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Psychological interventions for adolescent psychosis: A pilot controlled trial in routine care

Published online by Cambridge University Press:  15 April 2020

S. Browning
Affiliation:
Child and Adolescent Mental Health Services Clinical Academic Group, South London & Maudsley NHS Foundation Trust, Mapother House, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom
R. Corrigall
Affiliation:
Child and Adolescent Mental Health Services Clinical Academic Group, South London & Maudsley NHS Foundation Trust, Mapother House, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom
P. Garety
Affiliation:
King's College, PO77 Department of Psychology, Institute of Psychiatry, 16, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom
R. Emsley
Affiliation:
Centre for Biostatistics, Institute of Population Health, The University of Manchester, 4.304 Jean McFarlane Building, Oxford Road, Manchester M13 9PL, United Kingdom
S. Jolley*
Affiliation:
King's College, PO77 Department of Psychology, Institute of Psychiatry, 16, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom
*
*Corresponding author. Tel.: +20 7848 5028; fax: +20 7848 5006. E-mail address: [email protected] (S. Jolley).
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Abstract

Purpose

Evidence for the recommendation to deliver Cognitive Behavioural Therapy (CBT) and Family Interventions (FI) to under-18s with psychosis derives from adult research, and no previous study has focused exclusively on an adolescent population. We evaluated adaptations of these therapies for adolescent inpatients with psychosis (CBTpA and FIpA), delivered as an adjunct to inpatient standard care (SC).

Subjects and methods

Thirty adolescent inpatients with psychotic symptoms on admission were sequentially allocated to receive CBTpA + SC (n = 10); FIpA + SC (n = 10) or SC alone (n = 10). Psychotic symptoms and functioning were measured at admission and discharge.

Results

Group comparisons did not reach conventional significance, but effect sizes in this pilot study showed a promising impact of CBTpA compared to SC alone, in reducing symptoms (ES: d = 0.6), with smaller effect sizes for functioning (d = 0.2) and for FIpA (symptoms, d = 0.1 and functioning, d = 0.4). There was no advantage of either additional treatment in reducing length of stay, but self-report satisfaction ratings were higher for both psychological therapies.

Discussion and conclusions

The study is the first to focus on an exclusively adolescent population, using appropriately adapted therapy protocols. Findings suggest that the interventions are feasible, acceptable and helpful for adolescents with psychosis. Larger randomised controlled trials are now needed.

Type
Original article
Copyright
Copyright © European Psychiatric Association

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