Interventions and Transition in Youth at Risk of Psychosis

Devoe, Daniel J.; Farris, Megan S.; Townes, Parker; Addington, Jean

doi:10.4088/jcp.17r12053

Cited by 40 publications

(23 citation statements)

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“…Among all interventions in reducing risk for transition in FEP at 12 and 18 months, Cognitive Behavioral therapy (CBT) showed the strongest level of evidence, being effective in restoring thoughts and changing behaviors that maintain symptomatology and distress, while other types of interventions, even promising, require more clinical trials [107]. Additionally, it is important to treat potential other comorbid psychiatric disorders following actual guidelines and aim to improve recovery and quality of life [105].…”

Section: Models and Levels Of Preventive Interventions And Their Limitationmentioning

confidence: 99%

Primary Psychosis: Risk and Protective Factors and Early Detection of the Onset

et al. 2021

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Primary psychosis, which includes schizophrenia and other psychoses not caused by other psychic or physical conditions, has a strong impact worldwide in terms of disability, suffering and costs. Consequently, improvement of strategies to reduce the incidence and to improve the prognosis of this disorder is a current need. The purpose of this work is to review the current scientific literature on the main risk and protective factors of primary psychosis and to examine the main models of prevention, especially those related to the early detection of the onset. The conditions more strongly associated with primary psychosis are socio-demographic and economic factors such as male gender, birth in winter, ethnic minority, immigrant status, and difficult socio-economic conditions while the best-established preventive factors are elevated socio-economic status and an economic well-being. Risk and protective factors may be the targets for primordial, primary, and secondary preventive strategies. Acting on modifiable factors may reduce the incidence of the disorder or postpone its onset, while an early detection of the new cases enables a prompt treatment and a consequential better prognosis. According to this evidence, the study of the determinants of primary psychosis has a pivotal role in designing and promoting preventive policies aimed at reducing the burden of disability and suffering of the disorder.

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Section: Models and Levels Of Preventive Interventions And Their Limitationmentioning

confidence: 99%

Primary Psychosis: Risk and Protective Factors and Early Detection of the Onset

et al. 2021

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“…For prospectively registered trials with a pre-specified outcome measure and assessment time point, we examined changes in primary depression outcomes between registries and publications. Potential discrepancies included 4 : a) omission of registered primary outcome (non-reporting); b) addition of new, not registered, primary outcome; c) downgrading of registered primary outcome to secondary; d) upgrading of secondary registered outcome to primary; e) assessment time point changes; f) analysis method changes. Selective reporting was adjudicated for a) or b), and, for other discrepancies, on the basis of the judgement of two independent researchers.…”

Section: Selective Outcome Reporting and The Effectiveness Of Psychotherapies For Depressionmentioning

confidence: 99%

“…Cognitive behavioural therapy (CBT) is the currently recommended preventive intervention, but the most updated network meta-analysis 2 found no robust evidence to favour it (and any of the other indicated interventions) compared to the control condition (i.e., needs-based interventions). A subsequent independent pairwise meta-analysis by the Cochrane group 3 confirmed these findings, concluding that there was "no convincing unbiased, high-quality evidence" that any type of intervention is more effective than needs-based interventions (another pairwise meta-analysis was subsequently published 4 , but used older data). A further umbrella review showed no evidence that CBT impacts other clinical outcomes such as acceptability of treatments, severity of attenuated positive/negative psychotic symptoms, depression, symptom-related distress, social functioning, general functioning, and quality of life 5 .…”

Section: Lack Of Robust Meta-analytic Evidence To Favour Cognitive Behavioural Therapy For Prevention Of Psychosismentioning

confidence: 99%

Lack of robust meta‐analytic evidence to favour cognitive behavioural therapy for prevention of psychosis

2021

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“…A 2020 report concluded CBT was still the most promising intervention; it was more effective than control treatments at 12 and 18 months, although not at 6, 24, or 48 months. 33 This review included controlled, open-label, and naturalistic studies that assessed family therapy; omega-3 polyunsaturated fatty acids; integrated psychological therapy (a package of interventions that included family education, CBT, social skills training, and cognitive remediation); N-methyl-daspartate receptor modulators; mood stabilizers; and antipsychotics. In addition to the evidence supporting CBT, the results also indicated nonsignificant trends favoring family and integrated psychological therapy.…”

Section: Assessing Prevention and Fep Interventionsmentioning

confidence: 99%

Early interventions for psychosis

Goldman¹

2021

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Hence, evidence that a longer duration of untreated psychosis (DUP) aggravates-and early intervention with medication and social supports ameliorates-the long-term adverse consequences of psychotic disorders generated a great deal of interest. 3,4 This knowledge led to the development of diverse early intervention services worldwide aimed at this putative "critical window." It raised the possibility that appropriate interventions could prevent the long-term disability that makes chronic psychosis one of the most debilitating disorders. 5,6 However, even beyond the varied cultural and economic confounds, it is difficult to assess, compare, and optimize program effectiveness. 7 Obstacles include paucity of sufficiently powered, well-designed randomized controlled trials (RCTs), the absence of diagnostic biomarkers or other prognostic indicators to better account for the inherent heterogeneity in the population and associated outcomes, and the absence of modifiable risk factors that can guide interventions and provide intermediate outcomes. 4,[8][9][10] To better appreciate these issues, it is important to distinguish whether a program is designed to prevent psychosis, or to mitigate the effects of psychosis. Two models include the:• Prevention model, which focuses on young individuals who are not yet overtly psychotic but at high risk • First-episode recovery model, which focuses on those who have experienced a first episode of psychosis (FEP) but have not yet developed a chronic disorder. Early interventions for psychosis

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Interventions and Transition in Youth at Risk of Psychosis

Cited by 40 publications

References 0 publications

Primary Psychosis: Risk and Protective Factors and Early Detection of the Onset

Primary Psychosis: Risk and Protective Factors and Early Detection of the Onset

Lack of robust meta‐analytic evidence to favour cognitive behavioural therapy for prevention of psychosis

Early interventions for psychosis

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