. 2, P<0.001), hours worked per week (median 38 v. 22.5, P=0.006), jobs acquired (23 v. 3) and longevity of employment (median 5 weeks v. 0, P=0.021). The IPS group also significantly reduced their reliance on welfare benefits.ConclusionsIndividual placement and support has good potential to address the problem of vocational outcome in people with first-episode psychosis. This has economic, social and health implications.

The efficacy of an integrated treatment in comparison with treatment as usual in a group of youths with first-episode psychosis

2012 ◽  
Vol 60 (5) ◽  
pp. S284-S285 ◽  
Author(s):  
Z. Shahrivar ◽  
J. Alaghband-Rad ◽  
J. Mahmoudi Gharaie ◽  
A. Seddigh ◽  
N. Salesian ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
Integrated Treatment ◽  
First Episode ◽  
Treatment As Usual ◽  
Episode Psychosis
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