S23. EFFICACY OF COGNITIVE-BEHAVIORAL SOCIAL SKILLS TRAINING IMPROVING SYMPTOMS AND FUNCTIONING IN PATIENTS WITH EARLY-ONSET PSYCHOSIS: A RANDOMIZED CONTROLLED TRAIL
Authors: Puig-Navarro Olga , Badia Francina , Baeza Inmaculada , Varela Eva , Sugranyes Gisela , Garcia-Rizo Clemente , Forner Mireia , Gallegos Yuli , Granholm Eric 
Published: May 2020

Abstract

Background
The onset of a psychotic disorder before age 18 (early-onset psychosis, EOP) is a marker of greater clinical severity and poor outcome. There is a lack of studies examining the efficacy of psychological treatment in this population. The Cognitive-Behavioral Social Skills Training (CBSST) is an evidence-based psychological intervention for patients with schizophrenia. OBJECTIVE: To analyze the efficacy of the adolescent version of CBSTT (CBSST-Adolt) versus an active psychological intervention, administered during the critical period, to improve symptoms and functioning in patients with EOP.

Methods
Randomized controlled trail (RCT) of the adolescent version of the CBSST-Adol compared to an active control intervention. Interventions: The CBSTT-Adol included the 3 original modules (cognitive abilities, social skills, problem-solving skills) but number of sessions was reduced. It was administered in small groups. The active control intervention (PSYCHOED-Adol) included 3 modules (psychoeducation, relapse prevention, healthy life style) with the same format and number of sessions. The language and examples were adapted for adolescents in both interventions. Inclusion criteria: schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder, psychotic disorder not otherwise specified), diagnosed before 18; being in the critical period of the illness (first 5 years after the onset); being clinically stabilized (outpatients). Exclusion criteria: IQ&lt;70; having a substance dependence disorder; having a neurological disorder. Procedure: Patients (n=30) were randomized to both branches of the study after the baseline assessment and were re-assessed after the treatment (CBSST-Adol n=16, PSYCHOED-Adol n=14). The study included a group of healthy controls (HC, n=20) matched for age and sex, who were assessed only at baseline. Pharmacological treatment was supervised by patients’ clinical psychiatrists. Instruments: PANNS, GAF, GF:Role, GF:Social, Life Skills Profile (LSP), Caregivers’ Burden Inventory (CBI). Statistical analyses: T-test was used for comparisons between patients and HC. Lineal generalized models were run for examining group differences after the treatment between CBSST-Adol and PSYCHOED-Adol, controlling for baseline scores. Intention-to-treat analyses.

Results
There were no significant differences in sex or age, but in socioeconomic status (p&lt;0.001), between HC and EOP subjects. Patients with EOP had lower scores in all areas of functioning (global, role, social, daily living skills, caregivers’ burden, p&lt;0.001). There were no significant differences in any of the baseline characteristic between patients allocated in the CBSST-Adol and the PSYCHOED-Adol groups (sociodemographic variables, symptoms, functioning, pharmacological treatment, duration of the illness, p&gt;0.05). There was a similar rate of dropouts during the trail in both branches of the study (31% and 29%, p&gt;0.05). Improvements in clinical symptoms (PANSS total, p=0.045; PANSS positive symptoms, p=0.009) and functioning (GAF, p=0.002; GF:Social, p=0.025, CBI, p=0.020) were found at post-treatment in all sample. However, there was no a superior effect of CBSST-Adol compared to PSYCHOED-Adol in any variable. There was only a trend to a higher improving of the Communication and social contact subscale of the Life Skills Profile in the CBSST-Adol intervention (p=0.061).

Discussion
The results support the efficacy of psychological intervention improving symptoms and functioning in EOP. We find a similar positive effect after the treatment in both CBSTT-Adol and PSYCHOED-Adol interventions. Main limitations: not having a non-active control group and the sample size.