Acute-phase and 1-year follow-up results of a randomized controlled trial of CBT versus Befriending for first-episode psychosis: the ACE project.

Full Abstract

BACKGROUND: The ACE project involved 62 participants with a first episode of psychosis randomly assigned to either a cognitive behaviour therapy (CBT) intervention known as Active Cognitive Therapy for Early Psychosis (ACE) or a control condition known as Befriending. The study hypotheses were that: (1) treating participants with ACE in the acute phase would lead to faster reductions in positive and negative symptoms and more rapid improvement in functioning than Befriending; (2) these improvements in symptoms and functioning would be sustained at a 1-year follow-up; and (3) ACE would lead to fewer hospitalizations than Befriending as assessed at the 1-year follow-up. METHOD: Two therapists treated the participants across both conditions. Participants could not receive any more than 20 sessions within 14 weeks. Participants were assessed by independent raters on four primary outcome measures of symptoms and functioning: at pretreatment, the middle of treatment, the end of treatment and at 1-year follow-up. An independent pair of raters assessed treatment integrity. RESULTS: Both groups improved significantly over time. ACE significantly outperformed Befriending by improving functioning at mid-treatment, but it did not improve positive or negative symptoms. Past the mid-treatment assessment, Befriending caught up with the ACE group and there were no significant differences in any outcome measure and in hospital admissions at follow-up. CONCLUSIONS: There is some preliminary evidence that ACE promotes better early recovery in functioning and this finding needs to be replicated in other independent research centres with larger samples.

Author information

Author/s: Jackson, H J (HJ); McGorry, P D (PD); Killackey, E (E); Bendall, S (S); Allott, K (K); Dudgeon, P (P); Gleeson, J (J); Johnson, T (T); Harrigan, S (S);

Affiliation: Departments of Psychology and Psychiatry, University of Melbourne and ORYGEN Research Centre, Parkville, Australia. henryjj(-atsign-)unimelb.edu.au

Journal and publication information

Publication Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: Psychological medicine (Psychol Med), published in England. (Language: eng)

Reference: 2008-May; vol 38 (issue 5) : pp 725-35

Dates: Created 2008/04/03; Completed 2008/08/22;

PMID: 18005494, status: MEDLINE (last retrieved date: 2/18/2009)

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