Results of the German Research Network on Schizophrenia: Early intervention in the initial prodromal phase

Abstract

Background and Aims

To determine whether a differential state specific intervention in the initial prodromal state is effective for preventing progression to psychosis.

Method

128 patients in the early initial prodromal state (EIPS) were randomized to receive either a comprehensive cognitive behavior therapy (CBT) intervention or supportive counseling (SC) for 12 months. 124 patients in a putatively late initial prodromal state (LIPS) were randomly assigned to a needs-focused inter-vention (NFI) or to NFI plus amisulpride.

Results

In the EIPS trial Kaplan-Meier estimates of the risks of transitions to LIPS (5.3% vs. 18.5%, p=0.032), psychosis (1.6% vs. 13.8%, p=0.020) and schizophrenia (none vs. 13.8%, p=0.005) at month 12 were statistically significant lower in the CBT group than in the SC group. In the LIPS trial Amisul-pride+NFI produced superior effects to NFI alone on attenuated and full-blown psychotic symptoms, basic, depressive and negative symptoms and global functioning at week 12.

Conclusion

First results indicate that a differential intervention to the initial prodromal state is effective for preventing progression to psychosis.