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

Bechdolf, Andreas; Wagner, Michael; Ruhrmann, Stephan; Harrigan, Susy; Pützfeld, Verena; Pukrop, Ralf; Brockhaus-Dumke, Anke; Berning, Julia; Janssen, Birgit; Decker, P; Bottlender, Ronald; Maurer, Kurt; Möller, Hans‐Jürgen; Gäebel, Wolfgang; Häfner, Heinz; Maier, Wolfgang; Klosterkötter, Joachim

doi:10.1192/bjp.bp.109.066357

Cited by 194 publications

(206 citation statements)

References 43 publications

(105 reference statements)

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“…He might have taken a major interest in the wealth of research findings on early intervention, and that might have added to his therapeutic optimism [33]. However, he might have spent even more time in understanding the implementation gap, i.e.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial Interventions in People with Severe Mental Illness: A Bleulerian Perspective

Becker

Kösters²

2012

Neuropsychobiology

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Background: Eugen Bleuler, in his book Dementia praecox oder Gruppe der Schizophrenien, discussed issues of social psychiatry, and he considered complex interventions pivotal in the care for people with schizophrenia. Bleuler emphasised the potential of therapeutic communities in providing care, the drawbacks of extended hospitalisation and the therapeutic potential of planned ‘early discharge’ and job integration. Methods: Some of the current evidence on therapeutic communities, planned early hospital discharge, alternatives to inpatient care and job integration in people with severe mental illness are reviewed. Results: (i) Current evidence suggests that therapeutic communities (and new forms of milieu therapy, e.g. Soteria) are an effective ingredient of care; (ii) the evidence on planned early discharge suggests that there is scope for early discharge if continuity of care is ensured, and (iii) the evidence on supported employment suggests that there is scope for early job placement/supported employment among people with schizophrenia with little risk to clinical stability. Conclusion: Eugen Bleuler was a far-sighted social psychiatrist who concentrated on treatment issues and complex interventions that are considered cornerstones of care for people with severe mental illness one hundred years later.

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Section: Discussionmentioning

confidence: 99%

Psychosocial Interventions in People with Severe Mental Illness: A Bleulerian Perspective

Becker

Kösters²

2012

Neuropsychobiology

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“…The first compared supportive psychotherapy in an unblinded trial of an integrated treatment package of family support, cognitive behavioral therapy, low-dose Risperidone and computerized training across a range of domains using CogPack. 15 After 12 months, the active treatment group (N = 51) had a lower transition rate to psychosis (3.2%) than the treatment as usual group (16.9%, N = 57), with continued differences after 24 months. 15 While these results were quite promising, effects on cognition were not reported, nor was it possible to assess the relative impact of the individual treatment components in the active condition.…”

Section: Introductionmentioning

confidence: 99%

“…15 After 12 months, the active treatment group (N = 51) had a lower transition rate to psychosis (3.2%) than the treatment as usual group (16.9%, N = 57), with continued differences after 24 months. 15 While these results were quite promising, effects on cognition were not reported, nor was it possible to assess the relative impact of the individual treatment components in the active condition. Two single-sample pilot studies of cognitive training in CHRs have been conducted.…”

Section: Introductionmentioning

confidence: 99%

Intensive Auditory Cognitive Training Improves Verbal Memory in Adolescents and Young Adults at Clinical High Risk for Psychosis

Loewy

Fisher

Schlosser

et al. 2016

SCHBUL

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“…Convergent findings were reported from studies that had evaluated cognitive behavioral therapy without concomitant antipsychotics vis-à-vis more unspecific supportive treatment measures. Morrison et al (2004) in the UK, Addington et al (2011a) in Canada, as well as Bechdolf et al (2012) in Germany have performed such studies. With the exception of Addington et al (2011a), who found no group differences, probably due to small sample size and generally low conversion rates, all of these trials demonstrated lower conversion rates in the experimental treatment group, supporting the hypothesis that specific psychotherapeutic interventions also reduce or delay the risk of converting to full-blown psychosis in individuals suffering from prodromal symptoms.…”

Section: Psychosocial Interventionsmentioning

confidence: 96%

Managing the Prodrome of Schizophrenia

Fleischhacker

Simma

2012

Handbook of Experimental Pharmacology

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It is a well-known fact that managing schizophrenia patients as early as possible has a positive impact on the psychopathological and psychosocial outcomes of the disorder. Identifying people at risk for this serious disorder before its outbreak has become a major research aim in the past decade. Consequently, the intuitive notion that intervening at this early stage, before a diagnosis of schizophrenia is established, could be a preventive measure has been scientifically studied. In this context, a number of interventions, both pharmacological and psychosocial, have been evaluated in prospective controlled clinical trials. Amisulpride, olanzapine, risperidone, omega-3 fatty acids, and antidepressants have been compared to placebo or other control interventions and have been found somewhat helpful. With the exception of omega-3 fatty acids, however, the original positive findings were not maintained in follow-up studies. In addition, the rates of conversion to psychosis, although generally lower in the experimental treatment groups, were also reasonably low in the control groups. Similar findings have been established in psychotherapy trials.All evidence taken together makes it difficult to justify specific interventions at the prodromal stage of schizophrenia from the perspective of preventing or delaying the onset of the disorder. On the other hand, as many of the affected individuals suffer considerably, symptomatic treatment certainly is called for even though the evidence whether it should be pharmacological or psychosocial is not yet available.

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

Abstract: Integrated psychological intervention appears effective in delaying the onset of psychosis over a 24-month time period in people in an EIPS.

Cited by 194 publications

References 43 publications

Psychosocial Interventions in People with Severe Mental Illness: A Bleulerian Perspective

Psychosocial Interventions in People with Severe Mental Illness: A Bleulerian Perspective

Intensive Auditory Cognitive Training Improves Verbal Memory in Adolescents and Young Adults at Clinical High Risk for Psychosis

Managing the Prodrome of Schizophrenia

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