Abstract
BackgroundMultifamily group psychoeducation (MFG) has been shown to reduce relapse rates among individuals with first-episode psychosis. However, given the cognitive demands associated with participating in this intervention (e.g., learning and applying a structured problem-solving activity), the cognitive deficits that accompany psychotic disorders may limit the ability of certain individuals to benefit from this intervention. Thus, the goal of this study is to examine whether individuals with first-episode psychosis who participate simultaneously in MFG and cognitive remediation--an intervention shown to improve cognitive functioning among individuals with psychotic disorders--will be less likely to experience a relapse than individuals who participate in MFG alone.Methods/DesignForty individuals with first-episode psychosis and their caregiving relative will be recruited to participate in this study. Individuals with first-episode psychosis will be randomized to one of two conditions: (i) MFG with concurrent participation in cognitive remediation or (ii) MFG alone. The primary outcome for this study is relapse of psychotic symptoms. We will also examine secondary outcomes among both individuals with first-episode psychosis (i.e., social and vocational functioning, health-related quality of life, service utilization, independent living status, and cognitive functioning) and their caregiving relatives (i.e., caregiver burden, anxiety, and depression)DiscussionCognitive remediation offers the possibility of ameliorating a specific deficit (i.e., deficits in cognitive functioning) that often accompanies psychotic symptoms and may restrict the magnitude of the clinical benefits derived from MFG.Trial RegistrationClinicalTrials (NCT): NCT01196286
Highlights
Group psychoeducation (MFG) has been shown to reduce relapse rates among individuals with first-episode psychosis
Cognitive remediation offers the possibility of ameliorating a specific deficit that often accompanies psychotic symptoms and may restrict the magnitude of the clinical benefits derived from Multifamily group psychoeducation (MFG)
Among individuals with psychotic disorders, participation in MFG is associated with reduced rates of relapse [13,14], and the clinical benefit of this intervention appears to be greater among individuals with firstepisode psychosis as opposed to individuals with a chronic psychotic disorder [11]
Summary
Group psychoeducation (MFG) has been shown to reduce relapse rates among individuals with first-episode psychosis. One particular form of family psychoeducation which has shown promise among individuals with first-episode psychosis is multifamily group psychoeducation (MFG) [11] This intervention provides participants with information about the course and treatment of psychotic disorders and trains participants in the use of a structured problem-solving exercise designed to help them navigate the many challenges associated with living with a psychotic disorder or caring for a relative with a psychotic disorder. Among individuals with psychotic disorders, participation in MFG is associated with reduced rates of relapse [13,14], and the clinical benefit of this intervention appears to be greater among individuals with firstepisode psychosis as opposed to individuals with a chronic psychotic disorder [11] The success of this intervention among individuals with first-episode psychosis has led to the incorporation of MFG within several major international studies of first-episode psychosis (e.g., OPUS [15] and TIPS [16]). Despite the clear clinical benefits associated with participation in MFG, there is still room for improvement with regard to the clinical outcomes of individuals who participate in this intervention
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