Feasibility and Effectiveness of a Multi-Element Psychosocial Intervention for First-Episode Psychosis: Results From the Cluster-Randomized Controlled GET UP PIANO Trial in a Catchment Area of 10 Million Inhabitants

Giovanni De Girolamo, Mirella Ruggeri, Chiara Bonetto, Antonio Lasalvia, Angelo Fioritti, Paolo Santonastaso, Francesca Pileggi, Giovanni Neri, Daniela Ghigi, Franco Giubilini, Maurizio Miceli, Silvio Scarone, Angelo Cocchi, Stefano Torresani, Carlo Faravelli, Carla Cremonese, Paolo Scocco, Emanuela Leuci, Fausto Mazzi, Michela PratelliFrancesca Bellini, Sarah Tosato, Katia De Santi, Sarah Bissoli, Sara Poli, Elisa Ira, Silvia Zoppei, Paola Rucci, Laura Bislenghi, Giovanni Patelli, Doriana Cristofalo, Anna Meneghelli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

70 Citazioni (Scopus)

Abstract

Integrated multi-element psychosocial interventions have been suggested to improve the outcomes of first-episode psychosis (FEP) patients, but they have been studied primarily in experimental settings and in nonepidemiologically representative samples. Thus, we performed a cluster-randomized controlled trial, comparing an integrated multi-element psychosocial intervention, comprising cognitive behavioral therapy, family intervention, and case management, with treatment as usual (TAU) for FEP patients in 117 community mental health centers (CMHCs) in a large area of northern Italy (10 million inhabitants). The randomized units (clusters) were the CMHCs, and the units of observation the patients (and, when available, their family members). The primary hypotheses were that add-on multicomponent intervention: (1) results in greater improvements in symptoms, as assessed with positive and negative syndrome scale and (2) reduces in-hospital stay, based on days of hospitalization over the 9-month follow-up. Four hundred and forty-four FEP patients received the intervention or TAU and were assessed at baseline and 9 months. Based on the retention rates of patients (and families) in the experimental arm, multi-element psychosocial interventions can be implemented in routine mental health services. Regarding primary outcomes, patients in the experimental arm showed greater reductions in overall symptom severity, while no difference could be found for days of hospitalization. Among the secondary outcomes, greater improvements were detected in the experimental arm for global functioning, emotional well-being, and subjective burden of delusions. No difference could be found for service disengagement and subjective burden of auditory hallucinations. These findings support feasibility and effectiveness of early interventions for psychosis in generalist mental health services.
Lingua originaleEnglish
pagine (da-a)1192-203-1203
RivistaSchizophrenia Bulletin
Volume41
DOI
Stato di pubblicazionePubblicato - 2015
Pubblicato esternamente

Keywords

  • cognitive behavioral therapy
  • early psychosis
  • family intervention
  • outcome assessment
  • schizophrenia

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