Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups

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Standard

Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups. / van der Gaag, Mark; Smit, Filip; Bechdolf, Andreas et al.
In: Schizophrenia Research, Vol. 149, No. 1-3, 09.2013, p. 56-62.

Research output: Journal contributionsJournal articlesResearchpeer-review

Harvard

van der Gaag, M, Smit, F, Bechdolf, A, French, P, Linszen, D, Yung, AR, McGorry, P & Cuijpers, P 2013, 'Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups', Schizophrenia Research, vol. 149, no. 1-3, pp. 56-62. https://doi.org/10.1016/j.schres.2013.07.004

APA

van der Gaag, M., Smit, F., Bechdolf, A., French, P., Linszen, D., Yung, A. R., McGorry, P., & Cuijpers, P. (2013). Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups. Schizophrenia Research, 149(1-3), 56-62. https://doi.org/10.1016/j.schres.2013.07.004

Vancouver

van der Gaag M, Smit F, Bechdolf A, French P, Linszen D, Yung AR et al. Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups. Schizophrenia Research. 2013 Sept;149(1-3):56-62. doi: 10.1016/j.schres.2013.07.004

Bibtex

@article{45e1260d78904c68b0b0bd3b27af043f,
title = "Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups",
abstract = "Over the last decade many studies were conducted to assess the feasibility of early detection of people at risk of developing psychosis and intervention to prevent or delay a first psychotic episode. Most of these studies were small and underpowered. A meta-analysis can demonstrate the effectiveness of the efforts to prevent or postpone a first episode of psychosis. A search conducted according the PRISMA guideline identified 10 studies reporting 12-month follow-up data on transition to psychosis, and 5 studies with follow-ups varying from 24 to 48 months. Both random and fixed effects meta-analyses were conducted. The quality of the studies varied from poor to excellent. Overall the risk reduction at 12 months was 54% (RR = 0.463; 95% CI = 0.33–0.64) with a Number Needed to Treat (NNT) of 9 (95% CI = 6–15). Although the interventions differed, there was only mild heterogeneity and publication bias was small. All subanalyses demonstrated effectiveness. Also 24 to 48-month follow-ups were associated with a risk reduction of 37% (RR = .635; 95% CI = 0.44–0.92) and a NNT of 12 (95% CI = 7–59). Sensitivity analysis excluding the methodologically weakest study showed that the findings were robust. Early detection and intervention in people at ultra-high risk of developing psychosis can be successful to prevent or delay a first psychosis. Antipsychotic medication showed efficacy, but more trials are needed. Omega-3 fatty acid needs replication. Integrated psychological interventions need replication with more methodologically sound studies. The findings regarding CBT appear robust, but the 95% confidence interval is still wide.",
keywords = "Health sciences, psychosis, Meta-analysis, Prevention, Ultra-high risk, transition to psychosis, Psychology",
author = "{van der Gaag}, Mark and Filip Smit and Andreas Bechdolf and Paul French and Don Linszen and Yung, {Alison R.} and Patrick McGorry and Pim Cuijpers",
year = "2013",
month = sep,
doi = "10.1016/j.schres.2013.07.004",
language = "English",
volume = "149",
pages = "56--62",
journal = "Schizophrenia Research",
issn = "0920-9964",
publisher = "Elsevier B.V.",
number = "1-3",

}

RIS

TY - JOUR

T1 - Preventing a first episode of psychosis

T2 - meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups

AU - van der Gaag, Mark

AU - Smit, Filip

AU - Bechdolf, Andreas

AU - French, Paul

AU - Linszen, Don

AU - Yung, Alison R.

AU - McGorry, Patrick

AU - Cuijpers, Pim

PY - 2013/9

Y1 - 2013/9

N2 - Over the last decade many studies were conducted to assess the feasibility of early detection of people at risk of developing psychosis and intervention to prevent or delay a first psychotic episode. Most of these studies were small and underpowered. A meta-analysis can demonstrate the effectiveness of the efforts to prevent or postpone a first episode of psychosis. A search conducted according the PRISMA guideline identified 10 studies reporting 12-month follow-up data on transition to psychosis, and 5 studies with follow-ups varying from 24 to 48 months. Both random and fixed effects meta-analyses were conducted. The quality of the studies varied from poor to excellent. Overall the risk reduction at 12 months was 54% (RR = 0.463; 95% CI = 0.33–0.64) with a Number Needed to Treat (NNT) of 9 (95% CI = 6–15). Although the interventions differed, there was only mild heterogeneity and publication bias was small. All subanalyses demonstrated effectiveness. Also 24 to 48-month follow-ups were associated with a risk reduction of 37% (RR = .635; 95% CI = 0.44–0.92) and a NNT of 12 (95% CI = 7–59). Sensitivity analysis excluding the methodologically weakest study showed that the findings were robust. Early detection and intervention in people at ultra-high risk of developing psychosis can be successful to prevent or delay a first psychosis. Antipsychotic medication showed efficacy, but more trials are needed. Omega-3 fatty acid needs replication. Integrated psychological interventions need replication with more methodologically sound studies. The findings regarding CBT appear robust, but the 95% confidence interval is still wide.

AB - Over the last decade many studies were conducted to assess the feasibility of early detection of people at risk of developing psychosis and intervention to prevent or delay a first psychotic episode. Most of these studies were small and underpowered. A meta-analysis can demonstrate the effectiveness of the efforts to prevent or postpone a first episode of psychosis. A search conducted according the PRISMA guideline identified 10 studies reporting 12-month follow-up data on transition to psychosis, and 5 studies with follow-ups varying from 24 to 48 months. Both random and fixed effects meta-analyses were conducted. The quality of the studies varied from poor to excellent. Overall the risk reduction at 12 months was 54% (RR = 0.463; 95% CI = 0.33–0.64) with a Number Needed to Treat (NNT) of 9 (95% CI = 6–15). Although the interventions differed, there was only mild heterogeneity and publication bias was small. All subanalyses demonstrated effectiveness. Also 24 to 48-month follow-ups were associated with a risk reduction of 37% (RR = .635; 95% CI = 0.44–0.92) and a NNT of 12 (95% CI = 7–59). Sensitivity analysis excluding the methodologically weakest study showed that the findings were robust. Early detection and intervention in people at ultra-high risk of developing psychosis can be successful to prevent or delay a first psychosis. Antipsychotic medication showed efficacy, but more trials are needed. Omega-3 fatty acid needs replication. Integrated psychological interventions need replication with more methodologically sound studies. The findings regarding CBT appear robust, but the 95% confidence interval is still wide.

KW - Health sciences

KW - psychosis

KW - Meta-analysis

KW - Prevention

KW - Ultra-high risk

KW - transition to psychosis

KW - Psychology

UR - http://www.scopus.com/inward/record.url?scp=84881219514&partnerID=8YFLogxK

U2 - 10.1016/j.schres.2013.07.004

DO - 10.1016/j.schres.2013.07.004

M3 - Journal articles

C2 - 23870806

VL - 149

SP - 56

EP - 62

JO - Schizophrenia Research

JF - Schizophrenia Research

SN - 0920-9964

IS - 1-3

ER -