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Acute-phase and 1-year follow-up results of a randomized controlled trial of CBT versus Befriending for first-episode psychosis: the ACE project

Published online by Cambridge University Press:  16 November 2007

H. J. Jackson ,
P. D. McGorry ,
E. Killackey ,
S. Bendall ,
K. Allott ,
P. Dudgeon ,
J. Gleeson ,
T. Johnson  and
S. Harrigan
H. J. Jackson*
Affiliation:
Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia
P. D. McGorry
Affiliation:
Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia
E. Killackey
Affiliation:
Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia
S. Bendall
Affiliation:
Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia
K. Allott
Affiliation:
Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia
P. Dudgeon
Affiliation:
Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia
J. Gleeson
Affiliation:
Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia
T. Johnson
Affiliation:
Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia
S. Harrigan
Affiliation:
Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia
*
*Address for correspondence: Dr H. J. Jackson, Department of Psychology, 12th Floor, Redmond Barry Building, University of Melbourne, Parkville, 3052, VIC, Australia. (Email: [email protected])
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Abstract

Background

The ACE project involved 62 participants with a first episode of psychosis randomly assigned to either a cognitive behaviour therapy (CBT) intervention known as Active Cognitive Therapy for Early Psychosis (ACE) or a control condition known as Befriending. The study hypotheses were that: (1) treating participants with ACE in the acute phase would lead to faster reductions in positive and negative symptoms and more rapid improvement in functioning than Befriending; (2) these improvements in symptoms and functioning would be sustained at a 1-year follow-up; and (3) ACE would lead to fewer hospitalizations than Befriending as assessed at the 1-year follow-up.

Method

Two therapists treated the participants across both conditions. Participants could not receive any more than 20 sessions within 14 weeks. Participants were assessed by independent raters on four primary outcome measures of symptoms and functioning: at pretreatment, the middle of treatment, the end of treatment and at 1-year follow-up. An independent pair of raters assessed treatment integrity.

Results

Both groups improved significantly over time. ACE significantly outperformed Befriending by improving functioning at mid-treatment, but it did not improve positive or negative symptoms. Past the mid-treatment assessment, Befriending caught up with the ACE group and there were no significant differences in any outcome measure and in hospital admissions at follow-up.

Conclusions

There is some preliminary evidence that ACE promotes better early recovery in functioning and this finding needs to be replicated in other independent research centres with larger samples.

Keywords

ACEacute treatment phaseBefriendingCBTfirst-episode psychosisrandomized controlled treatmentsrecoveryschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 5 , May 2008 , pp. 725 - 735
Copyright
Copyright © Cambridge University Press 2007

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