Clinical and functional outcomes after 2 years in the early detection and intervention for the prevention of psychosis multisite effectiveness trial

William R. McFarlane, Bruce Levin, Lori Travis, F. Lee Lucas, Sarah Lynch, Mary Verdi, Deanna Williams, Steven Adelsheim, Roderick Calkins, Cameron S. Carter, Barbara Cornblatt, Stephan F. Taylor, Andrea M. Auther, Bentson McFarland, Ryan Melton, Margaret Migliorati, Tara Niendam, J. Daniel Ragland, Tamara Sale, Melina SalvadorElizabeth Spring

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

Objective: To test effectiveness of the Early Detection, Intervention, and Prevention of Psychosis Program in preventing the onset of severe psychosis and improving functioning in a national sample of at-risk youth. Methods: In a risk-based allocation study design, 337 youth (age 12-25) at risk of psychosis were assigned to treatment groups based on severity of positive symptoms. Those at clinically higher risk (CHR) or having an early first episode of psychosis (EFEP) were assigned to receive Family-aided Assertive Community Treatment (FACT); those at clinically lower risk (CLR) were assigned to receive community care. Between-groups differences on outcome variables were adjusted statistically according to regression-discontinuity procedures and evaluated using the Global Test Procedure that combined all symptom and functional measures. Results: A total of 337 young people (mean age: 16.6) were assigned to the treatment group (CHR + EFEP, n = 250) or comparison group (CLR, n = 87). On the primary variable, positive symptoms, after 2 years FACT, were superior to community care (2 df, p <.0001) for both CHR (p =.0034) and EFEP (p <.0001) subgroups. Rates of conversion (6.3% CHR vs 2.3% CLR) and first negative event (25% CHR vs 22% CLR) were low but did not differ. FACT was superior in the Global Test (p =.0007; p =.024 for CHR and p =.0002 for EFEP, vs CLR) and in improvement in participation in work and school (p =.025). Conclusion: FACT is effective in improving positive, negative, disorganized and general symptoms, Global Assessment of Functioning, work and school participation and global outcome in youth at risk for, or experiencing very early, psychosis.

Original languageEnglish (US)
Pages (from-to)30-43
Number of pages14
JournalSchizophrenia Bulletin
Volume41
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • assertive community treatment
  • family psychoeducation
  • multifamily group
  • schizophrenia
  • supported education
  • supported employment

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    McFarlane, W. R., Levin, B., Travis, L., Lucas, F. L., Lynch, S., Verdi, M., Williams, D., Adelsheim, S., Calkins, R., Carter, C. S., Cornblatt, B., Taylor, S. F., Auther, A. M., McFarland, B., Melton, R., Migliorati, M., Niendam, T., Ragland, J. D., Sale, T., ... Spring, E. (2015). Clinical and functional outcomes after 2 years in the early detection and intervention for the prevention of psychosis multisite effectiveness trial. Schizophrenia Bulletin, 41(1), 30-43. https://doi.org/10.1093/schbul/sbu108