Intervention for Adolescents With Early-Onset Psychosis and Their Families: A Randomized Controlled Trial

Calvo, Ana; Moreno, Miguel; Ruiz-Sancho, Ana; Rapado-Castro, Marta; Moreno, Carmen; Sánchez-Gutiérrez, Teresa; Arango, Celso; Mayoral, María

doi:10.1016/j.jaac.2014.04.004

Cited by 36 publications

(58 citation statements)

References 40 publications

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“…One trial (O'Brien et al, 2014 and Miklowitz et al, 2014) examined those at risk of developing psychosis, whilst the remaining 13 examined those with early or first episode psychosis. Where details were recorded, service users were aged between 12 and 40 years old, and three studies exclusively examined service users with “very early-onset” psychosis (those with onset under-18 years old; Rund et al, 1994; Browning et al, 2013; Calvo et al, 2014). Limited information was provided about the identified carers.…”

Section: Resultsmentioning

confidence: 99%

“…Some interventions were delivered to carers only (Cozolino et al, 1988; McCann et al, 2013; Calvo et al, 2014; Chien et al, 2016a,b), whilst others invited service users to join all or part of the intervention (Goldstein et al, 1978; Rund et al, 1994; Zhang et al, 1994; Linszen et al, 1996; De Giacomo et al, 1997; Rossberg et al, 2010; Miklowitz et al, 2014; O'Brien et al, 2014). Three studies did not mention whether service users attended the sessions or not (Leavey et al, 2004; Gleeson et al, 2010; Browning et al, 2013).…”

Section: Resultsmentioning

confidence: 99%

“…Conversely, general functioning , measured across studies using the Children's/Global Assessment Scales (CGAS, Shaffer et al, 1983; GAS, Endicott et al, 1976), significantly improved for service users in the family intervention group ( k = 4, d = 0.74, 95 % CI [0.13, 1.36]) but such gains were not maintained by follow up. Two of the studies reporting improvements in general functioning were RCTs, had active comparison groups and were rated as moderate to strong on the EPHPP (Browning et al, 2013 and Calvo et al, 2014) whilst one study (Rund et al, 1994) used an historic cohort as a comparison and was rated as weak on the EPHPP.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, the nature of comparison groups was highly variable. Several trials examined in this review described specialist early intervention for psychosis services as standard care (Gleeson et al, 2010; Rossberg et al, 2010; McCann et al, 2013; Calvo et al, 2014; O'Brien et al, 2014 and Miklowitz et al, 2014). These generally comprised set treatment protocols including optimal pharmacotherapy and a range of psychoeducational and psychosocial interventions, often including individual psychotherapy if required.…”

Section: Discussionmentioning

confidence: 99%

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Do Family Interventions Improve Outcomes in Early Psychosis? A Systematic Review and Meta-Analysis

2017

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Family interventions for psychosis (FIp) are effective in reducing service user relapse and carer distress in people with schizophrenia-spectrum conditions. Several treatment and best practice guidelines recommend FIp for all people with schizophrenia. However, outcome findings in relation to early psychosis groups have been inconsistent. The current paper reports a systematic review and meta-analyses of articles that evaluated FIp in early psychosis with a clearly defined comparison group. A combination of electronic database searches (using PsychINFO, Medline, and CENTRAL), citation searches and hand searches of key journals and reviews was conducted. Peer-reviewed articles published in English from database inception to June 2016 were included. Methodological quality was assessed using the Effective Public Health Practice Project Quality Assessment Tool (EPHPP). Seventeen papers from 14 studies met inclusion criteria for review, the overall quality of which was moderate. Meta-analytic synthesis showed that FIp improved service user functioning and reduced the likelihood of relapse by the end of treatment. Psychotic symptoms were significantly reduced in the FIp group at follow up, but this was not evident at end of treatment. In terms of FIp target mechanisms, carers receiving FIp were more likely to shift from high to low expressed emotion and less likely to report patient focused criticism or engage in conflict communication than carers randomized to standard care. Carer burden and well-being were improved by the end of treatment but gains were not sustained at follow up. FIp had no impact on carer emotional over-involvement. The findings indicate that FIp is an effective intervention for early psychosis service users and their relatives. However, further research is required to establish which key therapeutic components of FIp are most effective for whom, in addition to understanding the mechanisms by which FIp might affect positive change.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Do Family Interventions Improve Outcomes in Early Psychosis? A Systematic Review and Meta-Analysis

2017

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“…[38][39][40][41] Information technology-based interventions are discussed below. Family support is important in young patients in first episode services, [42][43][44] but little other recent work specific to early schizophrenia focuses on setting, support, and adherence. 3.…”

Section: Antipsychotic Formulation Long Acting Injectablementioning

confidence: 99%

Modeling Determinants of Medication Attitudes and Poor Adherence in Early Nonaffective Psychosis: Implications for Intervention

Drake

Nordentoft

Haddock

et al. 2015

Schizophrenia Bulletin

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We aimed to design a multimodal intervention to improve adherence following first episode psychosis, consistent with current evidence. Existing literature identified medication attitudes, insight, and characteristics of support as important determinants of adherence to medication: we examined medication attitudes, self-esteem, and insight in an early psychosis cohort better to understand their relationships. Existing longitudinal data from 309 patients with early Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nonaffective psychosis (83% first episode) were analyzed to test the hypothesis that medication attitudes, while meaningfully different from "insight," correlated with insight and self-esteem, and change in each influenced the others. Rosenberg SelfEsteem Scale, Birchwood Insight Scale, and Positive and Negative Syndrome Scale insight were assessed at presentation, after 6 weeks and 3 and 18 months. Drug Attitudes Inventory (DAI) and treatment satisfaction were rated from 6 weeks onward. Structural equation models of their relationships were compared. Insight measures' and DAI's predictive validity were compared against relapse, readmission, and remission. Analysis found five latent constructs best fitted the data: medication attitudes, selfesteem, accepting need for treatment, self-rated insight, and objective insight. All were related and each affected the others as it changed, except self-esteem and medication attitudes. Low self-reported insight at presentation predicted readmission. Good 6-week insight (unlike drug attitudes) predicted remission. Literature review and data modeling indicated that a multimodal intervention using motivational interviewing, online psychoeducation, and SMS text medication reminders to enhance adherence without damaging self-concept was feasible and appropriate.

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Psychological interventions for psychosis in adolescents

Datta

Daruvala

Kumar

2020

Cochrane Database of Systematic Reviews

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Intervention for Adolescents With Early-Onset Psychosis and Their Families: A Randomized Controlled Trial

Cited by 36 publications

References 40 publications

Do Family Interventions Improve Outcomes in Early Psychosis? A Systematic Review and Meta-Analysis

Do Family Interventions Improve Outcomes in Early Psychosis? A Systematic Review and Meta-Analysis

Modeling Determinants of Medication Attitudes and Poor Adherence in Early Nonaffective Psychosis: Implications for Intervention

Psychological interventions for psychosis in adolescents

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