Positive Emotions Program for Schizophrenia (PEPS)
Condition: Schizophrenia; Schizoaffective Disorder
MeSH terms: Schizophrenia; Psychotic Disorders
Study type: Interventional

Summary: 
      This study evaluates the addition of a 8 session psychological program, called Positive
      Emotions Program for Schizophrenia (PEPS) to improve motivation and pleasure in adults with
      schizophrenia. Half of the participants will receive their usual treatment and PEPS in
      combination, while the other half will receive usual treatment only.
    

Detailed description: 
      Recent literature has distinguished the negative symptoms associated with a diminished
      capacity to experience (apathy, anhedonia) from those which are associated with a limited
      capacity for expression (emotional blunting, alogia). The apathy-anhedonia syndrome tends to
      be associated with a poorer prognosis than the symptoms related to diminished expression,
      suggesting that it is the more severe facet of the psychopathology. However the efficacy of
      drug-based treatments and psychological interventions on primary negative symptoms remains
      limited. There is a clear clinical need for developing treatments for negative symptoms.

      The Positive Emotions Programs for Schizophrenia (PEPS) teaches skills to help overcome
      defeatist thinking and to increase the anticipation and maintenance of positive emotions.
      PEPS involves eight one-hour group sessions, administered using visual and audio materials as
      part of a PowerPoint presentation of slides projected onto a screen.

      The goal of the study is to establish if PEPS is clinically effective by using a randomized,
      controlled and assessor-blind trial. A combination of PEPS plus treatment as usual will be
      compared to treatment as usual alone. Participants diagnosed with a schizophrenia spectrum
      disorder will undergo either intervention for eight weeks. Testing will evaluate individuals'
      current psychopathology and ability to savor pleasure and will be performed at the time of
      inclusion, at the end of the eight-week intervention and at six month follow-up.
    

Intervention name(s): Positive Emotions Program for Schizophrenia; Treatment As Usual
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Each session of PEPS includes relaxation-meditation exercise, review of homework task given during the previous session, exercises to challenge defeatist beliefs. According to the session's theme, participants learn skills to improve their anticipation or maintenance of pleasure such as savoring a pleasant experience, expressing emotions by increasing behavioral expression, capitalizing on positive moments, and anticipating pleasant moments. A simple homework task is assigned to be done between each session. The pedagogical concept underpinning the program was built according to Kolb and Kolb's model of experiential learning. The program uses a collaborative, egalitarian approach.; TAU consists of psychiatric management by a clinical team composed of at least one psychiatrist and a social worker and/or a psychiatric nurse with additional access to community treatment or hospital admission. Treatment involves antipsychotic medication, regular office-based or community contact with the clinical team for treatment monitoring, and socialization groups, therapy, and psychoeducational groups. No attempts have been made to standardize this treatment as TAU is tailored to the patient's specific needs.
Other intervention name(s): PEPS; TAU
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Anhedonia; Apathy; Negative symptoms; Anticipatory pleasure; Savoring