A randomized controlled trial of relapse prevention therapy for first-episode psychosis patients.
OBJECTIVE
Patients with first-episode psychosis are responsive to acute-phase treatments, but relapse rates are high. This study aimed to evaluate the effectiveness of a psychosocial treatment designed to prevent the second episode of psychosis compared with standardized early psychosis care.


METHODS
In a randomized controlled trial, conducted at the Early Psychosis Prevention and Intervention Centre and Barwon Health, Australia, a multimodal individual and family cognitive-behavioral therapy for relapse prevention was compared with standardized case management within a specialist early psychosis service. Patients aged 15 to 25 years with a first episode of a DSM-IV psychotic disorder were recruited between November 2003 and May 2005. The main outcome measures were the number of relapses and time to first relapse.


RESULTS
Forty-one first-episode psychosis patients were randomly assigned to the relapse prevention therapy (RPT) and 40 to standardized case management. At the 7-month follow up, the relapse rate was significantly lower in the therapy condition compared to treatment as usual (p = .042) and time to relapse was significantly longer for the RPT condition (p = .03). The number needed to treat was 6 over 7 months.


CONCLUSIONS
Interim findings suggest that RPT provided within a specialist early psychosis program was effective in reducing relapse in early psychosis when compared with standardized early psychosis case management.


BACKGROUND
www.anzctr.org.au Identifier: ACTRN12605000514606.
Gleeson
John F M
JF
Department of Psychology, ORYGEN Youth Health Research Centre, Melbourne, Victoria, 3010, Australia. jgleeson@unimelb.edu.au
Cotton
Sue M
SM
Alvarez-Jimenez
Mario
M
Wade
Darryl
D
Gee
Donna
D
Crisp
Kingsley
K
Pearce
Tracey
T
Newman
Belinda
B
Spiliotacopoulos
Daniela
D
Castle
David
D
McGorry
Patrick D
PD