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Clinical Trial
. 2011 Sep;37 Suppl 2(Suppl 2):S111-21.
doi: 10.1093/schbul/sbr083.

Rationale and baseline characteristics of PREVENT: a second-generation intervention trial in subjects at-risk (prodromal) of developing first-episode psychosis evaluating cognitive behavior therapy, aripiprazole, and placebo for the prevention of psychosis

Andreas Bechdolf  1 , Hendrik Müller, Hartmut Stützer, Michael Wagner, Wolfgang Maier, Marion Lautenschlager, Andreas Heinz, Walter de Millas, Birgit Janssen, Wolfgang Gaebel, Tanja Maria Michel, Frank Schneider, Martin Lambert, Dieter Naber, Martin Brüne, Seza Krüger-Özgürdal, Thomas Wobrock, Michael Riedel, Joachim Klosterkötter; PREVENT study group
Collaborators, Affiliations
Clinical Trial

Rationale and baseline characteristics of PREVENT: a second-generation intervention trial in subjects at-risk (prodromal) of developing first-episode psychosis evaluating cognitive behavior therapy, aripiprazole, and placebo for the prevention of psychosis

Andreas Bechdolf et al. Schizophr Bull. 2011 Sep.

Abstract

Antipsychotics, cognitive behavioral therapy (CBT), and omega-3-fatty acids have been found superior to control conditions as regards prevention of psychosis in people at-risk of first-episode psychosis. However, no large-scale trial evaluating the differential efficacy of CBT and antipsychotics has been performed yet. In PREVENT, we evaluate CBT, aripiprazole, and clinical management (CM) as well as placebo and CM for the prevention of psychosis in a randomized, double-blind, placebo-controlled trial with regard to the antipsychotic intervention and a randomized controlled trial with regard to the CBT intervention with blinded ratings. The hypotheses are first that CBT and aripiprazole and CM are superior to placebo and CM and second that CBT is not inferior to aripiprazole and CM combined. The primary outcome is transition to psychosis. By November 2010, 156 patients were recruited into the trial. The subjects were substantially functionally compromised (Social and Occupational Functioning Assessment Scale mean score 52.5) and 78.3% presented with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition axis I comorbid diagnosis. Prior to randomization, 51.5% of the participants preferred to be randomized into the CBT arm, whereas only 12.9% preferred pharmacological treatment. First, assessments of audiotaped treatment sessions confirmed the application of CBT-specific skills in the CBT condition and the absence of those in CM. The overall quality rating of the CBT techniques applied in the CBT condition was good. When the final results of the trial are available, PREVENT will substantially expand the current limited evidence base for best clinical practice in people at-risk (prodromal) of first-episode psychosis.

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Figures

Fig. 1.
Fig. 1.
CONSORT diagram.
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