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Randomised controlled trial of early detection and cognitive therapy for preventing transition to psychosis in high-risk individuals: Study design and interim analysis of transition rate and psychological risk factors

  • A. P. Morrison (a1), R. P. Bentall (a2), P. French (a3), L. Walford (a3), A. Kilcommons (a3), A. Knight (a3), M. Kreutz (a3) and S. W. Lewis (a4)...

Abstract

Background

There is interest in the possibility of indicated prevention of psychosis. There is a strong case for using psychological approaches to prevent transition to psychosis in high-risk patients.

Aims

To identify individuals at high risk of transition to psychosis, and psychological characteristics relevant to the development of psychosis in this group.

Method

The design of a randomised controlled trial of cognitive therapy for the prevention of psychosis in people at high risk (meeting operational criteria of brief or attenuated psychotic symptoms, or first-degree family history with functional decline) is outlined. The first patients recruited are compared with non-patient samples on cognitive and personality factors; an interim analysis of transition rate is reported.

Results

Cases (n=31) were recruited mainly from primary care. Of the 23 high-risk patients monitored for 6–12 months, 5 (22%) made the transition to psychosis. The high-risk group scored significantly higher than non-patients on measures of schizotypy, metacognitive beliefs and dysfunctional self-schemas (sociotropy).

Conclusions

The findings validate the methods of identifying individuals at high risk of experiencing a psychotic episode. Compared with non-patient controls, the cases showed dysfunctional metacognitive beliefs and self-schemas.

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Copyright

Corresponding author

Dr Tony Morrison, Department of Psychology, University of Manchester, Oxford Road, Manchester M13 9PL, UK. Tel: +44 (0) 161 772 3439; fax: +44 (0) 161 772 3525; e-mail: tony.morrison@psy.man.ac.uk

Footnotes

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Presented in part at the European First Episode Schizophrenia Network Meeting, Whistler BC, Canada, 27 April, 2001.

Declaration of interest

Funded by North-West NHS Executive.

Footnotes

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Randomised controlled trial of early detection and cognitive therapy for preventing transition to psychosis in high-risk individuals: Study design and interim analysis of transition rate and psychological risk factors

  • A. P. Morrison (a1), R. P. Bentall (a2), P. French (a3), L. Walford (a3), A. Kilcommons (a3), A. Knight (a3), M. Kreutz (a3) and S. W. Lewis (a4)...

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Randomised controlled trial of early detection and cognitive therapy for preventing transition to psychosis in high-risk individuals: Study design and interim analysis of transition rate and psychological risk factors

  • A. P. Morrison (a1), R. P. Bentall (a2), P. French (a3), L. Walford (a3), A. Kilcommons (a3), A. Knight (a3), M. Kreutz (a3) and S. W. Lewis (a4)...
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