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Cognitive behavioral therapy in adolescents with early-onset psychosis: a randomized controlled pilot study.

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Title: Cognitive behavioral therapy in adolescents with early-onset psychosis: a randomized controlled pilot study.
Authors: Müller, Hendrik, Kommescher, Mareike, Güttgemanns, Jörn, Wessels, Helen, Walger, Petra, Lehmkuhl, Gerd, Kuhr, Kathrin, Hamacher, Stefanie, Lehmacher, Walter, Müller, Kerstin, Herrlich, Jutta, Wiedemann, Georg, Stösser, Dieter, Klingberg, Stefan, Bechdolf, Andreas
Source: European Child & Adolescent Psychiatry. Jul2020, Vol. 29 Issue 7, p1011-1022. 12p. 1 Diagram, 3 Charts, 1 Graph.
Subjects: Age factors in disease, Cognitive therapy, Delusions, Pathological psychology, Psychoses, Quality of life, Statistical sampling, Pilot projects, Effect sizes (Statistics), Randomized controlled trials, Treatment effectiveness, Adolescence
Abstract: Cognitive behavioral therapy for psychosis (CBT) is an effective treatment in adult patients with schizophrenia. However, no randomized controlled and blinded trial in adolescents with early-onset psychosis (EOP) has been conducted. Therefore, the present pilot study explores the acceptance, tolerability, feasibility, and safety of a modified CBT in adolescents with EOP. Twenty-five adolescents with EOP were randomized to either 9 months (20 sessions) of CBT + treatment as usual (TAU) or TAU alone. The primary endpoint was the PANSS-positive subscale (P1-7). Secondary endpoints included psychopathology, global functioning, and quality of life (QoL). Acceptance, tolerability, feasibility, and safety were assessed. Blinded assessments took place by the end of the treatment (9 months) and at 24-month follow-up. Despite improvements in both groups and lack of statistical significance between CBT + TAU and TAU regarding the primary endpoint, we observed between-group effect sizes of at least d = 0.39 in favor of CBT + TAU at post-treatment for delusions, negative symptoms, functioning and QoL after the intervention and effect sizes of at least d = 0.35 after 24 months. CBT in EOP was highly acceptable (73.5% agreed to randomization), well-tolerated (83.1% attendance rate, no drop-outs), and safe (one serious adverse event (SAE) in CBT + TAU in comparison with six SAEs in TAU). These findings suggest that CBT adapted to the needs of adolescents with EOP is a promising approach regarding negative symptoms, functioning, and QoL. CBT is a safe and tolerable treatment. However, due to the small sample size and the pilot character of the study, these conclusions are limited, and should be tested in a larger, adequately powered randomized controlled trial. [ABSTRACT FROM AUTHOR]
Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Cognitive behavioral therapy in adolescents with early-onset psychosis: a randomized controlled pilot study.
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  Data: <searchLink fieldCode="AR" term="%22Müller%2C+Hendrik%22">Müller, Hendrik</searchLink><br /><searchLink fieldCode="AR" term="%22Kommescher%2C+Mareike%22">Kommescher, Mareike</searchLink><br /><searchLink fieldCode="AR" term="%22Güttgemanns%2C+Jörn%22">Güttgemanns, Jörn</searchLink><br /><searchLink fieldCode="AR" term="%22Wessels%2C+Helen%22">Wessels, Helen</searchLink><br /><searchLink fieldCode="AR" term="%22Walger%2C+Petra%22">Walger, Petra</searchLink><br /><searchLink fieldCode="AR" term="%22Lehmkuhl%2C+Gerd%22">Lehmkuhl, Gerd</searchLink><br /><searchLink fieldCode="AR" term="%22Kuhr%2C+Kathrin%22">Kuhr, Kathrin</searchLink><br /><searchLink fieldCode="AR" term="%22Hamacher%2C+Stefanie%22">Hamacher, Stefanie</searchLink><br /><searchLink fieldCode="AR" term="%22Lehmacher%2C+Walter%22">Lehmacher, Walter</searchLink><br /><searchLink fieldCode="AR" term="%22Müller%2C+Kerstin%22">Müller, Kerstin</searchLink><br /><searchLink fieldCode="AR" term="%22Herrlich%2C+Jutta%22">Herrlich, Jutta</searchLink><br /><searchLink fieldCode="AR" term="%22Wiedemann%2C+Georg%22">Wiedemann, Georg</searchLink><br /><searchLink fieldCode="AR" term="%22Stösser%2C+Dieter%22">Stösser, Dieter</searchLink><br /><searchLink fieldCode="AR" term="%22Klingberg%2C+Stefan%22">Klingberg, Stefan</searchLink><br /><searchLink fieldCode="AR" term="%22Bechdolf%2C+Andreas%22">Bechdolf, Andreas</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22European+Child+%26+Adolescent+Psychiatry%22">European Child & Adolescent Psychiatry</searchLink>. Jul2020, Vol. 29 Issue 7, p1011-1022. 12p. 1 Diagram, 3 Charts, 1 Graph.
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  Data: Cognitive behavioral therapy for psychosis (CBT) is an effective treatment in adult patients with schizophrenia. However, no randomized controlled and blinded trial in adolescents with early-onset psychosis (EOP) has been conducted. Therefore, the present pilot study explores the acceptance, tolerability, feasibility, and safety of a modified CBT in adolescents with EOP. Twenty-five adolescents with EOP were randomized to either 9 months (20 sessions) of CBT + treatment as usual (TAU) or TAU alone. The primary endpoint was the PANSS-positive subscale (P1-7). Secondary endpoints included psychopathology, global functioning, and quality of life (QoL). Acceptance, tolerability, feasibility, and safety were assessed. Blinded assessments took place by the end of the treatment (9 months) and at 24-month follow-up. Despite improvements in both groups and lack of statistical significance between CBT + TAU and TAU regarding the primary endpoint, we observed between-group effect sizes of at least d = 0.39 in favor of CBT + TAU at post-treatment for delusions, negative symptoms, functioning and QoL after the intervention and effect sizes of at least d = 0.35 after 24 months. CBT in EOP was highly acceptable (73.5% agreed to randomization), well-tolerated (83.1% attendance rate, no drop-outs), and safe (one serious adverse event (SAE) in CBT + TAU in comparison with six SAEs in TAU). These findings suggest that CBT adapted to the needs of adolescents with EOP is a promising approach regarding negative symptoms, functioning, and QoL. CBT is a safe and tolerable treatment. However, due to the small sample size and the pilot character of the study, these conclusions are limited, and should be tested in a larger, adequately powered randomized controlled trial. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00787-019-01415-4
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      – SubjectFull: Delusions
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