A Multicentre, Randomised, Controlled Trial of a Combined Clinical Treatment for First-Episode Psychosis

Abstract

Introduction: There is evidence that early intervention contributes to improving the prognosis and course of first-episode psychosis (FEP). However, further randomised treatment clinical trials are needed. Objectives: The aim of this study was to compare the efficacy of a combined clinical treatment involving Cognitive Behavioural Therapy (CBT) as an adjunctive to treatment-as-usual (TAU) (CBT+TAU) versus TAU alone for FEP. Patients and methods: In this multicentre, single-blind, randomised controlled trial, 177 participants were randomly allocated to either CBT+TAU or TAU. The primary outcome was post-treatment patient functioning. Results: The CBT+TAU group showed a greater improvement in functioning, which was measured using the Global Assessment Functioning (GAF) and Functioning Assessment Short Test (FAST), compared to the TAU group post-treatment. The CBT+TAU participants exhibited a greater decline in depressive, negative, and general psychotic symptoms; a better awareness of the disease and treatment adherence; and a greater increase in brain-derived neurotrophic factor levels than TAU participants. Conclusions: Early intervention based on a combined clinical treatment involving CBT as an adjunctive to standard treatment may improve clinical and functional outcomes in FEP.

Cognitive Behavioral Therapy Program for Cannabis Use Cessation in First-Episode Psychosis Patients: A 1-Year Randomized Controlled Trial

“…Since cannabis has a significant role in the prognosis of FEP patients and given that the deleterious effect of cannabis could be reversed with the decrease or cessation of consumption, there is a need for early intervention for cannabis cessation after the onset of FEP. Although CBT has previously proven to be a useful therapeutic approach to treat and improve clinical and functional outcomes in FEP [ 62 ], to date no specific therapies had been found that have been shown to be effective for FEP cannabis users. This integrated psychological CBT intervention has been shown to be effective both in cannabis cessation use and in improving clinical and functional outcomes of FEP cannabis users, following the paradigm of precision psychotherapy [ 63 ].…”

Intervention Programs for First-Episode Psychosis: A Scoping Review Protocol

“…In recent years, teams dedicated to specific interventions in first-episode psychosis have proliferated, showing more promising results when compared to those obtained in standard services [ 1 , 15 , 19 ]. These teams promote recovery and a productive life.…”

“…These teams promote recovery and a productive life. They offer appropriate interventions aimed at ameliorating clinical outcomes, such as the impact of symptoms, improving functioning, and reducing relapse with a view to recovery as early as possible [ 19 , 20 , 21 ]. Recovery encompasses the issues of clinical recovery and personal recovery.…”