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Social recovery therapy plus early intervention benefits patients with psychosis

Enhanced social recovery therapy plus early intervention increased time spent in structured activity among patients with first-episode psychosis, indicating that social recovery therapy may help improve functional outcomes in these patients, according to findings published in The Lancet Psychiatry.

“New interventions targeting functional and social recovery are needed in people with first-episode psychosis,” David Fowler, MSc, professor in the department of psychology at the University of Sussex, in the U.K., and colleagues wrote. “Addressing these issues at an early stage is key because the presence of persistent early social decline is associated with a poor long-term course of schizophrenia. In addition to the personal consequences of functional disability, there are also large financial implications for society, with much of the cost of psychosis resulting from lost productivity.”

Researchers conducted a single-blind, phase 2, randomized controlled trial at four recruitment centers in the U.K to determine whether social recovery therapy plus early intervention services would help improve social recovery among patients with first-episode psychosis. Participants were aged 16 to 35 years, had non-affective psychosis, had been clients of early intervention services for 12 to 30 months, and had persistent and severe social disability. Fowler and colleagues randomly assigned participants 1:1 to receive social recovery therapy with early intervention services or only early intervention services. Primary outcome was time spent in structured activity at 9 months.

Seventy-six participants who received social recovery therapy plus early intervention services and 79 who received only early intervention services were assessed between Oct. 1, 2012 and June 20, 2014, and 143 participants had data for the primary outcome at 9 months.

Social recovery therapy plus early intervention services was associated with an increase in structured activity of 8.1 hours (95% CI, 2.5–13.6; P = .005) compared with only early intervention services. According to the researchers, these findings suggest that social recovery therapy may lead to improvements in functional outcomes among this patient population, especially in those unmotivated to engage in existing psychosocial interventions targeting functioning or who have comorbid difficulties.

“This study provides encouragement for practitioners in early intervention services to focus on this subgroup who are often neglected. The degree to which the treatment results in persistence of gains and longer-term effects likewise deserves further study,” Fowler and colleagues wrote. “The extent to which interventions of this type might be enhanced by top-up therapy or a greater number of sessions over a longer duration could be worthy of further scrutiny in view of evidence from similar studies in adults with more established schizophrenia.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.