TY - JOUR
T1 - Clinical and functional outcomes after 2 years in the early detection and intervention for the prevention of psychosis multisite effectiveness trial
AU - McFarlane, William R.
AU - Levin, Bruce
AU - Travis, Lori
AU - Lucas, F. Lee
AU - Lynch, Sarah
AU - Verdi, Mary
AU - Williams, Deanna
AU - Adelsheim, Steven
AU - Calkins, Roderick
AU - Carter, Cameron S.
AU - Cornblatt, Barbara
AU - Taylor, Stephan F.
AU - Auther, Andrea M.
AU - McFarland, Bentson
AU - Melton, Ryan
AU - Migliorati, Margaret
AU - Niendam, Tara
AU - Ragland, J. Daniel
AU - Sale, Tamara
AU - Salvador, Melina
AU - Spring, Elizabeth
N1 - Publisher Copyright:
© The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Objective: To test effectiveness of the Early Detection, Intervention, and Prevention of Psychosis Program in preventing the onset of severe psychosis and improving functioning in a national sample of at-risk youth. Methods: In a risk-based allocation study design, 337 youth (age 12-25) at risk of psychosis were assigned to treatment groups based on severity of positive symptoms. Those at clinically higher risk (CHR) or having an early first episode of psychosis (EFEP) were assigned to receive Family-aided Assertive Community Treatment (FACT); those at clinically lower risk (CLR) were assigned to receive community care. Between-groups differences on outcome variables were adjusted statistically according to regression-discontinuity procedures and evaluated using the Global Test Procedure that combined all symptom and functional measures. Results: A total of 337 young people (mean age: 16.6) were assigned to the treatment group (CHR + EFEP, n = 250) or comparison group (CLR, n = 87). On the primary variable, positive symptoms, after 2 years FACT, were superior to community care (2 df, p <.0001) for both CHR (p =.0034) and EFEP (p <.0001) subgroups. Rates of conversion (6.3% CHR vs 2.3% CLR) and first negative event (25% CHR vs 22% CLR) were low but did not differ. FACT was superior in the Global Test (p =.0007; p =.024 for CHR and p =.0002 for EFEP, vs CLR) and in improvement in participation in work and school (p =.025). Conclusion: FACT is effective in improving positive, negative, disorganized and general symptoms, Global Assessment of Functioning, work and school participation and global outcome in youth at risk for, or experiencing very early, psychosis.
AB - Objective: To test effectiveness of the Early Detection, Intervention, and Prevention of Psychosis Program in preventing the onset of severe psychosis and improving functioning in a national sample of at-risk youth. Methods: In a risk-based allocation study design, 337 youth (age 12-25) at risk of psychosis were assigned to treatment groups based on severity of positive symptoms. Those at clinically higher risk (CHR) or having an early first episode of psychosis (EFEP) were assigned to receive Family-aided Assertive Community Treatment (FACT); those at clinically lower risk (CLR) were assigned to receive community care. Between-groups differences on outcome variables were adjusted statistically according to regression-discontinuity procedures and evaluated using the Global Test Procedure that combined all symptom and functional measures. Results: A total of 337 young people (mean age: 16.6) were assigned to the treatment group (CHR + EFEP, n = 250) or comparison group (CLR, n = 87). On the primary variable, positive symptoms, after 2 years FACT, were superior to community care (2 df, p <.0001) for both CHR (p =.0034) and EFEP (p <.0001) subgroups. Rates of conversion (6.3% CHR vs 2.3% CLR) and first negative event (25% CHR vs 22% CLR) were low but did not differ. FACT was superior in the Global Test (p =.0007; p =.024 for CHR and p =.0002 for EFEP, vs CLR) and in improvement in participation in work and school (p =.025). Conclusion: FACT is effective in improving positive, negative, disorganized and general symptoms, Global Assessment of Functioning, work and school participation and global outcome in youth at risk for, or experiencing very early, psychosis.
KW - assertive community treatment
KW - family psychoeducation
KW - multifamily group
KW - schizophrenia
KW - supported education
KW - supported employment
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U2 - 10.1093/schbul/sbu108
DO - 10.1093/schbul/sbu108
M3 - Article
C2 - 25065017
AN - SCOPUS:84922777435
SN - 0586-7614
VL - 41
SP - 30
EP - 43
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - 1
ER -