Family-focused treatment improves attenuated psychotic symptoms, but does not differ from brief treatment in negative symptoms and social functioning in ultra high risk patients aged 12–35 years

摘要

Transition to psychotic episode can be reduced to about 50% by psy-chosocial interventions such as cognitive behavioural therapy (CBT), but there are no improvements in negative symptoms and social functioning. Antipsychotic medications are not usually indicated unless the person meets criteria for a DSM-IV/ICD-10 psychotic disorder.METHODS OF THE STUDY The sample consisted of young ultra high risk (UHR) patients aged from 12 to 35 years as assessed with the Structured Interview for Prodromal Symptoms (SIPS) and the Scale of Prodromal Symptoms (SOPS). One hundred and twenty-nine participants were recruited at eight sites of the North American Prodrome Longitudinal Study and 102 were followed up at 6 months. The patients were randomised to 18 sessions of family-focused treatment (FFT) for clinical high-risk individuals or three sessions of family psychoeducation (enhanced care, EC). FFT consists of psychoeducation (eg, teaching families to create a prevention plan summarising early symptoms, stressors and preventative manoeuvers), communication training, and problem solving skills training. EC teaches a personalised prevention plan in three sessions. Measurement was blind and the primary outcome was attenuated psychotic symptoms on the SIPS/SOPS. The secondary outcome was social functioning (Global Assessment of Functioning, GAF). Completer analyses with analysis of covariance (n=102) and, if significant, intention-to-treat mixed-effect regression analyses (ITT; n=129) were conducted.