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Meta-Analysis
. 2020 Jul 3;7(7):CD009533.
doi: 10.1002/14651858.CD009533.pub2.

Psychological interventions for psychosis in adolescents

Soumitra S Datta  1   2 , Rhea Daruvala  2 , Ajit Kumar  3
Affiliations
Meta-Analysis

Psychological interventions for psychosis in adolescents

Soumitra S Datta et al. Cochrane Database Syst Rev. .

Abstract

Background: Psychosis is an illness characterised by alterations in thoughts and perceptions resulting in delusions and hallucinations. Psychosis is rare in adolescents but can have serious consequences. Antipsychotic medications are the mainstay treatment, and have been shown to be effective. However, there is emerging evidence on psychological interventions such as cognitive remediation therapy, psycho-education, family therapy and group psychotherapy that may be useful for adolescents with psychosis.

Objectives: To assess the effects of various psychological interventions for adolescents with psychosis.

Search methods: We searched the Cochrane Schizophrenia Group's study-based Register of Trials including clinical trials registries (latest, 8 March 2019).

Selection criteria: All randomised controlled trials comparing various psychological interventions with treatment-as-usual or other psychological treatments for adolescents with psychosis. For analyses, we included trials meeting our inclusion criteria and reporting useable data.

Data collection and analysis: We independently and reliably screened studies and we assessed risk of bias of the included studies. For dichotomous data, we calculated risk ratios (RRs) and 95% confidence intervals (CIs) on an intention-to-treat basis. For continuous data, we used mean differences (MDs) and the 95% CIs. We used a random-effects model for analyses. We created a 'Summary of findings' table using GRADE.

Main results: The current review includes 7 studies (n = 319) assessing a heterogenous group of psychological interventions with variable risk of bias. Adverse events were not reported by any of the studies. None of the studies was sponsored by industry. Below, we summarise the main results from four of six comparisons, and the certainty of these results (based on GRADE). All scale scores are average endpoint scores. Cognitive Remediation Therapy (CRT) + Treatment-as-Usual (TAU) versus TAU Two studies compared adding CRT to participants' TAU with TAU alone. Global state (CGAS, high = good) was reported by one study. There was no clear difference between treatment groups (MD -4.90, 95% CI -11.05 to 1.25; participants = 50; studies = 1, very low-certainty). Mental state (PANSS, high = poor) was reported by one study. Scores were clearly lower in the TAU group (MD 8.30, 95% CI 0.46 to 16.14; participants = 50; studies = 1; very low-certainty). Clearly more participants in the CRT group showed improvement in cognitive functioning (Memory digit span test) compared to numbers showing improvement in the TAU group (1 study, n = 31, RR 0.58, 95% CI 0.37 to 0.89; very low-certainty). For global functioning (VABS, high = good), our analysis of reported scores showed no clear difference between treatment groups (MD 5.90, 95% CI -3.03 to 14.83; participants = 50; studies = 1; very low-certainty). The number of participants leaving the study early from each group was similar (RR 0.93, 95% CI 0.32 to 2.71; participants = 91; studies = 2; low-certainty). Group Psychosocial Therapy (GPT) + TAU versus TAU One study assessed the effects of adding GPT to participants' usual medication. Global state scores (CGAS, high = good) were clearly higher in the GPT group (MD 5.10, 95% CI 1.35 to 8.85; participants = 56; studies = 1; very low-certainty) but there was little or no clear difference between groups for mental state scores (PANSS, high = poor, MD -4.10, 95% CI -8.28 to 0.08; participants = 56; studies = 1, very low-certainty) and no clear difference between groups for numbers of participants leaving the study early (RR 0.43, 95% CI 0.15 to 1.28; participants = 56; studies = 1; very low-certainty). Cognitive Remediation Programme (CRP) + Psychoeducational Treatment Programme (PTP) versus PTP One study assessed the effects of combining two types psychological interventions (CRP + PTP) with PTP alone. Global state scores (GAS, high = good) were not clearly different (MD 1.60, 95% CI -6.48 to 9.68; participants = 25; studies = 1; very low-certainty), as were mental state scores (BPRS total, high = poor, MD -5.40, 95% CI -16.42 to 5.62; participants = 24; studies = 1; very low-certainty), and cognitive functioning scores (SPAN-12, high = good, MD 2.40, 95% CI -2.67 to 7.47; participants = 25; studies = 1; very low-certainty). Psychoeducational (PE) + Multifamily Treatment (MFT) Versus Nonstructured Group Therapy (NSGT, all long-term) One study compared (PE + MFT) with NSGT. Analysis of reported global state scores (CGAS, high = good, MD 3.38, 95% CI -4.87 to 11.63; participants = 49; studies = 1; very low-certainty) and mental state scores (PANSS total, high = poor, MD -8.23, 95% CI -17.51 to 1.05; participants = 49; studies = 1; very low-certainty) showed no clear differences. The number of participants needing hospital admission (RR 0.84, 95% CI 0.36 to 1.96; participants = 49; studies = 1) and the number of participants leaving the study early from each group were also similar (RR 0.52, 95% CI 0.10 to 2.60; participants = 55; studies = 1; low-certainty).

Authors' conclusions: Most of our estimates of effect for our main outcomes are equivocal. An effect is suggested for only four outcomes in the SOF tables presented. Compared to TAU, CRT may have a positive effect on cognitive functioning, however the same study reports data suggesting TAU may have positive effect on mental state. Another study comparing GPT with TAU reports data suggesting GPT may have a positive effect on global state. However, the estimate of effects for all the main outcomes in our review should be viewed with considerable caution as they are based on data from a small number of studies with variable risk of bias. Further data could change these results and larger and better quality studies are needed before any firm conclusions regarding the effects of psychological interventions for adolescents with psychosis can be made.

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Conflict of interest statement

Soumitra S Datta: none known.

Rhea Daruvala: none known.

Ajit Kumar: none known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
1.1
1.1. Analysis
Comparison 1: COGNITIVE REMEDIATION THERAPY (CRT) + TREATMENT‐AS‐USUAL (TAU) vs TAU (all short‐term), Outcome 1: Global state: 1a. Average endpoint score (CGAS, high = good)
1.2
1.2. Analysis
Comparison 1: COGNITIVE REMEDIATION THERAPY (CRT) + TREATMENT‐AS‐USUAL (TAU) vs TAU (all short‐term), Outcome 2: Mental state: Overall ‐ average endpoint score (PANSS total, high = poor)
1.3
1.3. Analysis
Comparison 1: COGNITIVE REMEDIATION THERAPY (CRT) + TREATMENT‐AS‐USUAL (TAU) vs TAU (all short‐term), Outcome 3: Cognitive functioning: 1. Clinically important change ‐ not attaining normal cognitive function
1.4
1.4. Analysis
Comparison 1: COGNITIVE REMEDIATION THERAPY (CRT) + TREATMENT‐AS‐USUAL (TAU) vs TAU (all short‐term), Outcome 4: Cognitive functioning: 2. Average endpoint score (various scales, high = poor)
1.5
1.5. Analysis
Comparison 1: COGNITIVE REMEDIATION THERAPY (CRT) + TREATMENT‐AS‐USUAL (TAU) vs TAU (all short‐term), Outcome 5: Global functioning: 1a. Average endpoint score (Life Skills Profile, high = good)
1.6
1.6. Analysis
Comparison 1: COGNITIVE REMEDIATION THERAPY (CRT) + TREATMENT‐AS‐USUAL (TAU) vs TAU (all short‐term), Outcome 6: Global functioning: 1b. Average endpoint score (VABS, high = good)
1.7
1.7. Analysis
Comparison 1: COGNITIVE REMEDIATION THERAPY (CRT) + TREATMENT‐AS‐USUAL (TAU) vs TAU (all short‐term), Outcome 7: Leaving the study early ‐ for any reason
2.1
2.1. Analysis
Comparison 2: GROUP PSYCHOSOCIAL THERAPY (GPT) + TAU (usual medication) vs TAU (usual medicatoin, all short‐term), Outcome 1: Global state: average endpoint score (CGAS, high = good)
2.2
2.2. Analysis
Comparison 2: GROUP PSYCHOSOCIAL THERAPY (GPT) + TAU (usual medication) vs TAU (usual medicatoin, all short‐term), Outcome 2: Mental state: Overall ‐ average endpoint score (PANSS total, high = poor))
2.3
2.3. Analysis
Comparison 2: GROUP PSYCHOSOCIAL THERAPY (GPT) + TAU (usual medication) vs TAU (usual medicatoin, all short‐term), Outcome 3: Quality of life: average endpoint score (PedsQL, high = good)
2.4
2.4. Analysis
Comparison 2: GROUP PSYCHOSOCIAL THERAPY (GPT) + TAU (usual medication) vs TAU (usual medicatoin, all short‐term), Outcome 4: Leaving the study early ‐ for any reason
3.1
3.1. Analysis
Comparison 3: STRUCTURAL GROUP THERAPY (SGT) + TAU (usual medication) vs HANDICRAFT GROUP (HC) + TAU (usual medication, all short‐term), Outcome 1: Mental state: 1a. Overall ‐ average endpoint score (PANSS total, high = poor)
3.2
3.2. Analysis
Comparison 3: STRUCTURAL GROUP THERAPY (SGT) + TAU (usual medication) vs HANDICRAFT GROUP (HC) + TAU (usual medication, all short‐term), Outcome 2: Mental state: 1b. Specific: Positive symptoms ‐ average endpoint score (PANSS positive, high = poor)
3.3
3.3. Analysis
Comparison 3: STRUCTURAL GROUP THERAPY (SGT) + TAU (usual medication) vs HANDICRAFT GROUP (HC) + TAU (usual medication, all short‐term), Outcome 3: Mental state: 1c. Specific: Negative symptoms ‐ average endpoint score (PANSS negative, high = poor)
3.5
3.5. Analysis
Comparison 3: STRUCTURAL GROUP THERAPY (SGT) + TAU (usual medication) vs HANDICRAFT GROUP (HC) + TAU (usual medication, all short‐term), Outcome 5: Leaving the study early ‐ for any reason
4.1
4.1. Analysis
Comparison 4: COGNITIVE REMEDIATION PROGRAMME + PSYCHOEDUCATIONAL TREATMENT PROGRAMME (CRP + PTP) vs PTP (all medium‐term), Outcome 1: Global state ‐ average endpoint score (GAS, high = good)
4.2
4.2. Analysis
Comparison 4: COGNITIVE REMEDIATION PROGRAMME + PSYCHOEDUCATIONAL TREATMENT PROGRAMME (CRP + PTP) vs PTP (all medium‐term), Outcome 2: Mental state: 1a. Overall ‐ average endpoint score (BPRS total, high = poor)
4.3
4.3. Analysis
Comparison 4: COGNITIVE REMEDIATION PROGRAMME + PSYCHOEDUCATIONAL TREATMENT PROGRAMME (CRP + PTP) vs PTP (all medium‐term), Outcome 3: Mental state: 1b. Overall ‐ average endpoint score (CBCL, high = poor)
4.4
4.4. Analysis
Comparison 4: COGNITIVE REMEDIATION PROGRAMME + PSYCHOEDUCATIONAL TREATMENT PROGRAMME (CRP + PTP) vs PTP (all medium‐term), Outcome 4: Mental state: 2a. Specific: Positive symptoms ‐ average endpoint score (BPRS positive, high = poor)
4.6
4.6. Analysis
Comparison 4: COGNITIVE REMEDIATION PROGRAMME + PSYCHOEDUCATIONAL TREATMENT PROGRAMME (CRP + PTP) vs PTP (all medium‐term), Outcome 6: Cognitive functioning: average endpoint score (various tests, high = good)
5.1
5.1. Analysis
Comparison 5: COMPUTER‐ASSISTED COGNITIVE REMEDIATION PROGRAMME (CACR) vs COMPUTER GAMES (CG, all short‐term), Outcome 1: Global state ‐ average endpoint score (HoNOSCA, high = good)
5.2
5.2. Analysis
Comparison 5: COMPUTER‐ASSISTED COGNITIVE REMEDIATION PROGRAMME (CACR) vs COMPUTER GAMES (CG, all short‐term), Outcome 2: Mental state: 1a. Overall ‐ average endpoint score (PANSS total, high = poor)
5.3
5.3. Analysis
Comparison 5: COMPUTER‐ASSISTED COGNITIVE REMEDIATION PROGRAMME (CACR) vs COMPUTER GAMES (CG, all short‐term), Outcome 3: Mental state: 1b. Specific: Positive symptoms ‐ average endpoint score (PANSS positive, high = poor)
5.4
5.4. Analysis
Comparison 5: COMPUTER‐ASSISTED COGNITIVE REMEDIATION PROGRAMME (CACR) vs COMPUTER GAMES (CG, all short‐term), Outcome 4: Mental state: 1c. Negative ‐ average endpoint score (PANSS negative, high = poor)
5.5
5.5. Analysis
Comparison 5: COMPUTER‐ASSISTED COGNITIVE REMEDIATION PROGRAMME (CACR) vs COMPUTER GAMES (CG, all short‐term), Outcome 5: Cognitive functioning: average endpoint score (RBANS, high = good)
5.6
5.6. Analysis
Comparison 5: COMPUTER‐ASSISTED COGNITIVE REMEDIATION PROGRAMME (CACR) vs COMPUTER GAMES (CG, all short‐term), Outcome 6: Global functioning: Overall ‐ average endpoint score (SOFAS, high = good)
5.7
5.7. Analysis
Comparison 5: COMPUTER‐ASSISTED COGNITIVE REMEDIATION PROGRAMME (CACR) vs COMPUTER GAMES (CG, all short‐term), Outcome 7: Leaving the study early ‐ for any reason
6.1
6.1. Analysis
Comparison 6: PSYCHOEDUCATIONAL + MULTIFAMILY TREATMENT (PE + MFT) vs NONSTRUCTURED GROUP THERAPY (NSGT, all long‐term), Outcome 1: Global state ‐ average endpoint score (CGAS, high = good)
6.2
6.2. Analysis
Comparison 6: PSYCHOEDUCATIONAL + MULTIFAMILY TREATMENT (PE + MFT) vs NONSTRUCTURED GROUP THERAPY (NSGT, all long‐term), Outcome 2: Mental state: 1a. Overall ‐ average endpoint score (PANSS total, high = poor)
6.3
6.3. Analysis
Comparison 6: PSYCHOEDUCATIONAL + MULTIFAMILY TREATMENT (PE + MFT) vs NONSTRUCTURED GROUP THERAPY (NSGT, all long‐term), Outcome 3: Mental state: 1b. Specific: Positive symptoms ‐ average endpoint score (PANSS positive, high = poor)
6.4
6.4. Analysis
Comparison 6: PSYCHOEDUCATIONAL + MULTIFAMILY TREATMENT (PE + MFT) vs NONSTRUCTURED GROUP THERAPY (NSGT, all long‐term), Outcome 4: Mental state: 1c. Specific: Negative symptoms ‐ average endpoint score (PANSS negative, high = poor)
6.5
6.5. Analysis
Comparison 6: PSYCHOEDUCATIONAL + MULTIFAMILY TREATMENT (PE + MFT) vs NONSTRUCTURED GROUP THERAPY (NSGT, all long‐term), Outcome 5: Service use: 1. Hospital admission: number of participants needing addmission
6.6
6.6. Analysis
Comparison 6: PSYCHOEDUCATIONAL + MULTIFAMILY TREATMENT (PE + MFT) vs NONSTRUCTURED GROUP THERAPY (NSGT, all long‐term), Outcome 6: Service use: 2. Number of days in hospital (high = poor)
6.7
6.7. Analysis
Comparison 6: PSYCHOEDUCATIONAL + MULTIFAMILY TREATMENT (PE + MFT) vs NONSTRUCTURED GROUP THERAPY (NSGT, all long‐term), Outcome 7: Leaving the study early ‐ for any reason
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD009533

References

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    1. 董亚辉, 刘忠, 王丽娟. Children with long-term effects of the condition and quality of life of family support interventions for schizophrenia after the rescue stray [家庭支持干预对救助后流浪精神分裂症患儿远期病情及生活质量影响]. China Journal of Health Psychology [中国健康心理学杂志] 2013;21(11):1714-5.
Edwards 2003 {published data only}
    1. Edwards J, Elkins K, Hinton M, Harrigan S, Donovan K, Athanasopoulos O. Randomized controlled trial of a cannabis-focused intervention versus psychoeducation for young people continuing to use cannabis in the 12 months following entry to treatment for first-episode psychosis. Schizophrenia Research 2004;70(1):61.
    1. Edwards J, Elkins K, Hinton M, Harrigan SM, Donovan K, Athanasopoulos O, et al. Randomized controlled trial of a cannabis-focused intervention for young people with first-episode psychosis. Acta Psychiatrica Scandinavica 2006;114(2):109-17. - PubMed
    1. Edwards J, Maude D, McGorry P, Cocks J, Burnett P, Davern M, et al. Treatment of enduring positive symptoms in first-episode psychosis: a randomised controlled trial of CBT and clozapine. Schizophrenia Research 1999;1-3:278. - PMC - PubMed
    1. Edwards J, Wong L, Burnett P, Harrigan SM, McGorry PD, Wade D, et al. Enduring positive symptoms in first episode psychosis: a randomised controlled trial of clozapine and CBT. Schizophrenia Research 2003;60:321. - PMC - PubMed
    1. Edwards J. Early psychosis service developments: becoming real. In: 3rd International Conference on Early Psychosis; 2002 Sep 25-28; Copenhagen, Denmark. 2002:56.
Farooq 2011 {published data only}
    1. Farooq S, Nazar Z, Irfan M, Akhter J, Gul E, Irfan U, et al. Schizophrenia medication adherence in a resource-poor setting: randomised controlled trial of supervised treatment in out-patients for schizophrenia (STOPS). British Journal of Psychiatry 2011;199(6):467-72. - PubMed
Fisher 2015 {published data only}
    1. Fisher M, Loewy R, Carter C, Lee A, Ragland JD, Niendam T, et al. Neuroplasticity-based auditory training via laptop computer improves cognition in young individuals with recent onset schizophrenia. Schizophrenia Bulletin 2015;41(1):250-8. - PMC - PubMed
Flach 2015 {published data only}
    1. Flach C, French P, Dunn G, Fowler D, Gumley AI, Birchwood M, et al. Components of therapy as mechanisms of change in cognitive therapy for people at risk of psychosis: analysis of the EDIE-2 trial. British Journal of Psychiatry 2015;207(2):123-9. - PubMed
Fohlmann 2010 {published data only}
    1. Fohlmann AH, Hjorthoej C, Larsen A, Nordentoft M. Randomized clinical trial: specialized addiction treatment (MI & CBT) versus treatment as usual for young patients with cannabis abuse and psychosis. Early Intervention in Psychiatry 2010;4(Suppl 1):159.
    1. Fohlmann AH, Hjorthoej C, Larsen A, Nordentoft M. Randomized clinical trial: specialized addiction treatment (MI & CBT) versus treatment as usual for young patients with cannabis abuse and psychosis. Early Intervention in Psychiatry 2010;4(Suppl 1):160.
Fowler 2018 {published data only}
    1. Birchwood M, McCarthy L. Sustaining positive engagement and recovery (SUPERDEN) - the next step after early intervention for psychosis. Study 3: Improving social recovery in young people with emerging severe social disability: a proof of principle randomised controlled trial. public.ukcrn.org.uk (accessed: 26 June 2012).
    1. Fowler D, Hodgekins J, French P, Marshall M, Freemantle N, McCrone P, et al. Social recovery therapy in combination with early intervention services for enhancement of social recovery in patients with first-episode psychosis (SUPEREDEN3): a single-blind, randomised controlled trial. Lancet Psychiatry 2018;5(1):41-50. - PMC - PubMed
    1. ISRCTN61621571. Sustaining positive engagement and recovery (SUPERDEN) - the next step after early intervention for psychosis. Study 3: Improving social recovery in young people with emerging severe social disability: a proof of principle randomised controlled trial. controlled-trials.com/ISRCTN61621571/ (accessed: 26 June 2012).
Gervey 2012 {published data only}
    1. Gervey R, Bedell JR, Parrish A. Supported employment versus paid pre-employment training for persons with psychiatric disabilities: a controlled study (as supplied 2012). Data on file .
Gleeson 2010 {published data only}
    1. ACTRN12605000594628. A pilot study of psychotherapeutic intervention for complex presentations of first-episode psychosis. https://anzctr.org.au/ACTRN12605000594628.aspx (date first received: 5 October 2005).
    1. Alvarez-Jimenez M, Gleeson J, Cotton S, Wade D, Gee D, Pearce T, et al. Duration of untreated psychosis, insight and adherence with cognitive-behavioural therapy in first-episode psychosis. Early Intervention in Psychiatry 2008;2(Suppl 1):A101.
    1. Cotton SM, Gleeson JF, Alvarez-Jimenez M, McGorry PD. Quality of life in patients who have remitted from their first episode of psychosis. Schizophrenia Research 2010;121(1-3):259-65. - PubMed
    1. Gleeson J, Alvarez-Jimenez M, Killackey E, McGorry P. Two year outcomes from the episode ii trial. Early Intervention in Psychiatry 2010;4(Suppl 1):24.
    1. Gleeson J, Cotton S, Alvarez-Jimenez M, Wade D, Gee D, Crisp K, et al. An RCT of relapse prevention therapy for first-episode psychosis patients. Early Intervention in Psychiatry 2008;2(Suppl 1):A20.
Goldsmith 2015b {published data only}
    1. Goldsmith LP, Bentall RP, Dunn G, Lewis SW. Psychological treatments for early psychosis can be beneficial or harmful, depending on the therapeutic alliance: an instrumental variables analysis. Schizophrenia Bulletin 2015;41:S173. - PMC - PubMed
    1. Goldsmith LP, Lewis SW, Dunn G, Bentall RP. Psychological treatments for early psychosis can be beneficial or harmful, depending on the therapeutic alliance: an instrumental variable analysis. Psychological Medicine 2015;45(11):2365-73. - PMC - PubMed
Gonzalez‐Blanch 2015 {published data only}
    1. Gonzalez-Blanch C, Gleeson JF, Koval P, Cotton SM, McGorry PD, Alvarez-Jimenez M. Social functioning trajectories of young first-episode psychosis patients with and without cannabis misuse: a 30-month follow-up study. PLOS One 2015;10(4):e0122404. - PMC - PubMed
Haas 2009 {published data only}
    1. Haas M, Eerdekens M, Kushner S, Singer J, Augustyns I, Quiroz J, et al. Efficacy, safety and tolerability of two dosing regimens in adolescent schizophrenia: double-blind study. British Journal of Psychiatry 2009;194(2):158-64. - PubMed
Hjorthoj 2012 {published data only}
    1. Hjorthoj C, Fohlmann A, Mette Larsen A, Gluud C, Arendt M, Nordentoft M. Capopus - intervention study for cannabis use disorder in psychosis. Early Intervention in Psychiatry 2012;6:28.
Hjorthøj 2013 {published data only}
    1. Hjorthøj CR, Fohlmann A, Larsen AM, Gluud C, Arendt M, Nordentoft M. Specialized psychosocial treatment plus treatment as usual (TAU) versus TAU for patients with cannabis use disorder and psychosis: the CapOpus randomized trial. Psychol Med 2013 Jul;1499-1510. doi(7):10. - PubMed
Jackson 2004 {published data only}
    1. Jackson H, McGorry P, Edwards J, Hulbert C, Henry L, Francey S, et al. Cognitively-oriented psychotherapy for early psychosis (COPE). Preliminary results. British Journal of Psychiatry 1998;172(33):93-100. - PubMed
    1. Jackson H, McGorry P, Edwards J, Hulbert C, Henry L, Harrigan S, et al. A controlled trial of cognitively oriented psychotherapy for early psychosis (COPE) with four-year follow-up readmission data. Psychological Medicine 2005;35(9):1295-306. - PubMed
    1. Jackson H, McGorry P, Edwards J, Hulbert C, Henry L, Harrigan S, et al. A randomised controlled trial of cognitively-orientated psychotherapy for early psychosis (cope) with 5-year follow-up relapse data. Schizophrenia Research 2004;70(1):61.
Jenner 2004 {published data only}
    1. Jenner J, Van De Willige G. Results of integrated treatment (HIT) in early psychoses: a pilot study. Schizophrenia Research 2004;70(1):16.
Kemp 2007 {published data only}
    1. Kemp R, Harris A, Vurel E, Sitharthan T. Stop using stuff: trial of a drug and alcohol intervention for young people with comorbid mental illness and drug and alcohol problems. Australasian Psychiatry 2007;15(6):490-3. - PubMed
Killackey 2014 {published data only}
    1. Killackey E, Allott K, Cotton S, Chinnery G, Jackson H. Baseline to 18 months: main results from a randomized controlled trial of individual placement and support for young people with first-episode psychosis. Early Intervention in Psychiatry 2014;8:152. - PubMed
    1. Killackey E, Allott K, Cotton SM, Chinnery G, Jackson HJ, Baksheev G. The role of neurocognition within a randomised controlled trial of individual placement and support for first-episode psychosis. Schizophrenia Bulletin 2013;39:S264-5.
    1. Killackey E, Allott K, Cotton SM, Jackson H, Scutella R, Tseng YP, et al. A randomized controlled trial of vocational intervention for young people with first-episode psychosis: method. Early Intervention in Psychiatry 2013;7(3):329-37. - PubMed
    1. Killackey E, Jackson H, Allott K, Cotton S. Vocational recovery in first episode psychosis: preliminary results from a large randomised controlled trial of individual placement and support. Schizophrenia Research 2014;153(Suppl 1):S282.
    1. Killackey E, Jackson H, McGorry P. Vocational intervention in a specialist early psychosis service: first results of a pilot randomised controlled trial. Schizophrenia Research 2006;86(Suppl 1):S28-9.
Kommescher 2014 {published data only}
    1. Kommescher M, Wagner M, Putzfeld V, Berning J, Janssen B, Decker P, et al. Coping as a predictor of treatment outcome in people at clinical high risk of psychosis. Early Intervention in Psychiatry 2016;10(1):17-27. - PubMed
Landa 2018 {published data only}
    1. Landa Y, Mueser K, Jacobs M, Jespersen R, Wyka K, Swiderski C, et al. Group and family based cognitive behavioral therapy for youth at risk for psychosis: from research to real-world practice. Early Intervention in Psychiatry 2018;12(Suppl 1):183.
Lang 2014 {published data only}
    1. 郎春英, 李伟丽, 王锋锐, 许小娜. 认知护理干预在儿童精神分裂症记忆损害患儿恢复中的应用. 护理实践与研究 2014;11(7):104-5.
Leclerc 2006 {published data only}
    1. Leclerc C, Gauvin D, Lecomte T. CBT group to maintain and improve relationships and intimacy abilities of young adults with a first psychotic episode - a pilot study. Schizophrenia Research 2006;86(Suppl 1):S138-9.
Li 2014 {published data only}
    1. 李红. 支持性的心里护理干预对首发精神分裂症患者服药依从性的影响. 医学信息 2014;27(7):296.
Li 2015 {published data only}
    1. 李日光, 廖锦仲, 刘永忠, 朱伟芳. 儿童精神分裂症住院患者的临床用药分析与比较. 北方药学 2015;12(1):50.
Linszen 2006 {published data only}
    1. Linszen D, De Haan L, Dingemans P, Lenior R, Van Amelsvoort T, Wouters L. The Amsterdam critical period intervention in the early phase of schizophrenia-like psychoses. Schizophrenia Research 2006;86(Suppl 1):S61.
Loewy 2015 {published data only}
    1. Loewy R, Fisher M, Carter CS, Niendam TA, Daniel Ragland J, Mathalon D, et al. Improved cognition and positive symptoms with targeted auditory processing training in recent-onset schizophrenia: 6-month follow-up. Schizophrenia Bulletin 2015;41:S87.
Mak 2007 {published data only}
    1. Mak GKL, Li FWS, Lee PWH. A pilot study on psychological interventions with Chinese young adults with schizophrenia. Hong Kong Journal of Psychiatry 2007;17(1):17-23.
Marvin 2016 {published data only}
    1. Marvin SE, Miklowitz DJ, O'Brien MP, Cannon TD. Family-focused therapy for individuals at clinical high risk for psychosis: treatment fidelity within a multisite randomized trial. Early Intervention in Psychiatry 2016;10(2):137-43. - PMC - PubMed
    1. Marvin SE, Miklowitz DJ, O'Brien MP, Cannon TD. Treatment fidelity and differentiation in a randomized controlled trial of family-focused therapy for youth at clinical high risk of psychosis. Early Intervention in Psychiatry 2012;6:95. - PMC - PubMed
Mathai 2004 {published data only}
    1. Mathai J, Bourne A. Pilot study investigating the effect of intercessory prayer in the treatment of child psychiatric disorders. Australasian Psychiatry 2004;12(4):386-9. - PubMed
McFarlane 2015 {published data only}
    1. McFarlane WR, Levin B, Travis L, Lucas FL, Lynch S, Verdi M, et al. Clinical and functional outcomes after 2 years in the early detection and intervention for the prevention of psychosis multisite effectiveness trial. Schizophrenia Bulletin 2015;41(1):30-43. - PMC - PubMed
McGorry 2007 {published data only}
    1. McGorry PD, Phillips LJ, Nelson B, Leicester S, Baker K, Krstev H, et al. A double blind, placebo-controlled randomized trial of low-dose risperidone, cognitive-behaviour therapy, and befriending in young people with subthreshold symptoms at incipient risk of psychotic disorder: six month outcome data. Schizophrenia Bulletin 2007;33(2):446.
    1. Nelson B, Phillips LJ, Yung AR, Francey SM, Leicester S, Baker K, et al. A double blind, placebo-controlled randomized trial of low-dose risperidone, intensive psychological treatment and supportive therapy in young people with subthreshold symptoms at incipient risk of psychotic disorder: baseline characteristics of the sample. Schizophrenia Bulletin 2007;33(2):450.
Meister 2010 {published data only}
    1. Meister K, Rietschel L, Burlon M, Jannsen H, Bock T, Wegscheider K, et al. A cluster-randomized, parallel group, observer blind trial of a group based motivational-behavioural therapy for young people with psychosis and substance use disorder. Early Intervention in Psychiatry 2010;4(Suppl 1):163.
Miklowitz 2014 {published data only}21449
    1. Miklowitz DJ, O'Brien MP, Schlosser DA, Addington J, Candan KA, Marshall C, et al. Family-focused treatment for adolescents and young adults at high risk for psychosis: results of a randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry 2014;53(8):848-58. [CSZG: 29019] - PMC - PubMed
Naslund 2015 {published data only}
    1. Naslund JA, Aschbrenner KA, Scherer EA, Pratt SI, Wolfe RS, Bartels SJ. Lifestyle intervention for people with severe obesity and serious mental illness. American Journal of Preventive Medicine 2016;50(2):145-53. - PMC - PubMed
NCT000003879 {published data only}
    1. NCT00000387. Self-management therapy for youth with schizophrenia. clinicaltrials.gov/ (date first received: 2 November 1999).
NCT00358709 {published data only}
    1. Beauchamp MC, Lecomte T, Lecomte C, Leclerc C, Corbiare M. Do personality traits matter when choosing a group therapy for early psychosis. Psychology and Psychotherapy 2013;86(1):19-32. - PubMed
    1. Beauchamp MC, Lecomte T, Lecomte C, Leclerc C, Corbiere M. Personality traits in early psychosis: relationship with symptom and coping treatment outcomes. Early Intervention in Psychiatry 2011;5(1):33-40. - PubMed
    1. Lecomte T, Leclerc C, Corbiere M, Wykes T, Wallace CJ, Spidel A. Group cognitive behavior therapy or social skills training for individuals with a recent onset of psychosis? Results of a randomized controlled trial. Journal of Nervous and Mental Disease 2008;196(12):866-75. - PubMed
    1. Lecomte T, Leclerc C, Wykes T, Spidel A. Group CBT for early psychosis - are there still benefits 1 year later? Early Intervention in Psychiatry 2010;4(Suppl 1):150.
    1. Lecomte T, Leclerc C, Wykes T, Wallace CJ, Spidel A, Corbiere M. Group CBT vs skills training for first episodes of psychosis - results of a RCT. Schizophrenia Research 2006;86(Suppl 1):S45-6.
NCT00980252 {published data only}
    1. NCT00980252. Medication adherence in schizophrenia: development of a CBT-based intervention. www.ClinicalTrials.gov/ct/show/ (date first received: 21 September 2009).
NCT03161249 {published data only}
    1. Arango C, Mayoral M. Long-term effects of an intervention for adolescents with early onset psychosis and their families. The PIENSA program. Early Intervention in Psychiatry 2018;12(Suppl 1):41.
    1. NCT03161249. Psychoeducative treatment of FEP with mobile training. ClinicalTrials.gov/show/NCT03161249 (date first received: 19 May 2017).
NCT03630471 {published data only}
    1. NCT03630471. Effectiveness of a problem-solving intervention for common adolescent mental health problems in India. ClinicalTrials.gov/show/NCT03630471 (date first received: 14 August 2018).
Newton 2005 {published data only}
    1. Newton E, Landau S, Smith P, Monks P, Shergill S, Wykes T. Early psychological intervention for auditory hallucinations: an exploratory study of young people's voices groups. Journal of Nervous and Mental Disease 2005;193(1):58-61. - PubMed
Nina 2018 {published data only}
    1. Nina TW, Miriam G, Sibylle M, Yolanda F, Susanne W, Maurizia F. A prospective follow-up intervention study of the combined treatment approach "robin" (standardized treatment manual combined with a smartphone application) for adolescents at high risk for developing a psychotic disorder. Early Intervention in Psychiatry 2018;12(Suppl 1):179.
Ostergaard 2014 {published data only}
    1. Ostergaard Christensen T, Vesterager L, Krarup G, Olsen BB, Melau M, Gluud C, et al. Cognitive remediation combined with an early intervention service in first episode psychosis. Acta Psychiatrica Scandinavica 2014;130(4):300-10. - PubMed
    1. Vesterager L, Christensen TO, Olsen BB, Krarup G, Melau M, Gluud C, et al. A randomised, controlled trial of computer-assisted cognitive training combined with a psychosocial treatment programme for young adults with first episode schizophrenia. Early Intervention in Psychiatry 2010;4(Suppl 1):79.
Piskulic 2015 {published data only}
    1. Piskulic D, Barbato M, Liu L, Addington J. Pilot study of cognitive remediation therapy on cognition in young people at clinical high risk of psychosis. Psychiatry Research 2015;225(1-2):93-8. - PubMed
Power 2003 {published data only}
    1. Power P, Bell R, Mills R, Herrmann-Doig T, Davern M, Henry L, et al. A randomized controlled trial of suicide prevention therapy for young people with first episode psychosis. In: 2nd International Conference on Early Psychosis; 2000 Mar 31 - Apr 2; New York, New York, USA. 2000.
    1. Power P, Bell R, Mills R, Herrmann-Doig T, Davern M, Yuen H, et al. A randomized controlled trial of a suicide preventative cognitive oriented psychotherapy for suicidal young pople with first episode psychosis. Schizophrenia Research 1999;36(1-3):332.
    1. Power PJ, Bell RJ, Mills R, Herrman-Doig T, Davern M, Henry L, et al. Suicide prevention in first episode psychosis: the development of a randomised controlled trial of cognitive therapy for acutely suicidal patients with early psychosis. Australian and New Zealand Journal of Psychiatry 2003;37(4):414-20. - PubMed
Power 2004 {published data only}
    1. Craig T, Garety P, Power P, Rahaman N, Colbert S, Fornells-Ambrojo M. Lambeth early onset service: a randomised controlled trial. Schizophrenia Research 2004;70(1):145-6. - PMC - PubMed
    1. Craig TKJ, Garety P, Power P, Rahaman N, Colbert S, Fornells-Ambrojo M, et al. The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. British Medical Journal 2004;329(7474):1067-70. - PMC - PubMed
    1. Craig TKJ. Brixton early psychosis project. National Research Register 2000.
    1. Garety PA, Craig TKJ, Dunn G, Fornells-Ambrojo M, Colbert S, Rahaman N, et al. "Specialised care for early psychosis: symptoms, social functioning and patient satisfaction: randomised controlled trial" corrigenda. British Journal of Psychiatry 2006;188(3):295. - PubMed
    1. Garety PA, Craig TKJ, Dunn G, Fornells-Ambrojo M, Colbert S, Rahaman N, et al. Specialised care for early psychosis: symptoms, social functioning and patient satisfaction: randomised controlled trial. British Journal of Psychiatry 2006;188(1):37-45. - PubMed
Rosenbaum 2002 {published data only}
    1. Rosenbaum B, Valbak K, Harder S, Knudsen P, Koster A, Lajer M, et al. The Danish National Schizophrenia Project: prospective, comparative longitudinal treatment study of first-episode psychosis. British Journal of Psychiatry 2005;186:394-9. - PubMed
    1. Rosenbaum B, Valbak K, Lajer M, Harder S, Knudsen P, Køster A, et al. The Danish National Schizophrenia Project: background, design and baseline data. In: 3rd International Conference on Early Psychosis; 2002 Sep 25-28; Copenhagen, Denmark. 2002:65.
Schepp 2009 {published data only}
    1. Schepp KG, Kim H. Measuring cognitive processing ability in adolescents with schizophrenia. Communicating Nursing Research 2010;43:261.
    1. Schepp KG, Lee H. Enhancing treatment fidelity in an RCT with families. Communicating Nursing Research 2010;43:296.
    1. Schepp KG, Lee H. Multifamily group psychoeducation treatment for mentally ill youth. Communicating Nursing Research 2009;42:289.
Secher 2015 {published data only}
    1. Bertelsen M. Randomized controlled trial of two years integrated treatment versus standard treatment of patients with first-episode of schizophrenia or psychosis, five years follow-up. The Opus trial. Schizophrenia Bulletin 2005;31:519-20.
    1. Secher RG, Hjorthoj CR, Austin SF, Thorup A, Jeppesen P, Mors O, et al. Ten-year follow-up of the OPUS specialized early intervention trial for patients with a first episode of psychosis. Schizophrenia Bulletin 2015;41(3):617-26. - PMC - PubMed
Shahrivar 2012 {published data only}
    1. Shahrivar Z, Alaghband-Rad J, Gharaie JM, Seddigh A, Salesian N, Roodsari MJ, et al. The efficacy of an integrated treatment in comparison with treatment as usual in a group of children and adolescents with first-episode psychosis during a two-year follow-up. Iranian Journal of Psychiatry and Clinical Psychology 2012;18(2):124-7.
    1. Shahrivar Z, Alaghband-Rad J, Mahmoudi Gharaie J, Seddigh A, Salesian N, Jalali Roodsari M, et al. The efficacy of an integrated treatment in comparison with treatment as usual in a group of youths with first-episode psychosis. Neuropsychiatrie de L'Enfance et de L'Adolescence 2012;60:S284-5.
    1. Shahrivar Z, Alaghband-Rad J, Mahmoudi-Gharaei J, Sharifi V, Amini H, Roudsari MJ, et al. Integrated standard program in comparison to the usual treatment in adolescents with first episode psychosis: a randomized clinical trial. Early Intervention in Psychiatry 2010;4(Suppl 1):143.
Stain 2006 {published data only}
    1. Stain HJ, Startup M, Carr V, Baker A, Schall U. The depth project: a multisite RCT for youths at risk for psychosis. Schizophrenia Research 2006;86(Suppl 1):S51-2.
Staring 2010 {published data only}
    1. Staring AB, Van der Gaag M, Koopmans GT, Selten JP, Van Beveren JM, Hengeveld MW, et al. Treatment adherence therapy in people with psychotic disorders: randomised controlled trial. British Journal of Psychiatry 2010;197:448-55. - PubMed
Teasdale 2016 {published data only}
    1. ACTRN12613001217796. Keeping the Body Mind: A lifestyle intervention for young people with first episode psychosis. https://apps.who.int/trialsearch/Trial.aspx?TrialID = ACTRN12613001217796 (date first received: 5 November 2013).
    1. Teasdale SB, Ward PB, Rosenbaum S, Watkins A, Curtis J, Kalucy M, et al. A nutrition intervention is effective in improving dietary components linked to cardiometabolic risk in youth with first-episode psychosis. British Journal of Nutrition 2016;115(11):1987-93. - PubMed
Thorup 2013 {published data only}
    1. Thorup A, Albert N, Bertelsen M, Petersen L, Jeppesen P, Le Quack P, et al. Gender differences in first-episode psychosis at 5-year follow-up - two different courses of disease? Results from the OPUS study at 5-year follow-up. European Psychiatry 2013;29(1):44-51. - PubMed
    1. Thorup A, Albert N, Mette B, Petersen L, Jeppesen P, Le Quarck P, et al. Gender differences in first episode psychosis at 5-year follow-up: two different courses of disease? European Archives of Psychiatry and Clinical Neuroscience 2013;263(Suppl 1):S62. - PubMed
    1. Thorup A. Gender differences in first-episode psychosis at five-year followup - results from the Danish OPUS study gender differences have been found. Early Intervention in Psychiatry 2010;4(Suppl 1):53.
Van Duin 2018 {published data only}
    1. Van Duin D, Kroon H, Veling W, Van Weeghel J. Does cognitive remediation enhance the vocational recovery of young people with first episode psychosis using individual placement and support? Results of the CREW study: a multisite randomized controlled trial in the Netherlands. Early Intervention in Psychiatry 2018;12(Suppl 1):17.
Van Nimwegen 2006 {published data only}
    1. Van Nimwegen L, De Haan L, Van Beveren N, Laan W, Van de Brink W, Linszen D. Obsessive compulsive symptoms in a randomized double blind study with olanzapine or risperidone in young patients with recent-onset schizophrenia or related disorders. In: 13th Biennial Winter Workshop on Schizophrenia; 2006 Feb 6-10; Davos, Switzerland. 2006.
    1. Van Nimwegen L, De Haan L, Van Beveren N, Laan W, Van den Brink W, Linszen D. Obsessive-compulsive symptoms in a randomized, double-blind study with olanzapine or risperidone in young patients with early psychosis. Journal of Clinical Psychopharmacology 2008;28(2):214-8. - PubMed
    1. Van Nimwegen L, De Haan L. Early withdrawal in a double-blind randomized clinical trial with olanzapine and risperidone performed in adolescents with first psychosis. Psychopathology 2006;39(3):158. - PubMed
Velden‐Hegelstad 2014 {published data only}
    1. Velden-Hegelstad WT, Langeveld J, Heitmann L, Joa I, Johannessen JO. JobPrescription: a Scandinavian initiative to optimize work and study engagement or young people with first-episode psychosis. Early Intervention in Psychiatry 2014;8:122.
Wang 2007 {published data only}
    1. Wang H. A controlled study of quetiapine and risperidone in the treatment of children with schizophrenia [奎硫平和利培酮治疗儿童精神分裂症对照研究]. Linchuang Jingshen Yixue Zazhi [临床精神医学杂志] 2007;17(3):199-200.
Wang 2014 {published data only}
    1. 王松烨, 朱玉星, 魏炜. Effect of humanistic care combined with tender nursing intervention in the nursing of children with schizophrenia. [人文关怀联合温情护理干预在儿童精神分裂患儿护理中应用的效果分析]. 中国伤残医学 2014;22(22):210-2.
Wei 2014 {published data only}
    1. 韦红梅, 肖爱祥, 夏志春, 杨航, 黄昭君, 魏福银, et al. Effect of cognitive self-knowledge education on nursing outcomes of patients with schizophrenia [认知自知力教育对精神分裂症患者护理结局的影响]. 国际护理学杂志 2014;33(5):1140-2.
Williams 2005 {published data only}
    1. Williams S. Effectiveness trial of systematic psychosocial interventions in early psychosis. National Research Register 2005;4.

References to studies awaiting assessment

Alaghband‐rad 2006 {published data only}
    1. Alaghband-rad J, Shahrivar Z, Mahmoodi J, Salesian N. First episode psychoses among Iranian adolescents. Schizophrenia Research 2006;86(Suppl 1):S65.
    1. Alaghband-rad J, Sharifi V, Amini H, Shahrivar Z, Mottaghipour Y, Mahmoodi J, et al. Management of first episode psychoses in Iran: unique features and challenges. Schizophrenia Research 2006;86(Suppl 1):S42.
NCT00465920 {published data only}
    1. Bechdolf A, Tecic T, Lehmkuhl G, Walger P, Mueller K, Wiedemann G, et al. Cognitive behavior therapy in adolescents with persistent psychotic symptoms: Results of randomised controlled trial. European Archives of Psychiatry and Clinical Neuroscience 2011;261:S14.
    1. NCT00465920. Development and pilot evaluation of modified cognitive behavioural therapy for adolescents with early onset psychosis. https://clinicaltrials.gov/ct2/show/NCT00465920 [Date Accessed: 27 April 2007].
    1. Tecic T, Guttgemanns J, Lehmkuhl G, Mueller K, Stoesser D, Wiedemann G, et al. Modified cognitive behavioral therapy in adolescents with persistent psychotic symptoms-results of a randomized controlled trial. Schizophrenia Research 2012;136:S302.
Sikich 2013 {published data only}
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References to ongoing studies

ACTRN12607000608460 {published data only}
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ISRCTN02672532 {published data only}
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ISRCTN82129964 {published data only}
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NCT00722163 {published data only}
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NCT01027962 {published data only}
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NCT01731977 {published data only}
    1. NCT01731977. Strengths-based family psychoeducation for youth psychosis. http://ClinicalTrials.gov/show/NCT01731977 [Date Accessed: 22 November 2012].
NCT02097563 {published data only}
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NCT02101372 {published data only}
    1. NCT02101372. Gene and Environment in Schizophrenia- Research Groups in Madrid. http://Clinicaltrials.gov/show/NCT02101372 [Date Accessed: 2 April 2014].
NCT02674932 {published data only}
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NCT03261557 {published data only}
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Nelson 2017 {published data only}
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