Disorders - Psychosis Disorders
Zhao, J., Chen, D. Y., Li, X. B., Xi, Y. J., Verma, S., Zhou, F.
C., Wang, C. Y.
BACKGROUND: Post-traumatic stress disorder (PTSD) is highly
prevalent in the individuals at clinical-high risk for psychosis (CHR). The aim of this study was to examine the efficacy and safety of Eye Movement
Desensitization and Reprocessing (EMDR) in individuals at CHR with comorbid PTSD or subthreshold PTSD in a randomized controlled trial.\rMETHODS:
Fifty-seven individuals at CHR with PTSD or subthreshold PTSD formed the study sample. The eligible participants were randomly assigned to a 12 weeks
EMDR treatment (N = 28) or a waiting list condition (WL, N = 29). The structured interview for psychosis risk syndrome (SIPS), the clinician
administered post-traumatic stress disorder scale (CAPS) and a battery of self-rating inventories covering depressive, anxiety and suicidal symptoms
were administered.\rRESULTS: Twenty-six participants in the EMDR group and all the participants in the WL group completed the study. The analyses of
covariance revealed greater reduction of the mean scores on CAPS (F = 23.2, Partial eta2 = 0.3, P < 0.001), SIPS positive scales (F =
17.8, Partial eta2 = 0.25, P < 0.001) and all the self-rating inventories in the EMDR group than in the WL group. Participants in the EMDR
group were more likely to achieve remission of CHR compared to those in the WL group at endpoint (60.7 % vs. 31 %, P = 0.025).\rCONCLUSIONS: EMDR
treatment not only effectively improved traumatic symptoms, but also significantly reduced the attenuated psychotic symptoms and resulted in a higher
remission rate of CHR. This study highlighted the necessity of adding a trauma-focused component to the present approach of early intervention in
psychosis.
, 256 : 1-
7
- Year: 2023
- Problem: Post Traumatic Stress Disorder, Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Eye movement desensitisation and reprocessing (EMDR)
Zhang, Z. J, Lo, H. H.
M, Ng, S. M, Mak, W. W. SWong, S. Y. S, Hung, K. S. Y, Lo, C. S. L, Wong, J. O. Y, Lui, S. S. Y, Lin, E, Siu, C.
M. W, Yan, E. W. C, Chan, S. H. W, Yip,
A, Poon, M. F, Wong, G. O. C, Mak, J. W. H, Tam, H. S. W, Tse, I. H. H, Leung, B. F. H.
OBJECTIVE: In this study, we investigated the effects of a mindfulness-based family psychoeducation (MBFPE) program on the mental-health
outcomes of both caregivers and young adults with first-episode psychosis with an onset in the past three years through a multi-site randomized
controlled trial. We also studied the outcomes of three potential mediating effects of interpersonal mindfulness, expressed emotions, and non-
attachment on the program.\rMETHOD: We randomly assigned 65 caregivers of young adults with psychosis to MBFPE (n = 33) or an ordinary family
psychoeducation (FPE) program (n = 32); among them, 18 young adults in recovery also participated in the evaluation of outcomes.\rRESULTS: Intent-
to-treat analyses were conducted. No significant time x group interaction effects of MBFPE and FPE programs were found in any of the caregivers'
outcomes. However, the young adults with psychosis reported higher levels of recovery after the MBFPE program than after the ordinary FPE program (F
= 8.268, p = 0.012, d = 1.484). They also reported a larger reduction in over-involvement of their caregivers (F = 4.846, p = 0.044, d = 1.136),
showing that MBFPE had a superior effect to FPE in promoting recovery and reducing over-involvement.\rCONCLUSIONS: A brief psychoeducation program
may not reduce the burden on or improve the mental-health outcome of caregivers of individuals with recent-onset psychosis. However, integrating
mindfulness into a conventional family psychoeducation program may reduce the expressed emotions of caregivers, especially over-involvement. Further
studies should explore how psychoeducation programs can reduce the impact of psychosis on family through sustainable effects in terms of reducing
their burden and expressed emotions, using a rigorous study and adequate sample size.
International Journal of Environmental Research & Public Health [Electronic
Resource], 20(2) : 05
- Year: 2023
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions, Mindfulness based
therapy
Xiao, J.
Background. Mania is one
of the common diseases in psychiatric department. With the accelerating pace of life, people are facing more and more pressure. Mental disorders and
mentally ill patients are also increasing, especially in the student group. Patients with mania may have clinical symptoms such as self-talk and
exaggerated actions, and depression. Seriou's mania has a great impact on students' life and mental state. In schools, teachers are more required
to carry out correct ideological education and psychological counseling for students. Therefore, the research is conducted from the ideological
education of college teachers and staff to improve students or treat students' mania symptoms. Subjects and Methods. 108 manic patients were
selected from 3 colleges and universities to participate in the designed manic intervention experiment. In the experiment, the subjects were divided
into experimental group and control group. The control group was treated with routine relaxation training; The experimental group was treated with
ideological education and regular relaxation training. The results were reflected by the Bech Rafaelsdn Mania Rating Scale (BRMS), Hamilton Anxiety
Scale, and Depression Scale. Results. Table 1 shows the results of manic scale scores in the intervention experiment. In Table 1, the BRMS score of
the control group decreased from 25.46 before the experiment to 18.25, with a decrease of 7.21 points; The BRMS score of the experimental group
decreased from 24.53 before the experiment to 12.15, a decrease of 12.38 points. Conclusions. Through the ideological education of college teachers
and staff, the research conducted intervention treatment on students' mania, and compared the decline trend of the scores of the two groups. The
decline trend of the experimental group was more obvious. The method adopted by the experimental group was more effective in the treatment of
students' mania. It shows that the ideological education of teaching staff plays an important role in the mental health of students. Colleges and
universities should give full play to the role of ideological education to ensure the mental health of students.
CNS Spectrums, 28(Supplement
1) : S30-S31
- Year: 2023
- Problem: Psychosis Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions, Relaxation
Wykes,
T, Stringer, D, Boadu,
J, Tinch-Taylor, R, Csipke, E, Cella, M, Pickles, A, McCrone, P, Reeder, C, Birchwood, M, Fowler, D, Greenwood, K, Johnson, S, Perez, J, Ritunnano,
R, Thompson, A, Upthegrove, R, Wilson, J, Kenny, A, Isok, I, Joyce, E. M.
BACKGROUND AND HYPOTHESIS:
Cognitive remediation (CR) benefits cognition and functioning in psychosis but we do not know the optimal level of therapist contact, so we evaluated
the potential benefits of different CR modes.\rSTUDY DESIGN: A multi-arm, multi-center, single-blinded, adaptive trial of therapist-supported CR.
Participants from 11 NHS early intervention psychosis services were independently randomized to Independent, Group, One-to-One, or Treatment-as-usual
(TAU). The primary outcome was functional recovery (Goal Attainment Scale [GAS]) at 15-weeks post randomization. Independent and TAU arms were closed
after an interim analysis, and three informative contrasts tested (Group vs One-to-One, Independent vs TAU, Group + One-to-One vs TAU). Health
economic analyses considered the cost per Quality Adjusted Life Year (QALY). All analyses used intention-to-treat principles.\rSTUDY RESULTS: We
analyzed 377 participants (65 Independent, 134 Group, 112 One-to-One, 66 TAU). GAS did not differ for Group vs One-to-One: Cohen's d: 0.07, -0.25 to
0.40 95% CI, P = .655; Independent vs TAU: Cohen's d: 0.07, -0.41 to 0.55 95% CI, P = .777. GAS and the cognitive score improved for Group + One-
to-One vs TAU favoring CR (GAS: Cohen's d: 0.57, 0.19-0.96 95% CI, P = .003; Cognitive score: Cohens d: 0.28, 0.07-0.48 95% CI, P = .008). The QALY
costs were 4306 for Group vs TAU and 3170 for One-to-One vs TAU. Adverse events did not differ between treatment methods and no serious adverse
events were related to treatment.\rCONCLUSIONS: Both active therapist methods provided cost-effective treatment benefiting functional recovery in
early psychosis and should be adopted within services. Some individuals benefited more than others so needs further investigation.\rTRIAL
REGISTRATION: ISRCTN14678860 https://doi.org/10.1186/ISRCTN14678860Now closed.
, 49(3) : 614-625
- Year: 2023
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive remediation
therapy, Technology, interventions delivered using technology (e.g. online, SMS), Other service delivery and improvement
interventions
Winter-van-Rossum, I, Weiser, M, Galderisi, S, Leucht, S, Bitter, I, Glenthoj, B, Hasan, A, Luykx, J, Kupchik, M, Psota, G, Rocca,
P, Stefanis, N, Teitelbaum, A, Bar- Haim, M, Leucht, C, Kemmler, G, Schurr, T, Davidson, M, Kahn, R. S, Fleischhacker, W. W.
BACKGROUND: Schizophrenia is a severe psychiatric disorder with periods of remission and relapse.
As discontinuation of antipsychotic medication is the most important reason for relapse, long-term maintenance treatment is key. Whether
intramuscular long-acting (depot) antipsychotics are more efficacious than oral medication in preventing medication discontinuation is still
unresolved. We aimed to compare time to all-cause discontinuation in patients randomly allocated to long-acting injectable (LAI) versus oral
medication.\rMETHODS: EULAST was a pragmatic, randomised, open-label trial conducted at 50 general hospitals and psychiatric specialty clinics in 15
European countries and Israel. Patients aged 18 years and older, with DSM-IV schizophrenia (as confirmed by the Mini International Neuropsychiatric
Interview 5 plus) and having experienced their first psychotic episode from 6 months to 7 years before screening, were randomly allocated (1:1:1:1)
using block randomisation to LAI paliperidone, LAI aripiprazole, or the respective oral formulations of these antipsychotics. Randomisation was
stratified by country and duration of illness (6 months up to 3 years vs 4 to 7 years). Patients were followed up for up to 19 months. The primary
endpoint was discontinuation, regardless of the reason, during 19 months of treatment. We used survival analysis to assess the time until all-cause
discontinuation in the intention-to-treat (ITT) group, and per protocol analyses were also done. This trial is registered with ClinicalTrials.gov,
NCT02146547, and is complete.\rFINDINGS: Between Feb 24, 2015, and Dec 15, 2018, 533 individuals were recruited and assessed for eligibility. The ITT
population included 511 participants, with 171 (33%) women and 340 (67%) men, and a mean age of 30.5 (SD 9.6) years. 410 (80%) of 511 participants
were White, 35 (7%) were Black, 20 (4%) were Asian, and 46 (9%) were other ethnicity. In the combined oral antipsychotics treatment group of 247
patients, 72 (29%) patients completed the study and 175 (71%) met all-cause discontinuation criteria. In the combined LAI treatment arm of 264
patients, 95 (36%) completed the study and 169 (64%) met the all-cause discontinuation criteria. Cox regression analyses showed that treatment
discontinuation for any cause did not differ between the two combined treatment groups (hazard ration [HR] 1.16, 95% CI 0.94-1.43, p=0.18). No
significant difference was found in the time to all-cause discontinuation between the combined oral and combined LAI treatment groups (log rank test
chi2=1.87 [df 1]; p=0.17). During the study, 121 psychiatric hospitalisations occurred in 103 patients, and one patient from each of the
LAI groups died; the death of the patient assigned to paliperidone was assessed to be unrelated to the medication, but the cause of other patient's
death was not shared with the study team. 86 (25%) of 350 participants with available data met akathisia criteria and 70 (20%) met parkinsonism
criteria at some point during the study.\rINTERPRETATION: We found no substantial advantage for LAI antipsychotic treatment over oral treatment
regarding time to discontinuation in patients with early-phase schizophrenia, indicating that there is no reason to prescribe LAIs instead of oral
antipsychotics if the goal is to prevent discontinuation of antipsychotic medication in daily clinical practice.\rFUNDING: Lundbeck and Otsuka.
The Lancet. Psychiatry, 10(3) : 197-
208
- Year: 2023
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Other service delivery and improvement
interventions
Weintraub, M. J., Denenny, D., Ichinose, M. C., Zinberg, J., Morgan-Fleming, G., Done, M., Brown, R. D., Bearden, C. E., Miklowitz, D. J.
OBJECTIVES: There is substantial evidence that cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT)
improve symptoms and functioning in adults with mood and psychotic disorders. There has been little work directly comparing these treatments among
adolescents with early-onset mood or psychosis symptoms.\rMETHOD: We conducted a randomized controlled trial comparing remotely administered group
CBT to group MBCT for adolescents (ages 13-17) with a mood disorder or attenuated psychosis symptoms. Adolescents attended nine sessions over 2
months; their parents attended parallel groups focused on the same skill practices. Participants were assessed for psychiatric symptoms and
functioning at posttreatment and 3 months posttreatment.\rRESULTS: Sixty-six youth (Mage = 15.1 years, SD = 1.4; 44 females [66.7%])
initiated the trial (32 in CBT and 34 in MBCT), with 54 retained at posttreatment and 53 at the 3-month follow-up. The treatments were associated
with comparable improvements in adolescents' mood, anxiety, attenuated psychosis symptoms, and psychosocial functioning over 5 months. CBT was
associated with greater improvements than MBCT in emotion regulation and well-being during the posttreatment period. MBCT (compared to CBT) was
associated with greater improvements in social functioning among adolescents with greater childhood adversity. Both treatments had comparable rates
of retention, but youth and parents reported more satisfaction with CBT than MBCT.\rCONCLUSIONS: The beneficial effect of both treatments in a group
telehealth format is encouraging. Due to our limited sample, future research should investigate whether adolescents' history of adversity and
treatment preferences replicate as treatment moderators for youth with mood or psychosis symptoms. (PsycInfo Database Record (c) 2023 APA, all rights
reserved).
Journal
of Consulting & Clinical Psychology, 91(4) : 234-241
- Year: 2023
- Problem: Anxiety Disorders (any), Bipolar Disorders, Depressive Disorders, Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Mindfulness based
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Wang, C, Tishler, T. A, Oughourlian, T, Nuechterlein, K. H, de-la-Fuente-Sandoval, C, Ellingson, B. M.
Widespread
anatomical alterations and abnormal functional connectivity have shown strong association with symptom severity in first-episode schizophrenia (FES)
patients. Second-generation antipsychotic treatment might slow disease progression and possibly modify the cerebral plasticity in FES patients.
However, whether a long-acting injectable antipsychotic (paliperidone palmitate [PP]), available in monthly and every-3-months formulations, is more
effective than oral antipsychotics (OAP) in improving cerebral organization has been unclear. Therefore, in the current longitudinal study, we
evaluated the differences in functional and microstructural changes of 68 FES patients in a randomized clinical trial of PP vs OAP. When compared to
OAP treatment, PP treatment was more effective in decreasing abnormally high fronto-temporal and thalamo-temporal connectivity, as well as increasing
fronto-sensorimotor and thalamo-insular connectivity. Consistent with previous studies, multiple white matter pathways showed larger changes in
fractional anisotropy (FA) and mean diffusivity (MD) in response to PP compared with OAP treatment. These findings suggest that PP treatment might
reduce regional abnormalities and improve cerebral connectivity networks compared with OAP treatment, and identified changes that may serve as
reliable imaging biomarkers associated with medication treatment efficacy.
, 255 : 222-232
- Year: 2023
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Other service delivery and improvement
interventions
Venkataraman, S, Hazan,
H, Musket, C, Ferrara, M, Shah, J, Levine, N, Li, F, Keshavan, M. S, Srihari, V. H.
Aims: A prolonged duration of untreated psychosis (DUP) is predictive of poor outcomes in
first-episode psychosis and is often linked with low socioeconomic status. The aim of this study is to determine if this known association between
low SES as determined based on monthly personal income (PI), and longer DUP can be reduced via early detection (ED) campaign. Method(s): Data were
collected between 2015 and 2019 during a nonrandomized controlled trial conducted at two clinics of first episodes of psychosis (FES) in (n = 147) or
outside (n = 75) an ED campaign. Multiple regressions were performed to determine the predictors of DUP, and hierarchical regression was performed to
determine whether PI predicted DUP beyond the effects the age, race, and ED. A general linear model was performed to test differences in DUP/ PI
slope between groups. Result(s): A longer DUP was associated with lower PI. Age, black race, and ED significantly predicted DUP. PI significantly
added to the prediction of DUP explaining 3.2% of its variability after accounting for age, race, and ED. The ED campaign moderated the association
between monthly PI and DUP after accounting for age and race, such that for every $1000 increase in PI there was a DUP reduction of ~89 days at the
no-ED site vs ~120 days at the ED site. Conclusion(s): ED campaign can reduce inequalities in access to health care by potentially reducing DUP for
low-income populations.
Early Intervention in Psychiatry, 17(Supplement
1) : 80
- Year: 2023
- Problem: Psychosis Disorders
- Type: Controlled clinical trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Tang, Y, Xu, L, Zhu, T, Cui, H, Qian, Z, Kong, G, Tang, X, Wei, Y, Zhang, T, Hu,
Y, Sheng, J, Wang, J.
BACKGROUND
AND HYPOTHESIS: Cognitive deficits in visuospatial learning (VSL) are highly associated with an increased risk of developing psychosis among
populations with clinical high risk (CHR) for psychosis. Early interventions targeting VSL enhancement are warranted in CHR but remain rudimentary.
We investigated whether personalized transcranial magnetic stimulation (TMS) over the left parieto-hippocampal network could improve VSL performance
in CHR patients and if it could reduce the risk of psychosis conversion within 1 year.\rSTUDY DESIGN: Sixty-five CHR patients were randomized to
receive active or sham TMS treatments using an accelerated TMS protocol, consisting of 10 sessions of 20 Hz TMS treatments within 2 days. TMS target
was defined by individual parieto-hippocampal functional connectivity and precisely localized by individual structural magnetic resonance imaging.
VSL performance was measured using Brief Visuospatial Memory Test-Revised included in measurement and treatment research to improve cognition in
schizophrenia consensus cognitive battery (MCCB). Fifty-eight CHR patients completed the TMS treatments and MCCB assessments and were included in the
data analysis.\rSTUDY RESULTS: We observed significant VSL improvements in the active TMS subgroup (Cohen's d = 0.71, P < .001) but not in the sham
TMS subgroup (Cohen's d = 0.07, P = .70). In addition, active TMS improved the precision of VSL performance. At a 1-year follow-up, CHR patients who
received active TMS showed a lower psychosis conversion rate than those who received sham TMS (6.7% vs 28.0%, chi2 = 4.45, P = .03).\rCONCLUSIONS:
Our findings demonstrate that personalized TMS in the left parieto-hippocampal network may be a promising preventive intervention that improves VSL
in CHR patients and reduces the risk of psychosis conversion at follow-up.
, 49(4) : 923-932
- Year: 2023
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Transcranial magnetic stimulation
(TMS)
Staines, L., Healy, C., Corcoran, P., Keeley, H., Coughlan, H., McMahon, E., Cotter, P., Cotter, D., Kelleher, I., Wasserman, C., Brunner, R., Kaess, M., Sarchiapone, M., Hoven, C. W., Carli, V., Wasserman,
D., Cannon, M.
INTRODUCTION: Psychotic experiences (PEs) are associated with increased risk of later mental disorders and so could
be valuable in prevention studies. However, to date few intervention studies have examined PEs. Given this lack of evidence, in the current study a
secondary data analysis was conducted on a clustered-randomized control trial (RCT) of 3 school based interventions to reduce suicidal behaviour, to
investigate if these may reduce rates of PEs, and prevent PE, at 3-month and 1-year follow-up. METHOD(S): The Irish site of the Saving and Empowering
Young Lives in Europe study, trial registration (DRKS00000214), a cluster-RCT designed to examine the effect of school-based interventions on
suicidal thoughts and behaviour. Seventeen schools (n=1096) were randomly assigned to one of three intervention arms or a control arm. The
interventions included a teacher training (gate-keeper) intervention, an interactive educational (universal-education) intervention, and a screening
and integrated referral (selective-indicative) intervention. The primary outcome of this secondary data-analysis was reduction in point-prevalence of
PEs at 12 months. A second analysis excluding those with PEs at baseline was conducted to examine prevention of PEs. Additional analysis was
conducted of change in depression and anxiety scores (comparing those with/without PEs) in each arm of the intervention. Statistical analyses were
conducted using mixed-effects modelling. RESULT(S): At 12-months, the screening and referral intervention was associated with a significant reduction
in PEs (OR:0.12,95%CI[0.02-0.62]) compared to the control arm. The teacher training and education intervention did not show this effect. Prevention
was also observed only in the screening and referral arm (OR:0.30,95%CI[0.09-0.97]). Participants with PEs showed higher levels of depression and
anxiety symptoms, compared to those without, and different responses to the screening and referral intervention & universal-education intervention.
CONCLUSION(S): This study provides the first evidence for a school based intervention that reduce & prevent PEs in adolescence. This intervention is
a combination of a school-based screening for psychopathology and subsequent referral intervention significantly reduced PEs in adolescents. Although
further research is needed, our findings point to the effectiveness of school-based programmes for prevention of future mental health problems.
Copyright © 2023. The Author(s).
BMC public health, 23
(1) : 219
- Year: 2023
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other service delivery and improvement
interventions
Singh, S. P, Tuomainen, H, Bouliotis, G, Canaway, A, De-
Girolamo, G, Dieleman, G. C, Franic, T, Madan, J, Maras, A, McNicholas, F, Paul,
M, Purper-Ouakil, D, Santosh, P, Schulze, U. M. E, Street, C, Tremmery,
S, Verhulst, F. C, Wells, P, Wolke, D, Warwick, J.
BACKGROUND: Poor transition planning contributes to discontinuity of care at the child-adult mental health
service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed
transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care
(UC). METHOD(S): A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took
place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were
receiving treatment or had a diagnosed mental disorder, had an IQ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention
that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness
Measure) and sharing of information between CAMHS and adult mental health services. The primary outcome was HoNOSCA (Health of the Nation Outcome
Scale for Children and Adolescents) score 15-months post-entry to the trial. RESULT(S): The mean difference in HoNOSCA scores between the MT and UC
arms at 15 months was -1.11 points (95% confidence interval -2.07 to -0.14, p = 0.03). The cost of delivering the intervention was relatively modest
(17-65 per service user). CONCLUSION(S): MT led to improved mental health of YP after the SB but the magnitude of the effect was small. The
intervention can be implemented at low cost and form part of planned and purposeful transitional care.
Psychological medicine, 53(6) : 2193-
2204
- Year: 2023
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Simmons, M. B., Cartner, S., MacDonald, R., Whitson, S., Bailey, A., Brown, E.
Background: Peer
workers support individuals experiencing mental health challenges by drawing on their shared lived experience. Peer support has become increasingly
popular for young people with anxiety and depression, but the evidence base is unclear. This systematic review aimed to understand the effectiveness
of peer support for youth depression and anxiety (either primary or comorbid), and to understand in which contexts, for whom, and why peer support
works. Method(s): A systematic search was conducted with the Orygen Evidence Finder, Embase, MEDLINE, and PsycInfo from January 1980 to July 2022.
Controlled trials of interventions to improve mental health in young people (mean age 14-24), delivered by a peer worker with lived experienced of
mental health challenges were included. Outcomes related to depression or anxiety were extracted and descriptive synthesis was undertaken due to the
heterogeneity of studies. Study quality was rated using the Critical Appraisal Skills Programme; reporting adheres to the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses (PRISMA) statement. Result(s): Nine randomised controlled trials with 2,003 participants were included, with
seven undertaken in high income countries. One targeted depression and anxiety, two stigma-distress (any mental disorder), one first episode
psychosis, four studies preventing eating disorders and one drug misuse. One study successfully reduced anxiety and depression, another reduced
depression only, four reported reductions in negative affect, with the final three measuring, but not having a significant impact on depression.
Study quality was rated as 'good' overall. Discussion(s): Despite the uptake of youth peer support globally, there is limited evidence from
controlled trials of the effect of peer support-related interventions on anxiety and depression. There is some effect on negative affect, especially
for university students. Further rigorously designed trials of peer delivered interventions for young people need to be conducted with a focus on
understanding the mechanisms of action underpinning peer support. Copyright © 2023, The Author(s).
BMC Psychiatry, 23(1) (no pagination) :
- Year: 2023
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any), Psychosis Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention), First episode (psychosis only)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions