Premium
Selection for psychosocial treatment for youth at clinical high risk for psychosis based on the North American Prodrome Longitudinal Study individualized risk calculator
Author(s) -
Worthington Michelle A.,
Miklowitz David J.,
O'Brien Mary,
Addington Jean,
Bearden Carrie E.,
Cadenhead Kristin S.,
Cornblatt Barbara A.,
Mathalon Daniel H.,
McGlashan Thomas H.,
Perkins Diana O.,
Seidman Larry J.,
Tsuang Ming T.,
Walker Elaine F.,
Woods Scott W.,
Can Tyrone D.
Publication year - 2021
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12914
Subject(s) - psychosocial , prodrome , psychosis , randomized controlled trial , medicine , clinical psychology , psychology , psychiatry
Aim Recent findings suggest that family‐focused therapy (FFT) is effective for individuals at clinical high‐risk for psychosis (CHR‐P). As outcomes of CHR‐P individuals are quite varied, certain psychosocial interventions may be differentially effective in subgroups. The present study examined change in positive symptoms for CHR‐P individuals at different levels of predicted risk for conversion to psychosis who received either FFT, a brief form of family education termed enhanced care (EC) or treatment as usual. Methods Participants were drawn from the North American Prodromal Longitudinal Study (NAPLS2). A subset of NAPLS2 participants completed a randomized study involving FFT or EC. The present study includes participants from the FFT‐CHR sub‐study and non‐randomized NAPLS2 participants. Predicted risk of conversion was calculated using the Individualized Risk Calculator for Psychosis. Robust linear regressions evaluated whether the association between predicted risk of conversion and positive symptom change differed across intervention groups. Results A total of 94 participants from the FFT‐CHR sub‐study (FFT‐CHR n = 50, EC n = 44) and 401 non‐randomized NAPLS2 participants were included in this study. There was a treatment group by predicted risk of conversion interaction that predicted positive symptom improvement: higher risk individuals improved more with FFT‐CHR than EC or the non‐randomized NAPLS group, whereas lower‐risk individuals did not differ in positive symptom improvement across treatment groups (FFT‐CHR vs EC: P = .03, β = 20.27; FFT‐CHR vs NAPLS2: P < .001, β = 28.40). Conclusions Intensive treatments such as FFT‐CHR may be most appropriate for individuals at the highest levels of clinical risk for psychosis.