Early Detection and Intervention for the Prevention of Psychosis
Condition: Schizophrenia; Bipolar Disorder; Depression; Psychotic Disorders
MeSH terms: Depression; Schizophrenia; Bipolar Disorder; Psychotic Disorders; Mental Disorders
Study type: Interventional

Summary: 
      EDIPP is a multisite trial of early identification and intervention to prevent the onset of
      psychosis in adolescents and young adults, carried out at six sites across the United States.
      The hypothesis is that very early identification and intervention will be effective in
      delaying or preventing onset of psychosis and improving social and occupational functioning.
    

Detailed description: 
      The study is structured as a cutoff, regression discontinuity design, in which lower
      risk-for-psychosis participants will not be treated by protocol but followed up for two
      years. Those at higher risk will be treated with anti-psychotic, antidepressant and mood
      stabilizing medications by symptom indications, and systematically provided psychoeducational
      multifamily group treatment, supported education and employment, and intensive clinical case
      management, using key elements of Assertive Community Treatment. Both arms of the study will
      be followed for two years and assessed at 6, 12, and 24 months. Outcome measures include
      rates of conversion to psychosis, relapse of psychosis, development of psychotic disorder
      diagnoses, levels of positive, negative and general symptoms, social and vocational
      functioning, family functioning, and neurocognitive functioning.

      The six sites include Sacramento, California; Salem Oregon; and surrounding counties,
      Ypsilanti and Washtenaw County, Michigan; Portland, Maine; Albuquerque, New Mexico and Glen
      Oaks, New York.

      In addition to symptomatic and functional outcomes, impact on incidence of psychotic
      disorders, including schizophrenia, will be assessed, as will cost-benefit effects.
    

Intervention name(s): aripiprazole; fluoxetine; bupropion; sertraline; lamotrigine; Psychoeducational multifamily group treatment; Supported employment and education
Intervention type(s): Drug; Behavioral; Behavioral
Intervention description(s): Oral, daily, generally at lower than manufacturer's recommendations; Families and patients are educated on psychobiology of psychosis and trained in coping skills to avoid psychosis by reducing stress and optimizing social environment at home, school, work; Participants are provided direct assistance, guidance and ongoing support to gain employment and succeed in their educational goals.
Other intervention name(s): Abilify; Prozac; Welbutrin; Zoloft; Lamictal; Family psychoeducation,; Family behavioral therapy; Multiple family group therapy; Supported employment; Supported education
Intervention MeSH terms: Lamotrigine; Aripiprazole; Bupropion; Fluoxetine; Sertraline
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Schizophrenia; Bipolar disorder; Psychosis; Prodromal psychosis; Family psychoeducation; Supported education; Supported employment; Ulra-high-risk for psychosis; Major depression; Bipolar disorder, with psychotic features; Major depression, with psychotic features; Attenuated, prodromal psychotic symptoms