Randomized-controlled trials in people at ultra high risk of psychosis: A review of treatment effectiveness
Abstract
As an extension of the early intervention in psychosis paradigm, different focused treatments are now offered to individuals at ultra high risk of psychosis (UHR) to prevent transition to schizophrenia, however the effectiveness of these treatments is unclear. A systematic literature search in PubMed/Medline and PsycINFO was performed to derive information on randomized control trials (RCTs) in UHR samples. Seven reports were identified detailing results from five independent RCT studies. Two studies used antipsychotic drugs (one in combination with cognitive behavior therapy); one study employed cognitive therapy; one study used a two-year program of intensive community care with family psychoeducation; one study assessed the effectiveness of 3-months omega-3 polyunsaturated fatty acids (Omega-3 PUFAs) supplementation. Intensive community care and the Omega-3 PUFAs supplementation were effective in reducing the transition to psychosis at 12 months. Overall, rates of transition to psychosis at 1 year were 11% for focused treatment groups (n=180) and 31.6% for control UHR groups (n=157). Receiving any of the focused treatment was associated with a lower risk of developing psychosis if compared with no treatment or treatment as usual (Relative Risk=0.36; 95%CI: 0.22-0.59). The available evidence at 2/3 years follow-up indicates that the effects of focused treatments are not stable after intervention cessation and when treatment is delivered over a restricted time (e.g. 6 months or less), it may achieve only a delay in psychosis onset. Due to the heterogeneity in the interventions considered, the current results do not allow recommendation for any specific treatment.
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Previous pairwise meta-analyses in this field had methodological limitations, including heterogeneous interventions, non-standard clinical high risk samples, non-randomized trials, pooling of time-dependent outcomes, and poor meta-analytical approaches.
“The other meta-analyses were affected by mistakes 19 or methodological limitations”
From Lack of evidence to favor specific preventive interventions in psychosis: a network meta‐analysis (2018) · cites this paper as [12]
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- Authors
- Preti, A., & Cella, M.
- Affiliations
- King's College London (GB)
- Corresponding author
- Preti, Antonio
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 123
- Issue
- 1
- Pages
- 30-36
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2096616288
- Cited by
- 167
- References
- 61
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 8 · 2020: 7 · 2019: 8 · 2018: 4 · 2017: 8 · 2016: 13 · 2015: 17 · 2014: 24 · 2013: 27 · 2012: 30
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- early intervention in psychosis
- MeSH terms
- Olanzapine, Benzodiazepines, Humans, Psychotic Disorders, Antipsychotic Agents, Randomized Controlled Trials as Topic, Treatment Outcome
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