Clinical and functional outcomes after 2 years in the early detection and intervention for the prevention of psychosis multisite effectiveness trial.
| Title: | Clinical and functional outcomes after 2 years in the early detection and intervention for the prevention of psychosis multisite effectiveness trial. |
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| Authors: | McFarlane WR; Tufts University School of Medicine, Boston, MA; Maine Medical Center Research Institute, Portland, ME; mcfarw@mmc.org.; Levin B; Mailman School of Public Health, Columbia University, New York, NY;; Travis L; Maine Medical Center Research Institute, Portland, ME;; Lucas FL; Maine Medical Center Research Institute, Portland, ME;; Lynch S; Maine Medical Center Research Institute, Portland, ME;; Verdi M; Maine Medical Center Research Institute, Portland, ME;; Williams D; Maine Medical Center Research Institute, Portland, ME;; Adelsheim S; Department of Psychiatry, Stanford University School Of Medicine, Palo, Alto, CA;; Calkins R; Marion County Health Department, Salem, OR;; Carter CS; Department of Psychiatry, University of California at Davis, Sacramento, CA;; Cornblatt B; Zucker Hillside Hospital, Glen Oaks, NY;; Taylor SF; Department of Psychiatry, University of Michigan, Ann Arbor, MI; Washtenaw Community Health Organization, Ypsilanti, MI;; Auther AM; Zucker Hillside Hospital, Glen Oaks, NY;; McFarland B; Department of Psychiatry, Oregon Health Sciences University, Portland, OR;; Melton R; Portland State University, Portland, OR;; Migliorati M; University of New Mexico, Albuquerque, NM;; Niendam T; Department of Psychiatry, University of California at Davis, Sacramento, CA;; Ragland JD; Department of Psychiatry, University of California at Davis, Sacramento, CA;; Sale T; Portland State University, Portland, OR; Mid-Valley Behavioral Care Network, Salem, OR.; Salvador M; Department of Psychiatry, Stanford University School Of Medicine, Palo, Alto, CA;; Spring E; Washtenaw Community Health Organization, Ypsilanti, MI; |
| Source: | Schizophrenia bulletin [Schizophr Bull] 2015 Jan; Vol. 41 (1), pp. 30-43. Date of Electronic Publication: 2014 Jul 26. |
| Publication Type: | Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 0236760 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1745-1701 (Electronic) Linking ISSN: 05867614 NLM ISO Abbreviation: Schizophr Bull Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2005- : Cary, NC : Oxford University Press; Original Publication: [Chevy Chase, Md., For sale by the Supt. of Docs., U. S. Govt. Print. Off. Washington] |
| MeSH Terms: | Antipsychotic Agents/*therapeutic use ; Community Mental Health Services/*methods ; Family Therapy/*methods ; Psychotic Disorders/*prevention & control; Anti-Anxiety Agents/therapeutic use ; Antidepressive Agents/therapeutic use ; Antimanic Agents/therapeutic use ; Anxiety Disorders/drug therapy ; Anxiety Disorders/psychology ; Mood Disorders/drug therapy ; Mood Disorders/psychology ; Psychotic Disorders/psychology ; Adolescent ; Adult ; Child ; Early Diagnosis ; Early Medical Intervention ; Employment, Supported ; Female ; Humans ; Longitudinal Studies ; Male ; Severity of Illness Index ; Treatment Outcome ; Young Adult |
| Abstract: | Objective: To test effectiveness of the Early Detection, Intervention, and Prevention of Psychosis Program in preventing the onset of severe psychosis and improving functioning in a national sample of at-risk youth.; Methods: In a risk-based allocation study design, 337 youth (age 12-25) at risk of psychosis were assigned to treatment groups based on severity of positive symptoms. Those at clinically higher risk (CHR) or having an early first episode of psychosis (EFEP) were assigned to receive Family-aided Assertive Community Treatment (FACT); those at clinically lower risk (CLR) were assigned to receive community care. Between-groups differences on outcome variables were adjusted statistically according to regression-discontinuity procedures and evaluated using the Global Test Procedure that combined all symptom and functional measures.; Results: A total of 337 young people (mean age: 16.6) were assigned to the treatment group (CHR + EFEP, n = 250) or comparison group (CLR, n = 87). On the primary variable, positive symptoms, after 2 years FACT, were superior to community care (2 df, p < .0001) for both CHR (p = .0034) and EFEP (p < .0001) subgroups. Rates of conversion (6.3% CHR vs 2.3% CLR) and first negative event (25% CHR vs 22% CLR) were low but did not differ. FACT was superior in the Global Test (p = .0007; p = .024 for CHR and p = .0002 for EFEP, vs CLR) and in improvement in participation in work and school (p = .025).; Conclusion: FACT is effective in improving positive, negative, disorganized and general symptoms, Global Assessment of Functioning, work and school participation and global outcome in youth at risk for, or experiencing very early, psychosis.; (© The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.) |
| Comments: | Comment in: Schizophr Bull. 2015 Jan;41(1):22. doi: 10.1093/schbul/sbu140.. (PMID: 25316912); Comment in: Schizophr Bull. 2015 Jan;41(1):20-1. doi: 10.1093/schbul/sbu139.. (PMID: 25323580); Comment in: Schizophr Bull. 2015 Jan;41(1):25. doi: 10.1093/schbul/sbu144.. (PMID: 25326636); Comment in: Schizophr Bull. 2015 Jan;41(1):23-4. doi: 10.1093/schbul/sbu143.. (PMID: 25332408); Comment in: Schizophr Bull. 2015 Jan;41(1):26-7. doi: 10.1093/schbul/sbu149.. (PMID: 25344948); Comment in: Schizophr Bull. 2015 Jan;41(1):4-5. doi: 10.1093/schbul/sbu160.. (PMID: 25399025); Erratum in: Schizophr Bull. 2015 Mar;41(2):532. doi: 10.1093/schbul/sbu219.. (PMID: 25694500) |
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| Grant Information: | R01 MH061523 United States MH NIMH NIH HHS; R01 MH084895 United States MH NIMH NIH HHS; U01 MH081857 United States MH NIMH NIH HHS |
| Contributed Indexing: | Keywords: assertive community treatment; family psychoeducation; multifamily group; schizophrenia; supported education; supported employment |
| Molecular Sequence: | ClinicalTrials.gov NCT00531518 |
| Substance Nomenclature: | 0 (Anti-Anxiety Agents); 0 (Antidepressive Agents); 0 (Antimanic Agents); 0 (Antipsychotic Agents) |
| Entry Date(s): | Date Created: 20140728 Date Completed: 20150818 Latest Revision: 20220321 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC4266296 |
| DOI: | 10.1093/schbul/sbu108 |
| PMID: | 25065017 |
| Database: | MEDLINE |
Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't