Preventing progression to first-episode psychosis in early initial prodromal states

• Published in: British journal of psychiatry Vol. 200; no. 1; pp. 22 - 29
• Main Authors: Bechdolf, A., Wagner, M., Ruhrmann, S., Harrigan, S., Putzfeld, V., Pukrop, R., Brockhaus-Dumke, A., Berning, J., Janssen, B., Decker, P., Bottlender, R., Maurer, K., Möller, H.-J., Gaebel, W., Häfner, H., Maier, W., Klosterkötter, J.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.01.2012
• Subjects: Adolescent; Adult; Ambulatory Care; Behavior modification; Cognition & reasoning; Cognitive ability; Cognitive therapy; Cognitive Therapy - methods; Cognitive-behavioral factors; Colleges & universities; Counseling; Counselling; Disability; Disease Progression; Disease Susceptibility - psychology; Family Health; Female; First time; Group therapy; Help seeking behavior; Helpseeking; Humans; Intervention; Kaplan-Meier Estimate; Learning disabled people; Male; Mental disorders; Obstetrics; Patient Education as Topic; Population; Prevention; Prospective Studies; Psychiatric Status Rating Scales; Psychiatry; Psychoeducational treatment; Psychological intervention; Psychoses; Psychosis; Psychotherapy; Psychotic Disorders - pathology; Psychotic Disorders - prevention & control; Psychotic Disorders - psychology; Schizophrenia; Schizophrenia - prevention & control; Schizophrenic Psychology; Skill development; Time Factors; Treatment Outcome; Young Adult; Youth; Germany
• ISSN: 0007-1250; 1472-1465; 1472-1465
• DOI: 10.1192/bjp.bp.109.066357

Young people with self-experienced cognitive thought and perception deficits (basic symptoms) may present with an early initial prodromal state (EIPS) of psychosis in which most of the disability and neurobiological deficits of schizophrenia have not yet occurred. To investigate the effects of an integrated psychological intervention (IPI), combining individual cognitive-behavioural therapy, group skills training, cognitive remediation and multifamily psychoeducation, on the prevention of psychosis in the EIPS. A randomised controlled, multicentre, parallel group trial of 12 months of IPI v. supportive counselling (trial registration number: NCT00204087). Primary outcome was progression to psychosis at 12- and 24-month follow-up. A total of 128 help-seeking out-patients in an EIPS were randomised. Integrated psychological intervention was superior to supportive counselling in preventing progression to psychosis at 12-month follow-up (3.2% v. 16.9%; P = 0.008) and at 24-month follow-up (6.3% v. 20.0%; P = 0.019). Integrated psychological intervention appears effective in delaying the onset of psychosis over a 24-month time period in people in an EIPS.