TY - JOUR
T1 - The CIRCuiTS study (Implementation of cognitive remediation in early intervention services)
T2 - Protocol for a randomised controlled trial
AU - Wykes, Til
AU - Joyce, Eileen
AU - Velikonja, Tjasa
AU - Watson, Andrew
AU - Aarons, Gregory
AU - Birchwood, Max
AU - Cella, Matteo
AU - Dopson, Sue
AU - Fowler, David
AU - Greenwood, Kathy
AU - Johnson, Sonia
AU - McCrone, Paul
AU - Perez, Jesus
AU - Pickles, Andrew
AU - Reeder, Clare
AU - Rose, Diana
AU - Singh, Swaran
AU - Stringer, Dominic
AU - Taylor, Matthew
AU - Taylor, Rumina
AU - Upthegrove, Rachel
PY - 2018/3/15
Y1 - 2018/3/15
N2 - BACKGROUND: Cognitive problems in people with schizophrenia predict poor functional recovery even with the best possible rehabilitation opportunities and optimal medication. A psychological treatment known as cognitive remediation therapy (CRT) aims to improve cognition in neuropsychiatric disorders, with the ultimate goal of improving functional recovery. Studies suggest that intervening early in the course of the disorder will have the most benefit, so this study will be based in early intervention services, which treat individuals in the first few years following the onset of the disorder. The overall aim is to investigate different methods of CRT.METHODS: This is a multicentre, randomised, single-blinded, controlled trial based in early intervention services in National Health Service Mental Health Trusts in six English research sites. Three different methods of providing CRT (intensive, group, and independent) will be compared with treatment as usual. We will recruit 720 service users aged between 16 and 45 over 3 years who have a research diagnosis of non-affective psychosis and will be at least 3 months from the onset of the first episode of psychosis. The primary outcome measure will be the degree to which participants have achieved their stated goals using the Goal Attainment Scale. Secondary outcome measures will include improvements in cognitive function, social function, self-esteem, and clinical symptoms.DISCUSSION: It has already been established that cognitive remediation improves cognitive function in people with schizophrenia. Successful implementation in mental health services has the potential to change the recovery trajectory of individuals with schizophrenia-spectrum disorders. However, the best mode of implementation, in terms of efficacy, service user and team preference, and cost-effectiveness is still unclear. The CIRCuiTS trial will provide guidance for a large-scale roll-out of CRT to mental health services where cognitive difficulties impact recovery and resilience.TRIAL REGISTRATION: ISRCTN, ISRCTN14678860 , Registered on 6 June 2016.
AB - BACKGROUND: Cognitive problems in people with schizophrenia predict poor functional recovery even with the best possible rehabilitation opportunities and optimal medication. A psychological treatment known as cognitive remediation therapy (CRT) aims to improve cognition in neuropsychiatric disorders, with the ultimate goal of improving functional recovery. Studies suggest that intervening early in the course of the disorder will have the most benefit, so this study will be based in early intervention services, which treat individuals in the first few years following the onset of the disorder. The overall aim is to investigate different methods of CRT.METHODS: This is a multicentre, randomised, single-blinded, controlled trial based in early intervention services in National Health Service Mental Health Trusts in six English research sites. Three different methods of providing CRT (intensive, group, and independent) will be compared with treatment as usual. We will recruit 720 service users aged between 16 and 45 over 3 years who have a research diagnosis of non-affective psychosis and will be at least 3 months from the onset of the first episode of psychosis. The primary outcome measure will be the degree to which participants have achieved their stated goals using the Goal Attainment Scale. Secondary outcome measures will include improvements in cognitive function, social function, self-esteem, and clinical symptoms.DISCUSSION: It has already been established that cognitive remediation improves cognitive function in people with schizophrenia. Successful implementation in mental health services has the potential to change the recovery trajectory of individuals with schizophrenia-spectrum disorders. However, the best mode of implementation, in terms of efficacy, service user and team preference, and cost-effectiveness is still unclear. The CIRCuiTS trial will provide guidance for a large-scale roll-out of CRT to mental health services where cognitive difficulties impact recovery and resilience.TRIAL REGISTRATION: ISRCTN, ISRCTN14678860 , Registered on 6 June 2016.
KW - Adolescent
KW - Adult
KW - Cognitive Remediation
KW - Cost-Benefit Analysis
KW - Humans
KW - Middle Aged
KW - Multicenter Studies as Topic
KW - Outcome Assessment, Health Care
KW - Randomized Controlled Trials as Topic
KW - Schizophrenia/therapy
KW - Single-Blind Method
KW - Young Adult
UR - http://www.scopus.com/inward/record.url?scp=85043790725&partnerID=8YFLogxK
U2 - 10.1186/s13063-018-2553-3
DO - 10.1186/s13063-018-2553-3
M3 - Article
C2 - 29544551
AN - SCOPUS:85043790725
SN - 1745-6215
VL - 19
JO - Trials
JF - Trials
IS - 1
M1 - 183
ER -
