An Integrated Program for the Treatment of First Episode of Psychosis
Condition: Schizophrenia; Schizoaffective Disorder; Schizophreniform Disorder; Brief Psychotic Disorder; Psychotic Disorder NOS
MeSH terms: Schizophrenia; Mental Disorders; Psychotic Disorders
Study type: Interventional

Summary: 
      The purpose of this study is to determine how services should be provided to reduce symptoms
      and improve life functioning for adolescents and adults who have been recently diagnosed with
      schizophrenia.
    

Detailed description: 
      Schizophrenia is a major mental illness characterized by psychosis, negative symptoms (e.g.,
      apathy, social withdrawal, anhedonia), and cognitive impairment. Depression and substance
      abuse commonly co-occur. These individuals have impaired functioning in the areas of work,
      school, parenting, self-care, independent living, interpersonal relationships, and leisure
      time. Among adult psychiatric disorders, schizophrenia is the most disabling, and its
      treatment accounts for a disproportionate share of mental health services.

      This study is part of the National Institute of Mental Health's Recovery After an Initial
      Schizophrenia Episode (RAISE) Project. The RAISE Project seeks to fundamentally change the
      trajectory and prognosis of schizophrenia through coordinated and aggressive treatment in the
      earliest stages of illness. This study, the RAISE Early Treatment Program (ETP), is one of
      the two independent research studies that NIMH has funded to conduct the NIMH RAISE Project.
      ETP is being supported in whole or in part with Federal funds from the American Recovery and
      Reinvestment Act of 2009 and the NIMH, National Institutes of Health, Department of Health
      and Human Services.

      The ETP study aims to compare two early treatment interventions for adolescents and adults
      experiencing a first episode of psychosis. The clinical centers have been randomly allocated
      to offer one of the two treatment programs. Both treatment interventions are designed to
      provide a person with treatment soon after he or she experiences the early signs of
      schizophrenia. Participants will be offered mental health services such as medication and
      psychosocial therapy. These strategies are all aimed at promoting symptom reduction and
      improving life functioning. Participation in this study will last between 2 and 3 years. All
      participants will first undergo an initial videoconference interview to confirm a diagnosis
      of schizophrenia, schizoaffective disorder, psychosis NOS, brief psychotic disorder, or
      schizophreniform disorder. Eligible participants will then be offered mental health services.

      In addition to the mental health services, participants will participate in a series of
      research interviews. Participants will be interviewed every 3 months for the first 6 months
      and then every 6 months for up to 3 years. At the research visit, participants will complete
      an interview about their symptoms and general quality of life, complete questions about
      experiences with their illness, their vital signs will be measured, and a blood draw will be
      collected. At the initial, 12 and 24 month visits, participants will also complete a brief
      test that assesses skills such as memory, attention and problem solving. Participants will
      also have monthly telephone interviews about their illness and services that they have
      received.
    

Intervention name(s): Integrated Treatment; Community Care
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Integrated program of treatments and services delivered by a coordinated team of providers that includes:
education about schizophrenia and its treatment for the participants and their family members
medication for symptoms and preventing relapse that uses a computerized decision support system
strategies for managing the illness and building personal resilience
help getting back to school or work using a supported employment/education model; Standard mental health treatments and services offered at the local agency that may include :
medication for symptoms and preventing relapse
psychosocial therapy which may include a range of behavioral treatments and supportive services
Case management
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Schizophrenia; Schizoaffective Disorder; Schizophreniform Disorder; Brief Psychotic Disorder; Psychotic Disorder NOS; First Episode