Clinical trial NCT05558332: Youth Nominated Support Team
Official title: Youth Nominated Support Team for Suicidal Adolescents at Clinical High Risk for Psychosis
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Psychosis
Suicide
Health Care Utilization
Family Members
Lead sponsor: University of California, Irvine
Sponsor class: OTHER
Collaborators: name: University of Maryland, Baltimore County
First posted: 2022-09-28
Enrollment: 70
Sex: ALL
Minimum age (years): 12
Maximum age (years): 25
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: One group will recieve the adapted YST treatment (YST-CHR) and the other group will receive treatment as usual. Participants receiving the existing treatment will be offered YST-CHR after the study is over if appropriate
Primary purpose: TREATMENT

Brief summary: This study aims to adapt the current Youth-Nominated Support Team (YST) manual used to treat suicide risk for people at clinical high risk for psychosis.

Detailed description: Psychotic disorders are characterized by high rates of suicidal ideation and behavior, and the risk for suicide appears to be greatest during the earliest stages of psychosis. A recent meta-analysis showed that the majority of youth at clinical high-risk (CHR) for psychosis experience suicidal ideation, and that approximately one in five make at least one suicide attempt. There are, however, no suicide prevention interventions specifically tailored to the needs of transition-aged youth at CHR, and no current best practice guidelines for how to respond to suicide risk in this population. The Youth-Nominated Support Team (YST) intervention has recently been shown to reduce mortality among adolescents and is potentially highly adaptable within the context of existing CHR services. YST is intended as an adjunctive treatment and is primarily delivered towards support persons rather than the youth themselves, and therefore would not interfere or overlap with the already extensive direct services provided in CHR treatment settings. The proposed project intends to adapt the YST intervention for CHR populations. Specifically, the investigators aim to: (1) adapt YST for CHR based on stakeholder input (i.e., clients, family/friends, clinicians) and to develop a new treatment manual and submit an additional IRB to cover the next two aims -- (2) to implement YST in a single CHR clinic and to revise the intervention based on input from clients, providers, and support person and (3) conduct a pilot randomized clinical trial at four SAMHSA funded CHR sites to test the efficacy of the adapted YST intervention and to identify underlying mechanisms of change. The investigators hypothesize that the revised intervention will be superior to existing practice for the reduction of suicidal ideation and behavior.

Eligibility criteria: Inclusion Criteria:

* A person with suicidal ideation in the past 3 months or suicidal attempt in the past year
* A person who is receiving or has received treatment for psychosis risk symptoms
* Between the ages of 12-25

Exclusion Criteria:

* Cannot have participated in the first 2 phases of the study (focus groups and adaption of the YST-CHR manual)

Primary outcomes:
measure: Social Connectedness
timeFrame: 3-months after intervention
measure: Increased Hope
timeFrame: 3-months after intervention
measure: Treatment Engagement
timeFrame: 3-months after intervention
Secondary outcomes:
measure: Severity and Intensity of Suicidal Ideation
timeFrame: Baseline, 6 weeks after intervention, and 3 months after intervention
measure: Severity and Intensity of Suicidal Ideation
timeFrame: baseline, 6 weeks after intervention, and 3 months after intervention
Other outcomes:
measure: Interpersonal Conflict
timeFrame: 3 months after intervention
Locations:
city: Irvine
country: United States
facility: The PREVENT Lab, University of California, Irvine
state: California
Study officials:
References:
citation: Palmer BA, Pankratz VS, Bostwick JM. The lifetime risk of suicide in schizophrenia: a reexamination. Arch Gen Psychiatry. 2005 Mar;62(3):247-53. doi: 10.1001/archpsyc.62.3.247.
citation: Bachmann S. Epidemiology of Suicide and the Psychiatric Perspective. Int J Environ Res Public Health. 2018 Jul 6;15(7):1425. doi: 10.3390/ijerph15071425.
citation: Bertolote JM, Fleischmann A. Suicide and psychiatric diagnosis: a worldwide perspective. World Psychiatry. 2002 Oct;1(3):181-5. No abstract available.
citation: Alaraisanen A, Miettunen J, Rasanen P, Fenton W, Koivumaa-Honkanen HT, Isohanni M. Suicide rate in schizophrenia in the Northern Finland 1966 Birth Cohort. Soc Psychiatry Psychiatr Epidemiol. 2009 Dec;44(12):1107-10. doi: 10.1007/s00127-009-0033-5. Epub 2009 Mar 25.
citation: Popovic D, Benabarre A, Crespo JM, Goikolea JM, Gonzalez-Pinto A, Gutierrez-Rojas L, Montes JM, Vieta E. Risk factors for suicide in schizophrenia: systematic review and clinical recommendations. Acta Psychiatr Scand. 2014 Dec;130(6):418-26. doi: 10.1111/acps.12332. Epub 2014 Sep 18.