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COGNITIVE BEHAVIORAL THERAPY PROGRAM TO FIRST-EPISODE PSYCHOSIS PATIENTS AND CANNABIS ABUSE

Not Applicable
Completed
Conditions
Cannabis Abuse
First-episode Psychosis
Interventions
Behavioral: Cognitive-behavioral therapy program to first-episode psychosis patients and cannabis abuse
Behavioral: Psychoeducation
Registration Number
NCT02319746
Lead Sponsor
Basque Health Service
Brief Summary

General objective:

To assess the effectiveness of a treatment program specific for cannabis abuse (cognitive behavioral treatment + pharmacological treatment) compared to standard treatment (pharmacological treatment + psychoeducation) in patients with first episodes psychosis (FEP) cannabis users.

Design A multicenter single-blind randomized study with 1 year of follow-up. The effectiveness of a treatment program specific for cannabis abuse (cognitive behavioral treatment + pharmacological treatment) compared to standard treatment (pharmacological treatment + psychoeducation) in patients with first episodes psychosis (FEP) cannabis users will be assessed.

Patients will be randomly assigned to one of two treatments:

1. Experimental group (N=50): Cognitive-behavioral treatment specific for cannabis abuse + pharmacological treatment

2. Control group (N=50): standard treatment: psychoeducation + pharmacological treatment

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
88
Inclusion Criteria
    • Having a first psychotic episode. DSM-IV-TR diagnosis of a psychotic disorder (i.e. schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, bipolar disorder, atypical psychosis, brief psychotic disorder, or major depressive disorder with psychotic symptoms).
    • Being a regular cannabis user according DSM-IV
  1. -Being in remission from the first psychotic episode (not exceeding 5 years).
Exclusion Criteria
  1. Presenting organic brain pathology.
  2. Presenting mental retardation according to DSM-IV criteria.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Experimental groupCognitive-behavioral therapy program to first-episode psychosis patients and cannabis abuseThe subjects of experimental group will receive a cognitive-behavioral treatment program specific for reduce cannabis use composed of 16 weekly sessions (one hour in duration), in addition to regular psychiatric review and pharmacological treatment. The group will consist of 6-8 subjects.
Control groupPsychoeducationThe control group will receive standard care for psychotic episodes which includes pharmacological treatment and psychoeducation, following the same format as the experimental group. 16 weekly sessions of psychoeducation (one hour in duration) will be conducted, in addition to regular psychiatric review and pharmacological treatment. Like the experimental group the group will consist of 6-8 subjects.
Primary Outcome Measures
NameTimeMethod
Normalizing the possible alterations in the endogenous cannabinoid systemBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To assess whether treatment program specific for cannabis abstinence is capable of normalizing the possible alterations in the endogenous cannabinoid system in patients that reduce the cannabis use.

Changes in the components of the endogenous cannabinoid systemBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To determine whether changes in the components of the endogenous cannabinoid system at systematic level are produced in FEP cannabis abusers.

Cannabis use reduction in the follow-upBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up.

To assess whether cannabis focused psychological intervention is associated with a cannabis use reduction according to Europ-ASI scale compared to standard treatment

Improvement in the development of psychotic disorderBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To assess whether cannabis focused psychological intervention is associated with an improvement in the development of psychotic disorder (ie, reduction of symptoms and improvement of psychosocial functioning) compared with standard treatment at the end of treatment and at follow-up (at three and six months and one year of follow-up).

Secondary Outcome Measures
NameTimeMethod
Decrease the number of cannabis usersBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To determinate the number of patient who use cannabis in the follow-up in each group

Improvement in the psychosocial functioningBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To compare the improvement of psychosocial functioning in each group by Functioning Assessment Short Test (FAST).

Decrease of negative and positive psychotic symptomsBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To compare the decrease of negative and positive psychotic symptoms measured by Positive and Negative Syndrome Scale (PANSS), at post-treatment and follow-up.

Decrease of manic, depressive and anxiety symptomsBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To compare the decrease of manic, depressive and anxiety symptoms at post-treatment and follow-up. Manic symptoms will be measured using Young Mania Rating Scale (YMRS). Anxiety and depressive symptoms will be measured using Hamilton Anxiety Scale (HAM-A) and Hamilton Depression Scale (HAM-D), respectively.

Improvement in the adherence to pharmacological treatmentBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To compare the adherence to pharmacological treatment in each group using Morisky-Green Scale.

Withdrawal of patientsBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To evaluate percentage of withdrawal in the follow-up.

Decrease the number of relapses and rehospitalizationsBaseline, 16 weeks (posttreatment), at 3 and 6 months and at one year of follow up

To compare the number of relapses and rehospitalizations in in each group.

Trial Locations

Locations (1)

Araba University Hospital

🇪🇸

Vitoria, Alava, Spain

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