Table 1 Qualitative summary of the included trials.
Cognitive Behavioural Therapy (CBT) | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Article (Name of trial, if any) | Country | Primary outcome measure for transition to psychosis | CHR-P Ascertainment method | Active Intervention – (description) | Control Intervention (description) | Duration of intervention | Assessment time points of interest for meta-anlysis | N Interv | Age Interv | Gender Interv Males N (%) | N Control | Age Control | Gender Control Males |
1. Addington [47] | Canada | POPS (McGlashan [60]) | SIPS | CBT | Supportive Therapy (Active listening supporting individuals to cope with current problems) | 6 months | 6, 12, 18, 24 | 27 | 20.8 (4.5) | 18 (35.3) | 24 | 21.1 (3.7) | 18 (35.3) |
2. Addington [29] | Canada/US | SIPS | SIPS | CBT + SST (Group CBT enriched with social skill training) | Supportive Therapy (Active listening supporting individuals to cope with current problems) | 4.5 months | 12 | 104 | 17.4 (4.0) | 29 (41.4) | 99 | 17.5 (4.1) | 40 (48.8) |
3. Bechdolf [28] (PREVENT)a | Germany | POPS | COGDIS / SIPS | CBT | Case Management + Placebo pill (Case Management: Psychoeducation on the at-risk mental state and pharmacotherapy) | 12 months | 6, 12 | 129 | 24.2 (5.4) | 78 (60.5) | 55 | 24.9 (5.4) | 33 (60.0) |
4. McGorry [27], (SMART) | Australia | CBT + Case Management | SPS (“Manualized supportive counselling and problem-solving strategy) | 12 months | 6 | 153 | 17.7* (3.1) *overall group | 144* (42.1) *overall group | 159 | 17.7* (3.1) *overall group | 144* (42.1) *overall group | ||
UK | PANSS | PANSS | CBT + Case Management | Case Management (“to resolve crisis regarding social issues and mental health risks”) | 6 months | 6, 12, 36+ | 37 | 20.6 (4.9) | 21 (60.0) | 23 | 21.5 (5.2) | 19 (82.6) | |
6. Morrison [49] | UK | CAARMS | CAARMS | CBT + Monitoring of mental state | Monitoring of mental state (Supportive listening + signposting to local services for unmet needs or crisis management) | 6 months | 6,12,18,24 | 144 | 20.7 (4.2) | 89 (61.8) | 144 | 20.7 (4.5) | 91 (63.2) |
7, Pozza [50] | Italy | SCID-I | CAARMS | CBT (CBT enriched with social skill training and interventions targeting comorbid anxiety/depression) | “TAU” (Supportive listening) | 7 months | 6, 14 | 29 | 25.4 (6.1) | 19 (65.5) | 29 | 26.0 (5.7) | 17 (69) |
8. Stain [51] (DEPth) | Australia | CAARMS | CAARMS | CBT | NDRL (Supportive listening) | 6 months | 6, 12 | 30 | 16.2 (2.7) | 10 (33.0) | 27 | 16.5 (3.2) | 14 (48.0) |
Netherlands | CAARMS | CAARMS | CBT (CBT + psychoeducation on dopamine supersensitivy) | “TAU” (“Treatment for the mental problems that they are seeking help for – e.g., depression, anxiety, ADHD”) | 6 months | 6,12,18,36+ | 98b | 22.9 (5.6) | 49 (50.0) | 103 | 22.6 (5.5) | 50 (48.5) | |
Australia | CAARMS | CAARMS | CBT + Placebo pill | Supportive therapy + Placebo pill (“Therapy aimed to provide the patient with emotional and social support, basic problem solving, stress management, psychoeducation about psychosis”) | 12 months | 6, 12 | 44 | 18 (2.7) | 17 (39.0) | 28 | 18.8 (3.7) | 13 (46.0) | |
Family interventions | |||||||||||||
1. McFarlane [55] (EDIP) | US | SIPS/POPS | SIPS | F-ACT (Family psychoeducation, assertive community treatment, supported education/employment, psychotropic medications) | Enhanced Treatment (Psychotropic drugs, individual case management, family education, crisis intervention) | Unclear | Up to 60 months | 50 | 16.5 (3.1) | 26 (52.0) | 50 | 16.1 (2.8) | 26 (52.0) |
2. Miklovitz [56] | US | SIPS | SIPS | FFT-CHR (Family psychoeducation targeting stressors that may contribute to psychotic symptoms + social skill training) | Enhanced Care (Family educational intervention for 1 month) | 6 months | 6 | 66 | 17.3 (4.2) | 39 (57.4) | 63 | 17.4 (3.9) | 35 (55.6) |
Sleep Interventions | |||||||||||||
1. Waite [31], (SleepWell) | UK | CAARMS | CAARMS | SleepWell (“Psychological intervention targeting three mechanisms that regulate sleep: sleep pressure, circadian rhythm, and hyper arousal”) | TAU (“Infrequent contact with a general practitioner for assessment, and prescription of psychotropic medication as needed”) | 4 months | 6, 12* *9 months | 21 | 17.0 (2.2) | 9 (42.0) | 19 | 16.8 (2.8) | 10 (48.0) |
Systemic Therapy | |||||||||||||
1. Shi [57] | China | SIPS | SIPS | ST (Systemic Therapy: “contextualise attenuated psychotic symptoms by addressing an individual’s social system to which he/she attaches importance”) | Supportive Therapy (Supportive listening) | 6 months | 6 | 13 | 18.9 (3.2) | 4 (35.8) | 13 | 18.9 (4.3) | 8 (61.5) |
Cognitive Remediation | |||||||||||||
1. Glenthøj [58], (FOCUS) | Denmark | CAARMS | CAARMS | Cognitive remediation (Manualised neuro- and social-cognitive remediation) | TAU (“Regular contact with health professionals and supportive counselling”) | 5 months | 6 | 73 | 23.9 (4.7) | 35 (48.0) | 73 | 23.9 (3.8) | 29 (39.8) |
Integrated Psychotherapy (CBT + cognitive remediation) | |||||||||||||
1. Bechdolf [59] (EIPS) | Germany | PANSS | ERIaos | IPI (CBT + SST+ cognitive remediation +family psychoeducation) | Supportive Counselling (Basic psychoeducation + active listening) | 12 months | 12, 24 | 63 | 25.2 (5.4) | 39 (61.9) | 65 | 26.8 (6.2) | 42 (64.6) |
Antipsychotics | |||||||||||||
1. Bechdolf [28] (PREVENT)c | Germany | POPS | COGDIS /SIPS | Aripiprazole (5–15 mg/day) + Case Management (Psychoeducation on the at-risk mental state and pharmacotherapy) | Placebo pill + Case Management (Psychoeducation on the at-risk mental state and pharmacotherapy) | 12 months | 6, 12 | 96 | 24.2 (5.0) | 71 (74.0) | 55 | 24.9 (5.4) | 33 (60.0) |
2. McGlashan [60] | US | POPS | SIPS | Olanzapine (5–15 mg/day) | Placebo pill | 12 months | 6, 12 | 31 | 18.2 (5.5) | 21 (67.7) | 29 | 17.2 (4.0) | 18 (62.1) |
3. Woods [61] | US | SIPS | SIPS | Ziprasidone (20–160 mg/day) + Supportive Interpersonal Therapy | Placebo pill + Supportive Interpersonal Therapy | 6 months | 6 | 24 | NR | NR | 27 | NR | NR |
Australia | CAARMS | CAARMS | Risperidone (max 2 mg/day) + CBT (CBT focussed on patients’ need, including subthreshold psychotic symptoms) | Placebo pill + CBT (CBT focussed on patients’ need, including subthreshold psychotic symptoms) | 12 months | 6, 12 | 43 | 17.6 (3.0) | 15 (34.9) | 44 | 18.0 (2.7) | 17 (38.6) | |
Omega 3 | |||||||||||||
Austria | PANSS | PANSS | ω-3 PUFAs (1.2 g/day) | Placebo pill | 3 months | 6,12,36+ | 41 | 16.8 (2.4) | 14 (34.0) | 40 | 16.0 (1.7) | 13 (33.0) | |
2. Cadenhead [64] | US | SIPS | SIPS | ω-3 PUFAs (740 mg EPA and 400 mg DHA/day) | Placebo pill | 6 months | 6,12 | 65 | 62 | ||||
Australia | CAARMS | CAARMS | ω-3 PUFAs (1.4 g/day) 0–6 months. ω-3 PUFAs (1.4 g/day) + CBCM 6–12 months. | Placebo pill 0–6 months. Placebo pill + CBCM 6-12 months. | 12 months | 6,12 | 153 | 19.4 (4.8) | 78 (51.0) | 151 | 18.9 (4.3) | 61 (40.4) | |
4. Qurashi [71]d (NAYAB) | Pakistan | CAARMS | CAARMS | ω-3 PUFAs (1.2 g/day; 720 mg EPA and 480 mg DHA/day) | Placebo pill | 12 months | 6, 12 | 80 | 23.8 (5.4) | 47 (58.8) | 82 | 23.9 (5.3) | 50 (61.0) |
Minocycline | |||||||||||||
1. Qurashi [71]d (NAYAB) | Pakistan | CAARMS | CAARMS | Minocycline [Minocycline + ω-3 PUFAs]d | Placebo pill | 12 months | 6, 12 | 82 | 25.2 (5.3) | 48 (59.5) | 82 | 23.9 (5.3) | 50 (61.0) |
Combined (psychotherapy + antipsychotics) | |||||||||||||
Australia | CAARMS | CAARMS | Risperidone (max 2 mg/day) + CBT | NBI (Needs-based psychotherapy focussed on social relationships and vocational/family issues + needs-based pharmacotherapy) | 6 months | 6, 12, 36–48 | 31 | 20 (4.0) | 20 (65) | 28 | 20 (3.0) | 14 (50) | |
Australia | CAARMS | CAARMS | Risperidone (max 2 mg/day) + CBT (CBT focussed on patients’ need, including subthreshold psychotic symptoms) | Supportive therapy + Placebo pill (“Therapy aimed to provide the patient with emotional and social support, basic problem solving, stress management, psychoeducation about psychosis”) | 12 months | 6, 12 | 43 | 17.6 (3.0) | 15 (34.9) | 28 | 18.8 (3.7) | 13 (46.0) | |
Transcranial Magnetic Stimulation (TMS) | |||||||||||||
1. Tang [30] | China | SIPS | SIPS | TMS over the parieto-hippocampal network (10 sessions over two days) | Sham TMS | 2 days | 12 months | 31 | 19.0 (5.9) | 12 (39.7) | 27 | 19.6 (6.0) | 19 (70.4) |
