Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-17T19:18:10.523Z Has data issue: false hasContentIssue false
  • English
  • Français

Motivational interviewing and interaction skills training for parents of young adults with recent-onset schizophrenia and co-occurring cannabis use: 15-month follow-up

Published online by Cambridge University Press:  11 May 2015

M. Smeerdijk ,
R. Keet ,
B. van Raaij ,
M. Koeter ,
D. Linszen ,
L. de Haan  and
G. Schippers
M. Smeerdijk*
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
R. Keet
Affiliation:
Mental Health Service North Holland North, Alkmaar, The Netherlands
B. van Raaij
Affiliation:
Training Company ‘Bureau de Mat’, Haarlem, The Netherlands
M. Koeter
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
D. Linszen
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
L. de Haan
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
G. Schippers
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
*
* Address for correspondence: M. Smeerdijk, M.Sc., Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands. (Email: A.M.Smeerdijk@amc.uva.nl)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There is a clear need for effective interventions to reduce cannabis use in patients with first-episode psychosis. This follow-up of a randomized trial examined whether an intervention for parents, based on motivational interviewing and interaction skills (Family Motivational Intervention, FMI), was more effective than routine family support (RFS) in reducing cannabis use in patients with recent-onset schizophrenia.

Method

In a single-blind trial with 75 patients in treatment for recent-onset schizophrenia, 97 parents were randomly assigned to either FMI or RFS. Assessments were conducted at baseline and at 3 and 15 months after the interventions had been ended. Analyses were performed on an intention-to-treat basis using mixed-effect regression models.

Results

From baseline to the 15-month follow-up, there was a significantly greater reduction in FMI compared to RFS in patients’ quantity (p = 0.01) and frequency (p < 0.01) of cannabis use. Patients’ craving for cannabis use was also significantly lower in FMI at 15 months follow-up (p < 0.01). Both groups improved in parental distress and sense of burden; however, only FMI parents’ appraisal of patients’ symptoms showed further improvement at the 15-month follow-up (p < 0.05).

Conclusions

The results support the sustained effectiveness of FMI in reducing cannabis use in patients with recent-onset schizophrenia at 15 months follow-up. Findings were not consistent with regard to the long-term superiority of FMI over RFS in reducing parents’ distress and sense of burden.

Keywords

Cannabis usefamily interventioninteraction skillsmotivational interviewingrecent-onset schizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 13 , October 2015 , pp. 2839 - 2848
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, J, Jones, B, Ko, T, Addington, D (2001). Family intervention in early psychosis. Psychiatric Rehabilitation Skills 5, 272–286.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Andreasen, NC, Flaum, M, Arndt, S (1992). The Comprehensive Assessment of Symptoms and History (CASH): an instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615–623.Google Scholar
Baeza, I, Graell, M, Moreno, D, Castro-Fornieles, J, Parellada, M, González-Pinto, A, Payá, B, Soutullo, C, de la Serna, E, Arango, C (1999). Cannabis use in children and adolescents with first-episode psychosis: influence on psychopathology and short-term outcome (CAFEPS study). Schizophrenia Research 113, 129–137.Google Scholar
Baker, AL, Thornton, KL, Hides, L, Dunlop, A (2012). Treatment of cannabis use among people with psychotic disorders: a critical review of randomized controlled trials. Current Pharmaceutical Design 18, 4923–4937.Google Scholar
Barnett, JH, Werners, U, Secher, SM, Hill, KE, Brazil, R, Masson, K, Pernet, DE, Kirkbride, JB, Murray, GK, Bullmore, ET, Jones, PB (2007). Substance use in a population-based clinic sample of people with first-episode psychosis. British Journal of Psychiatry 190, 515–520.Google Scholar
Barrowclough, C, Haddock, G, Tarrier, N, Lewis, SW, Moring, J, O'Brien, R, Schofield, N, McGovern, L (2001). Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorder. American Journal of Psychiatry 158, 1706–1713.CrossRefGoogle Scholar
Barrowclough, C, Haddock, G, Wykes, T, Beardmore, R, Conrod, P, Craig, T, Davies, L, Dunn, G, Eisner, E, Leweis, S, Moring, J, Steel, C, Tarrier, N (2010). Integrated motivational interviewing and cognitive behavioral therapy for people with psychosis and comorbid substance misuse: randomized controlled trial. British Medical Journal 341, c6325.Google Scholar
Barrowclough, C, Ward, J, Weardon, A, Gregg, L (2005). Expressed emotion and attributions in relatives with and without substance misuse. Social Psychiatry and Psychiatric Epidemiology 40, 1–8.Google Scholar
Beunckens, C, Molenberghs, G, Kenward, MG (2005). Direct likelihood analysis versus simple forms of imputation for missing data in randomized clinical trials. Clinical Trials 2, 379–386.CrossRefGoogle ScholarPubMed
Bird, V, Premkumar, P, Kendall, T, Whittington, C, Mitchell, J, Kuipers, E (2010). Early intervention services, cognitive-behavioural therapy and family intervention in early psychosis: systematic review. British Journal of Psychiatry 197, 350–356.CrossRefGoogle ScholarPubMed
Bonsack, C, Gibellini, MS, Favrod, J, Montagrin, Y, Besson, J, Bovet, P, Conus, P (2011). Motivational intervention to reduce cannabis use in young people with psychosis: a randomized controlled trial. Psychotherapy and Psychosomatics 80, 287–297.CrossRefGoogle ScholarPubMed
Butzlaff, RL, Hooley, JM (1998). Expressed emotion and psychiatric relapse - a meta-analysis. Archives of General Psychiatry 55, 547–552.CrossRefGoogle ScholarPubMed
Cantwell, R, Brewin, J, Glazebrook, C, Dalin, T, Fox, R, Medley, I, Harrison, G (1999). Prevalence of substance misuse in first-episode psychosis. British Journal of Psychiatry 174, 150–153.CrossRefGoogle ScholarPubMed
Cleary, M, Hunt, GE, Matheson, S, Walter, G (2008). Psychosocial treatments for people with co-occurring severe mental illness and substance misuse: systematic review. Journal of Advanced Nursing 65, 238–258.Google Scholar
De Jonge, JM (2005). Motivation for change in the addictions: studies in assessment. Unpublished doctoral dissertation. The University of Groningen: The Netherlands.Google Scholar
De Vries, K, van Heck, GL (1995). The Dutch version of the WHOQOL-100. University of Tilburg: Tilburg.Google Scholar
Dekker, N, Koeter, M, van den Brink, W, GROUP Investigators (2012). Craving for cannabis in patients with psychotic disorder, their non-affected siblings and healthy controls: psychometric analysis of the obsessive compulsive drug use scale. International Journal of Methods in Psychiatric Research 21, 286–300.Google Scholar
Dixon, L, McNary, S, Kegnab, A (1995). Substance abuse and family relationships of persons with severe mental illness and co-occurring substance use disorder. American Journal of Psychiatry 152, 456–458.Google Scholar
Franken, IH, Hendriks, VM, van den Brink, W (2002). Initial validation of two opiate craving questionnaires: the obsessive compulsive drug use scale and the desire for drug questionnaire. Addictive Behaviors 27, 675–685.CrossRefGoogle Scholar
Goldberg, DP, Hillier, VF (1979). A scaled version of the General Health Questionnaire. Psychological Medicine 9, 139–145.Google Scholar
Haddock, G, Barrowclough, C, Tarrier, N, Morning, J, O'Brien, R, Schofield, N, Quinn, J, Palmer, S, Davies, L, Lowens, I, McGovern, J, Lewis, S (2003). Cognitive-behavioural therapy and motivational intervention for schizophrenia and substance misuse. 18-month outcomes of a randomsed controlled trial. British Journal of Psychiatry 183, 418–426.CrossRefGoogle Scholar
Hjorthøj, CR, Fohlmann, A, Larsen, A, Arendt, M, Nordentoft, M (2011). Correlations and agreement between delta-9-tetrahydrocannabinol (THC) in blood plasma and timeline follow-back (TLFB)-assisted self-reported use of cannabis of patients with cannabis use disorder and psychotic illness attending the CapOpus randomized clinical trial. Addiction 107, 1123–1131.Google Scholar
Hjorthøj, CR, Orlovska, S, Fohlmann, A, Nordentoft, M (2013). Psychiatric treatment following participation in the CapOpus randomized trial for patients with comorbid cannabis use disorder and psychosis. Schizophrenia Research 151, 191–196.Google Scholar
Kashner, M, Rader, L, Rodell, D, Beck, C, Rodell, L, Muller, K (1991). Family characteristics, substance abuse, and hospitalization patterns of patients with schizophrenia. Hospital and Community Psychiatry 42, 195–197.Google Scholar
Kuipers, T (2003). Show them where you're coming from: interaction Skills Training for Psychiatry [in Dutch]. Maandblad Geestelijke Volksgezondheid 58, 1137–1148.Google Scholar
Kuipers, T (2008). Disability and prosthesis in psychiatry [in Dutch]. Maandblad Geestelijke Volksgezondheid 63, 20–32.Google Scholar
Lambert, M, Conus, P, Lubman, DI, Wade, D, Yuen, H, Moritz, S, Naber, D, McGorry, PD, Schimmelmann, BG (2005). The impact of substance use disorders on clinical outcome in 643 patients with first-episode psychosis. Acta Psychiatrica Scandinavica 112, 141–148.Google Scholar
Linszen, DH, Dingemans, P, Lenior, M (1994). Cannabis abuse and the course of recent-onset schizophrenic disorders. Archives of General Psychiatry 51, 273–279.CrossRefGoogle ScholarPubMed
Linszen, DH, Dingemans, P, van der Does, AJW, Nugter, A, Scholte, P, Lenior, R, Goldstein, MJ (1996). Treatment, expressed emotion and relapse in recent-onset schizophrenic disorders. Psychological Medicine 26, 333–342.CrossRefGoogle ScholarPubMed
Lopez, SR, Nelson, KA, Snyder, KS, Mintz, J (1999). Attributions and affective reactions of family members and course of schizophrenia. Journal of Abnormal Psychology 108, 307–314.Google Scholar
Madigan, K, Brennan, D, Lawlor, E, Turner, N, Kinsella, A, O'Connor, JJ, Russell, V, Waddington, JL, O'Callaghan, E (2013). A multi-center, randomized controlled trial of a group psychological intervention for psychosis with comorbid cannabis dependence over the early course of illness. Schizophrenia Research 143, 138–142.Google Scholar
Miller, WR, Rollnick, S (2002). Motivational Interviewing: Preparing People to Change, 2nd edn. Guilford Press: New York.Google Scholar
Moyers, TB, Martin, T, Manuel, J, Miller, WR, Ernst, D (2007). Revised global scales: Motivational Interviewing Treatment Integrity 3.0 (MITI 3.0). http://casaa.unm.edu/download/miti3.pdf.Google Scholar
Mueser, KT, Glynn, SM, Cather, C, Xie, H, Zarate, R, Smith, LF, Clark, RE, Gottlieb, JD, Wolfe, R, Feldman, J (2013). A randomized controlled trial of family intervention for co-occurring substance use and severe psychiatric disorders. Schizophrenia Bulletin 39, 658–672.Google Scholar
Norman, R, Malla, A, Manchanda, R, Harricharan, R, Takhar, J, Northcott, S (2005). Social support and three-year symptom and admission outcomes for first episode psychosis. Schizophrenia Research 80, 227–234.Google Scholar
Quinn, J, Barrowclough, C, Tarrier, N (2003). The Family Questionnaire (FQ): a scale for measuring symptom appraisal in relatives of schizophrenic patients. Acta Psychiatrica Scandinavica 208, 290–296.Google Scholar
Salim, A, Mackinnon, A, Christensen, H, Griffiths, K (2008). Comparison of data analysis strategies for intent-to-treat analysis in pre-test-post-test designs with substantial dropout rates. Psychiatry Research 160, 4335–345.Google Scholar
Smeerdijk, M, Keet, R, Dekker, N, van Raaij, B, Krikke, M, Koeter, M, de Haan, L, Barrowclough, C, Schippers, G, Linszen, D (2012). Motivational interviewing and interaction skills training for parents to change cannabis use in young adults with recent-onset schizophrenia: a randomized controlled trial. Psychological Medicine 42, 1627–1636.Google Scholar
Smeerdijk, M, Keet, R, de Haan, L, Barrowclough, C, Linszen, D, Schippers, G (2014). Feasibility of teaching motivational interviewing to parents of young adults with recent-onset schizophrenia and co-occurring cannabis use. Journal of Substance Abuse Treatment 3, 340–345.Google Scholar
Smeerdijk, M, Linszen, D, Kuipers, T, Keet, R (2009). Family motivational intervention in early psychosis and cannabis misuse. In A Casebook of Family Interventions for Psychosis (ed. Lobban, F. and Barrowclough, C.), pp. 117–138. Wiley-Blackwell: UK.Google Scholar
Szmukler, GI, Burgess, P, Herrman, H, Benson, A, Colusa, S, Bloch, S (1996). Caring for relatives with serious mental illness: the development of the Experience of Caregiving Inventory. Social Psychiatry and Psychiatric Epidemiology 31, 137–148.Google Scholar
Sobell, LC, Sobell, MB (1992). Timeline follow back: a technique for assessing self-reported alcohol consumption. In Measuring Alcohol Consumption (ed. Litten, R.Z. and Allen, J.P.), pp. 41–72. Humana Press: Towota, NJ.Google Scholar
van Mastright, S, Addington, J, Addington, D (2004). Substance misuse at presentation to an early psychosis program. Social Psychiatry and Psychiatric Epidemiology 39, 69–72.CrossRefGoogle Scholar
van Meijel, B, Megens, Y, Koekkoek, B, de Vogel, W, Kruitwagen, C, Grypdonck, M (2009). Effective interaction with patients with schizophrenia: qualitative evaluation of the interaction skills training programme. Perspectives in Psychiatric Care 45, 254–261.CrossRefGoogle ScholarPubMed
WHOQOL Group (1998). Development of the World Health Organisation WHOQOL BREF quality of live assessment. Psychological Medicine 28, 551–558.Google Scholar
Wisdom, JP, Manual, JI, Drake, RE (2011). Substance use disorder among people with first-episode psychosis: a systematic review of course and treatment. Psychiatric Services 62, 1007–1012.Google Scholar
Zammit, S, Moore, THM, Lingford-Hughes, A, Barnes, TRE, Jones, PB, Burke, M, Lewis, G (2008). Effects of cannabis use on outcomes of psychotic disorders: systematic review. British Journal of Psychiatry 193, 357–363.Google Scholar