title: A randomized controlled trial of relapse prevention therapy for first-episode psychosis patients: outcome at 30-month follow-up.
abstract: The effectiveness of a novel 7-month psychosocial treatment designed to prevent the second episode of psychosis was evaluated in a randomized controlled trial at 2 specialist first-episode psychosis (FEP) programs. An individual and family cognitive behavior therapy for relapse prevention was compared with specialist FEP care. Forty-one FEP patients were randomized to the relapse prevention therapy (RPT) and 40 to specialist FEP care. Participants were assessed on an array of measures at baseline, 7- (end of therapy), 12-, 18-, 24-, and 30-month follow-up. At 12-month follow-up, the relapse rate was significantly lower in the therapy condition compared with specialized treatment alone (P = .039), and time to relapse was significantly delayed for those in the relapse therapy condition (P = .038); however, such differences were not maintained. Unexpectedly, psychosocial functioning deteriorated over time in the experimental but not in the control group; these differences were no longer statistically significant when between-group differences in medication adherence were included in the model. Further research is required to ascertain if the initial treatment effect of the RPT can be sustained. Further research is needed to investigate if medication adherence contributes to negative outcomes in functioning in FEP patients who have reached remission, or, alternatively, if a component of RPT is detrimental.
authors: School of Psychology, Australian Catholic University, Level 2, 115 Victoria Parade Fitzroy, VIC 3065, Australia. john.gleeson@acu.edu.au
authors: John F M
authors: JF
authors: Gleeson
authors: Sue M
authors: SM
authors: Cotton
authors: Mario
authors: M
authors: Alvarez-Jimenez
authors: Darryl
authors: D
authors: Wade
authors: Donna
authors: D
authors: Gee
authors: Kingsley
authors: K
authors: Crisp
authors: Tracey
authors: T
authors: Pearce
authors: Daniela
authors: D
authors: Spiliotacopoulos
authors: Belinda
authors: B
authors: Newman
authors: Patrick D
authors: PD
authors: McGorry
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003695:Delivery of Health Care; D005196:Family Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011618:Psychotic Disorders / Q000517:prevention & control*; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents