title: Preventing progression to first-episode psychosis in early initial prodromal states.
abstract: BACKGROUND
  Young people with self-experienced cognitive thought and perception deficits (basic symptoms) may present with an early initial prodromal state (EIPS) of psychosis in which most of the disability and neurobiological deficits of schizophrenia have not yet occurred.
  
  
  OBJECTIVE
  To investigate the effects of an integrated psychological intervention (IPI), combining individual cognitive-behavioural therapy, group skills training, cognitive remediation and multifamily psychoeducation, on the prevention of psychosis in the EIPS.
  
  
  METHODS
  A randomised controlled, multicentre, parallel group trial of 12 months of IPI v. supportive counselling (trial registration number: NCT00204087). Primary outcome was progression to psychosis at 12- and 24-month follow-up.
  
  
  RESULTS
  A total of 128 help-seeking out-patients in an EIPS were randomised. Integrated psychological intervention was superior to supportive counselling in preventing progression to psychosis at 12-month follow-up (3.2% v. 16.9%; P = 0.008) and at 24-month follow-up (6.3% v. 20.0%; P = 0.019).
  
  
  CONCLUSIONS
  Integrated psychological intervention appears effective in delaying the onset of psychosis over a 24-month time period in people in an EIPS.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Germany. andreas.bechdolf@uk-koeln.de
authors.forename: A
authors.initials: A
authors.lastname: Bechdolf
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.forename: S
authors.initials: S
authors.lastname: Ruhrmann
authors.forename: S
authors.initials: S
authors.lastname: Harrigan
authors.forename: V
authors.initials: V
authors.lastname: Putzfeld
authors.forename: R
authors.initials: R
authors.lastname: Pukrop
authors.forename: A
authors.initials: A
authors.lastname: Brockhaus-Dumke
authors.forename: J
authors.initials: J
authors.lastname: Berning
authors.forename: B
authors.initials: B
authors.lastname: Janssen
authors.forename: P
authors.initials: P
authors.lastname: Decker
authors.forename: R
authors.initials: R
authors.lastname: Bottlender
authors.forename: K
authors.initials: K
authors.lastname: Maurer
authors.forename: H-J
authors.initials: HJ
authors.lastname: Möller
authors.forename: W
authors.initials: W
authors.lastname: Gaebel
authors.forename: H
authors.initials: H
authors.lastname: Häfner
authors.forename: W
authors.initials: W
authors.lastname: Maier
authors.forename: J
authors.initials: J
authors.lastname: Klosterkötter
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003376:Counseling; D018450:Disease Progression; D004198:Disease Susceptibility / Q000523:psychology; D005192:Family Health; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D010353:Patient Education as Topic; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000473:pathology / Q000517:prevention & control* / Q000523:psychology; D012559:Schizophrenia / Q000517:prevention & control*; D012565:Schizophrenic Psychology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult