Psychological interventions for adolescent psychosis: A pilot controlled trial in routine care

TY - JOUR

T1 - Psychological interventions for adolescent psychosis

T2 - A pilot controlled trial in routine care

AU - Browning, S.

AU - Corrigall, R.

AU - Garety, P.

AU - Emsley, R.

AU - Jolley, S.

PY - 2013/9

Y1 - 2013/9

N2 - Purpose: Evidence for the recommendation to deliver Cognitive Behavioural Therapy (CBT) and Family Interventions (FI) to under-18s with psychosis derives from adult research, and no previous study has focused exclusively on an adolescent population. We evaluated adaptations of these therapies for adolescent inpatients with psychosis (CBTpA and FIpA), delivered as an adjunct to inpatient standard care (SC). Subjects and methods: Thirty adolescent inpatients with psychotic symptoms on admission were sequentially allocated to receive CBTpA + SC (n = 10); FIpA + SC (n = 10) or SC alone (n = 10). Psychotic symptoms and functioning were measured at admission and discharge. Results: Group comparisons did not reach conventional significance, but effect sizes in this pilot study showed a promising impact of CBTpA compared to SC alone, in reducing symptoms (ES: d = 0.6), with smaller effect sizes for functioning (d = 0.2) and for FIpA (symptoms, d = 0.1 and functioning, d = 0.4). There was no advantage of either additional treatment in reducing length of stay, but self-report satisfaction ratings were higher for both psychological therapies. Discussion and conclusions: The study is the first to focus on an exclusively adolescent population, using appropriately adapted therapy protocols. Findings suggest that the interventions are feasible, acceptable and helpful for adolescents with psychosis. Larger randomised controlled trials are now needed.

AB - Purpose: Evidence for the recommendation to deliver Cognitive Behavioural Therapy (CBT) and Family Interventions (FI) to under-18s with psychosis derives from adult research, and no previous study has focused exclusively on an adolescent population. We evaluated adaptations of these therapies for adolescent inpatients with psychosis (CBTpA and FIpA), delivered as an adjunct to inpatient standard care (SC). Subjects and methods: Thirty adolescent inpatients with psychotic symptoms on admission were sequentially allocated to receive CBTpA + SC (n = 10); FIpA + SC (n = 10) or SC alone (n = 10). Psychotic symptoms and functioning were measured at admission and discharge. Results: Group comparisons did not reach conventional significance, but effect sizes in this pilot study showed a promising impact of CBTpA compared to SC alone, in reducing symptoms (ES: d = 0.6), with smaller effect sizes for functioning (d = 0.2) and for FIpA (symptoms, d = 0.1 and functioning, d = 0.4). There was no advantage of either additional treatment in reducing length of stay, but self-report satisfaction ratings were higher for both psychological therapies. Discussion and conclusions: The study is the first to focus on an exclusively adolescent population, using appropriately adapted therapy protocols. Findings suggest that the interventions are feasible, acceptable and helpful for adolescents with psychosis. Larger randomised controlled trials are now needed.

KW - Schizophrenia

KW - Cognitive Behavioural Therapy

KW - Family Intervention

KW - Inpatient

KW - COGNITIVE-BEHAVIORAL THERAPY

KW - AUDITORY HALLUCINATIONS

KW - FAMILY INTERVENTION

U2 - 10.1016/j.eurpsy.2013.05.008

DO - 10.1016/j.eurpsy.2013.05.008

M3 - Article

SN - 0924-9338

VL - 28

SP - 423

EP - 426

JO - European Psychiatry

JF - European Psychiatry

IS - 7

M1 - N/A

ER -