Preventing progression to first-episode psychosis in early initial prodromal states
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Background: Young people with self-experienced cognitive thought and perception deficits (basic symptoms) may present with an early initial prodromal state (EIPS) of psychosis in which most of the disability and neurobiological deficits of schizophrenia have not yet occurred. Aims: To investigate the effects of an integrated psychological intervention (IPI), combining individual cognitive–behavioural therapy, group skills training, cognitive remediation and multifamily psychoeducation, on the prevention of psychosis in the EIPS. Method: A randomised controlled, multicentre, parallel group trial of 12 months of IPI v. supportive counselling (trial registration number: NCT00204087). Primary outcome was progression to psychosis at 12- and 24-month follow-up. Results: A total of 128 help-seeking out-patients in an EIPS were randomised. Integrated psychological intervention was superior to supportive counselling in preventing progression to psychosis at 12-month follow-up (3.2% v. 16.9%; P = 0.008) and at 24-month follow-up (6.3% v. 20.0%; P = 0.019). Conclusions: Integrated psychological intervention appears effective in delaying the onset of psychosis over a 24-month time period in people in an EIPS.
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Only two included studies had an overall low risk of bias; five had unclear risk and nine had high risk.
“Only two studies had an overall low risk of bias 33,79 ; five had unclear risk [72][73][74][75][76] , and nine had high risk 30,31,36,37,39,41,77,78,81 .”
From Lack of evidence to favor specific preventive interventions in psychosis: a network meta‐analysis (2018) · cites this paper as [39]
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Self-citation
- Authors
- Bechdolf, A., Wagner, M., Ruhrmann, S., Harrigan, S., Putzfeld, V., Pukrop, R., Brockhaus-Dumke, A., Berning, J., Janssen, B., Decker, P., Bottlender, R., Maurer, K., Möller, H.-J., Gaebel, W., Häfner, H., Maier, W., & Klosterkötter, J.
- Affiliations
- The University of Melbourne (AU)
- University of Bonn (DE)
- University of Cologne (DE)
- Heinrich Heine University Düsseldorf (DE)
- Ludwig-Maximilians-Universität München (DE)
- Central Institute of Mental Health (DE)
- Corresponding author
- Bechdolf, A.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2012-01
- Volume
- 200
- Issue
- 1
- Pages
- 22-29
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2153557212
- Cited by
- 224
- References
- 49
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 7 · 2023: 8 · 2022: 7 · 2021: 13 · 2020: 17 · 2019: 20 · 2018: 13 · 2017: 11 · 2016: 21 · 2015: 22 · 2014: 24 · 2013: 34 · 2012: 15
- FWCI
- 16.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bundesministerium für Bildung und Forschung (01GI9935)
- Universität zu Köln
- Rheinische Friedrich-Wilhelms-Universität Bonn
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- psychosis prevention, first-episode psychosis, cognitive behavioral therapy, cognitive remediation, group skills training, supportive counseling, basic symptoms, schizophrenia
- MeSH terms
- Adolescent, Adult, Ambulatory Care, Counseling, Disease Susceptibility, Family Health, Female, Humans, Male, Patient Education as Topic, Prospective Studies, Psychiatric Status Rating Scales, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome, Disease Progression, Kaplan-Meier Estimate, Young Adult
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