A Randomized Controlled Trial of Individual Therapy for First Episode Psychosis (PSTEP)
Recruitment status was Recruiting
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Purpose
In the first year of treatment after a FE of SCZ, 75% to 90% of patients achieve remission from psychotic symptoms. However, approximately 40% of FE patients are non-adherent to medication regimes and more than 60% have intermittent periods of gaps of non-adherence. Relapse rates are high with 82% of patients relapsing at least once within 5 years. Unfortunately even amongst those who do achieve full remission from psychotic symptoms, functional recovery remains a major challenge for patients. All the evidence suggests that individuals with SCZ do best with a combination of pharmacology and psychosocial intervention. Cognitive-behavior therapy (CBT) is gaining recognition as an effective treatment in SCZ and is in fact the only psychosocial treatment in SCZ with proven durability at short term follow-up. Although it is currently being used, the investigators need to learn more about the impact of CBT on FE SCZ especially as experts are advocating for CBT to be a critical component of FE clinical services.
| Condition | Intervention | Phase |
|---|---|---|
|
Psychosis |
Other: Cognitive Behavioural Therapy Other: befriending |
Phase 0 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Single Blind (Outcomes Assessor) |
| Official Title: | A Randomized Controlled Trial of Individual Therapy for First Episode Psychosis |
- Social Functioning [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Positive & negative symptoms [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Individual dimensions of psychotic symptoms [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Depression [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Substance use [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Alcohol and Drug Use [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Medication adherenceAdaptation to illness [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Self Esteem [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Coping Skills (MACS) [ Time Frame: 18 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 330 |
| Study Start Date: | September 2007 |
| Estimated Study Completion Date: | March 2013 |
| Estimated Primary Completion Date: | May 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
behavioural
|
Other: Cognitive Behavioural Therapy |
|
Active Comparator: 2
befriending
|
Other: befriending |
|
No Intervention: 3
TAU
|
Detailed Description:
The primary problem to be addressed is the incomplete functional recovery following a FE of SCZ and whether CBT is an effective treatment to aid this recovery. If CBT were to positively impact recovery in the FE we then need to address (i) which mechanisms are responsible for this improvement, and (ii) whether this treatment is effective for all FE patients.
Eligibility| Ages Eligible for Study: | 16 Years to 35 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- stabilized outpatients,
- ages 16 to 35
- meet DSM-IV criteria for: schizophrenia, schizophreniform disorder, brief psychotic disorder, delusional disorder, schizoaffective disorder, substance induced psychotic disorder, or psychotic disorder NOS. Participants who also meet DSM-IV criteria for substance abuse or dependence will not be excluded.
- are competent and willing to give consent
- are within 12 months of admission to the FEPP for a FE.
Exclusion:
- serious risk of suicide or violence to others
- a primary diagnosis of drug-induced psychosis or psychosis due to a general medical condition.
Contacts and Locations| Contact: Diane Kirsopp, BA | 416-535-8501 ext 6288 | diane_kirsopp@camh.net |
| Canada, Ontario | |
| Centre for Addiction and Mental Health | Recruiting |
| Toronto, Ontario, Canada, M5T 1R8 | |
| Principal Investigator: Jean Addington, PHD | |
| Principal Investigator: | Jean Addington, PhD | Centre for Addiction and Mental Health |
More Information
No publications provided
| Responsible Party: | Dr. Jean Addington, Centre for Addiction and Mental Health |
| ClinicalTrials.gov Identifier: | NCT00722163 History of Changes |
| Obsolete Identifiers: | NCT00495911 |
| Other Study ID Numbers: | 195/2006 |
| Study First Received: | July 23, 2008 |
| Last Updated: | July 23, 2008 |
| Health Authority: | Canada: Ethics Review Committee |
Keywords provided by Ontario Mental Health Foundation:
|
Cognitive Behavioural therapy Psychosis |
Additional relevant MeSH terms:
|
Mental Disorders Psychotic Disorders Schizophrenia and Disorders with Psychotic Features |
ClinicalTrials.gov processed this record on June 18, 2013