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Young people with self-experienced cognitive thought and perception deficits (basic symptoms) may present with an early initial prodromal state (EIPS) of psychosis in which most of the disability and neurobiological deficits of schizophrenia have not yet occurred.
To investigate the effects of an integrated psychological intervention (IPI), combining individual cognitive–behavioural therapy, group skills training, cognitive remediation and multifamily psychoeducation, on the prevention of psychosis in the EIPS.
A randomised controlled, multicentre, parallel group trial of 12 months of IPI v. supportive counselling (trial registration number: NCT00204087). Primary outcome was progression to psychosis at 12- and 24-month follow-up.
A total of 128 help-seeking out-patients in an EIPS were randomised. Integrated psychological intervention was superior to supportive counselling in preventing progression to psychosis at 12-month follow-up (3.2% v. 16.9%; P = 0.008) and at 24-month follow-up (6.3% v. 20.0%; P = 0.019).
Integrated psychological intervention appears effective in delaying the onset of psychosis over a 24-month time period in people in an EIPS.
Cognitive disturbances have been demonstrated in individuals with
potentially prodromal symptoms in objective–neuropsychological as well as
subjective-symptomatic studies. Yet, the relation between subjective and
objective deficits and to different prodromal states is unclear
To explore interactions between subjective and objective cognitive
measures in different prodromal states
In participants with an early (n=33) or late
(n=69) initial prodromal state, cognitive subjective
and objective deficits were assessed with the Schizophrenia Proneness
Instrument and a comprehensive neuropsychological test battery
Participants with an early initial prodromal state were less impaired
than those with a late initial state. Subjective and objective cognitive
deficits were unrelated, excepttime-limited neurocognitive speed measures
and subjectively reduced stress tolerance, especially in participants
with an early initial prodromal state
Subjective and objective cognitive deficits are generally unrelated in
the psychosis prodrome and as such they can add complementary information
valuable for prediction. However, possible associations between the two
levels might be better detectable in the less impaired early initial
Depression is a frequent condition in early psychosis. Therefore, early
detection instruments should distinguish depression from beginning
To examine whether basic symptoms, i.e. subtle subjective deficits,
differ between participants suffering from a potential prodrome
(n = 146), first-episode schizophrenia
(n= 153) and non-psychotic depression
(n = 115)
Basic symptoms were assessed with the Schizophrenia Proneness
The prodrome and schizophrenia groups did not differ in level of basic
symptoms but both had higher levels than the depression group. DSM – IV
depression was frequent in those suffering from a potential prodrome
(38%) and first-episode schizophrenia (21%). In both groups, participants
with and without depression did not differ in basic symptoms. In
multivariate analyses, consideration of current depression generally
facilitated correct group classification, except for participants
suffering from both a potential prodrome and depression
Cognitive basic symptoms distinguished well between all three groups.
However, identification of persons suffering from a potential prodrome
might be enhanced by considering current affective status
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