title: A brief motivational intervention for substance misuse in recent-onset psychosis.
abstract: Substance misuse is common in early psychosis, and impacts negatively on outcomes. Little is known about effective interventions for this population. We report a pilot study of brief intervention for substance misuse in early psychosis (Start Over and Survive: SOS), comparing it with Standard Care (SC). Twenty-five in-patients aged 18-35 years with early psychosis and current misuse of non-opioid drugs were allocated randomly to conditions. Substance use and related problems were assessed at baseline, 6 weeks and 3, 6 and 12 months. Final assessments were blind to condition. All 13 SOS participants who proceeded to motivational interviewing reported less substance use at 6 months, compared with 58% (7/12) in SC alone. Effects were well maintained to 12 months. However, more SOS participants lived with a relative or partner, and this also was associated with better outcomes. Engagement remained challenging: 39% (16/41) declined participation and 38% (5/13) in SOS only received rapport building. Further research will increase sample size, and address both engagement and potential confounds.
authors.affiliation: Department of Psychiatry, School of Medicine, The University of Queensland, Herston, Australia. davidk@psychiatry.uq.edu.au
authors.forename: David J
authors.initials: DJ
authors.lastname: Kavanagh
authors.forename: Ross
authors.initials: R
authors.lastname: Young
authors.forename: Angela
authors.initials: A
authors.lastname: White
authors.forename: John B
authors.initials: JB
authors.lastname: Saunders
authors.forename: Jeff
authors.initials: J
authors.lastname: Wallis
authors.forename: Natalie
authors.initials: N
authors.lastname: Shockley
authors.forename: Linda
authors.initials: L
authors.lastname: Jenner
authors.forename: Anne
authors.initials: A
authors.lastname: Clair
mesh_terms: D000293:Adolescent; D000328:Adult; D010054:Brief Psychiatric Rating Scale; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D010865:Pilot Projects; D011614:Psychotherapy, Brief / Q000379:methods*; D011618:Psychotic Disorders / Q000209:etiology*; D012559:Schizophrenia / Q000209:etiology; D016037:Single-Blind Method; D019966:Substance-Related Disorders / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation*; D013997:Time Factors