OBJECTIVES: Cognitively oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and preventing or alleviating secondary morbidity in the wake of the first psychotic episode. The present study reports on the outcomes of a controlled trial comparing two conditions: COPE <i>versus</i> No-COPE. METHOD: Ninety-one people participated in the trial which was analysed by intention-to-treat, including 12 people who were assigned to COPE but refused to participate. Assessments were conducted at pre-treatment, mid-treatment and post-treatment. Hospital readmission data were obtained through a Psychiatric Case Register. The study was conducted in a front-line public mental health service, the Early Psychosis Prevention and Intervention Centre (EPPIC). Clients in both COPE and No-COPE were provided with full access to the complete range of EPPIC services. RESULTS: There were no significant differences between the two conditions on the nine primary outcome variables. Hospital readmissions were assessed for each client at yearly intervals up to 4 years following the completion of treatment and again there were no significant between-group differences. CONCLUSIONS: The study indicated that there was no significant advantage to COPE over and above routine care at EPPIC. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Background. Carers' satisfaction with psychiatric services related to information and advice is generally poor. This may be particularly true for services trying to meet the needs of ethnically diverse communities. It is important that services attempt to ameliorate carers' concerns as early as possible. The authors aimed to assess the impact of a brief educational and advice support service on carers of patients with a first episode of psychotic illness. Method. Carers of all patients identified with a first episode of psychosis in a defined psychiatric catchment area of North London were invited to participate. Following consent from patients and relatives, relatives were randomly allocated to receive (in addition to usual services) a brief intervention comprising education and advice about the disorder from a support team or to usual care from community psychiatric services. Results. One hundred and six carers were recruited to the study. Take-up of the intervention was less than expected and the intervention had little impact. The authors found no differences over time between the randomized arms for relatives' satisfaction (F=2.3,P = 0.14, df= 1) or number of days spent by patients in hospital over nine months from entry to the trial (F= 1.7, p = p 18, df= 1). Conclusions. It was found that the support and advice intervention for families had little impact on their satisfaction or on patients' outcomes. However, failure to take up the intervention threatens the conclusions as the power to show an effect was reduced. Although family interventions, in general, are considered an important adjunct to the treatment of patients with chronic psychosis, there may be difficulties in providing an educational and support intervention shortly after first onsel. How and when psychiatric services provide information and advice to carers of people newly diagnosed with a psychosis requires further study. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Publication Thread
COAST(Croydon Outreach and Assertive Support Team)
OBJETIVE: To study the long term effect of cognitive behavior intervention on first episode schizophrenia Method:251 first episode schizophrenics were randomly divided into intervention group (receiving cognitive behavior intervention and regular antipsychotics, n=126) and control group (receiving regular antipsychotics only, n=125) There was no significant difference of antipsychotics used between the two groups Both groups were followed for 2 years, using PANSS (positive and negative symptom scale) to assess the severity of symptoms The rate of relapse, compliance with treatment and insight to illness were also recorded. RESULT:The intervention group had lower rates of relapse (1 6% at half-year in follow up, 7 1% at the end of 2 years follow up) than control (12 8% and 23 2% respectively) The total score and factor scores of PANSS were lower in intervention groups Patients in intervention groups had also better insight to illness and better compliance to treatment CONCLUSIONS:The cognitive behavior intervention is benefit patients with first episode schizophrenia
At the time of discharge from their first stay in psychiatric hospital, 78 male schizophrenic patients were randomly assigned to a family intervention (experimental) group or a 'standard care' control group and were followed for the next 18 months. The family intervention consisted of both group and individual counselling sessions every 1-3 months that focused on education about the illness and on methods of dealing with the patient. There was a significantly lower rate of hospital readmission in the family intervention group than in the control group (15.4% versus 53.8%, chi 2 = 12.75, P < 0.01), and the mean hospital-free period for those who were readmitted was significantly longer in the experimental group than in the control group (245 days versus 130 days, t = 2.91, P < 0.01). Moreover, the clinical status and overall level of functioning in patients who were not readmitted were significantly better in experimental subjects than in control subjects. Stratified analysis showed that family intervention and regular use of medication had independent and additive effects on the outcome. During the 18 months after the index discharge patients who did not take medication regularly and who did not receive family intervention were 7.9 times as likely to be readmitted to hospital as patients who took medication regularly and received family intervention.
