Intervention for adolescents with early-onset psychosis and their families: a randomized controlled trial.
OBJECTIVE
The present study aims to assess the efficacy of a structured psychoeducational group intervention for adolescents with early-onset psychosis and their families. The intervention was implemented in parallel in 2 separate groups by focusing specifically on problem-solving strategies and structured psychosis-related information to manage daily life difficulties associated with the disease, to mitigate crises, and to prevent relapses.


METHODS
We performed a 9-month, randomized, rater-blinded clinical trial involving 55 adolescent patients with early-onset psychosis and either or both of their parents. A psychoeducational problem-solving group intervention (n = 27) was compared with a nonstructured group intervention (n = 28). The primary outcomes were number of hospitalizations, days of hospitalization, and visits to the emergency department. The secondary outcome measures were clinical variables and family environment.


RESULTS
Assessments were performed before and after the intervention. At the end of the group intervention, 15% of patients in the psychoeducational group and 39% patients in the nonstructured group had visited the emergency department (χ² = 3.62, df = 1, p = .039). The improvement in negative symptoms was more pronounced in the psychoeducational group (12.84 [7.87]) than in the nonstructured group (15.81 [6.37]) (p = .039).


CONCLUSIONS
A parallel psychoeducational group intervention providing written instructions in a structured manner could help adolescents with early-onset psychosis and their parents to manage crises by implementing problem-solving strategies within the family, thus reducing the number of visits to the emergency department. Negative symptoms improved in adolescents in the psychoeducational group. Clinical trial registration information--Intervention Module AGES (AGES-CM); http://clinicaltrials.gov/; NCT02101372. [corrected].
Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. Electronic address: acalvo@iisgm.com.
Ana
A
Calvo
Gipuzkoako Osasun MentalekoSarea, Red de Salud Mental de Guipuzcoa, San Sebastian, Spain.
Miguel
M
Moreno
VocAcción Director-Group Processes and Institutional Consulting, Madrid, Spain.
Ana
A
Ruiz-Sancho
Hospital General Universitario Gregorio Maranon School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Orygen Youth Health Research Centre, Centre for Youth Mental Health, and Melbourne Neuropsychiatry Centre, the University of Melbourne, and Melbourne Health, Australia.
Marta
M
Rapado-Castro
Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Carmen
C
Moreno
Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Teresa
T
Sánchez-Gutiérrez
Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Celso
C
Arango
Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
María
M
Mayoral
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011340:Problem Solving / Q000502:physiology; D011618:Psychotic Disorders / Q000628:therapy*; D016037:Single-Blind Method; D016896:Treatment Outcome
families; group therapy; psychoeducation; psychosis