Acute-phase and 1-year follow-up results of a randomized controlled trial of CBT versus Befriending for first-episode psychosis:: the ACE project
Acute-phase and 1-year follow-up results of a randomized controlled trial of CBT versus Befriending for first-episode psychosis:: the ACE project
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DOI：
10.1017/s0033291707002061
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发表时间：
2008-05-01
影响因子：
6.9
通讯作者：
Harrigan, S.
中科院分区：
文献类型：
--
作者：
Jackson, H. J.;McGorry, P. D.;Harrigan, S.
背景ACE项目涉及62名首次精神病发作的参与者，他们被随机分配到认知行为疗法（CBT）干预（称为早期精神病主动认知疗法（ACE））或控制条件（称为交友）。研究假设是：（1）在急性期用ACE治疗参与者将导致阳性和阴性症状的更快减少，并且比Befriending更快地改善功能;（2）症状和功能的这些改善将在1年随访时持续;（3）ACE将导致比Befriending更少的住院，如在I年随访时评估的那样。两名治疗师在两种情况下治疗参与者。参与者在14周内接受的培训不得超过20次。参与者由独立评估者对症状和功能的四个主要结局指标进行评估：治疗前，治疗中期，治疗结束和1年随访。一对独立的评估者评估治疗的完整性。随着时间的推移，两组都有明显改善。ACE通过改善治疗中期的功能显著优于交友，但它没有改善阳性或阴性症状。经过治疗中期评估后，友谊治疗组与ACE治疗组的疗效相当，随访时的任何结果指标和住院率均无显著差异。有一些初步证据表明，ACE促进更好的早期恢复功能，这一发现需要在其他独立的研究中心与更大的样本复制。
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 I-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.