Article

Intervention for Adolescents With Early Onset Psychosis and Their Families: A Randomized Controlled Trial

Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 6.35). 06/2014; DOI: 10.1016/j.jaac.2014.04.004

ABSTRACT Objective
The present study aims to assess the efficacy of a structured psychoeducational group intervention for adolescents with early onset psychosis and their families. The intervention was implemented in parallel in 2 separate groups by focusing specifically on problem-solving strategies and structured psychosis-related information to manage daily life hassles associated with the disease in order to mitigate crises and prevent relapses.

Method
We performed a 9-month, randomized, rater-blind clinical trial involving 55 adolescent patients with early onset psychosis and 1 or both of their parents. A psychoeducational problem-solving group intervention (n = 27) was compared with a nonstructured group intervention (n = 28). The primary outcomes were number of hospitalizations, days of hospitalization, and visits to the emergency department. The secondary outcome measures were clinical variables and family environment.

Results
Assessments were performed before and after the intervention. At the end of the group intervention, 15% of patients in the psychoeducational group and 39% patients in the nonstructured group had visited the emergency department (χ² = 3.62, df = 1, P = .039). The improvement in negative symptoms was more pronounced in the psychoeducational group (12.84 [7.87]) than in the nonstructured group (15.81 [6.37]) (P = .039).

Conclusion
A parallel psychoeducational group intervention providing written instructions in a structured manner could help adolescents with early onset psychosis and their parents to manage crises by implementing problem-solving strategies within the family, thus reducing the number of visits to the emergency department. Negative symptoms improved in adolescents in the psychoeducational group.

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