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Predictors and moderators of treatment outcome in patients receiving multi-element psychosocial intervention for early psychosis: Results from the GET UP pragmatic cluster randomised controlled trial

  • Antonio Lasalvia (a1), Chiara Bonetto (a2), Jacopo Lenzi (a3), Paola Rucci (a3), Laura Iozzino (a2), Massimo Cellini (a4), Carla Comacchio (a2), Doriana Cristofalo (a2), Armando D'Agostino (a5), Giovanni de Girolamo (a6), Katia De Santi (a1), Daniela Ghigi (a7), Emanuela Leuci (a8), Maurizio Miceli (a4), Anna Meneghelli (a9), Francesca Pileggi (a10), Silvio Scarone (a5), Paolo Santonastaso (a11), Stefano Torresani (a12), Sarah Tosato (a2), Angela Veronese (a11), Angelo Fioritti (a13), Mirella Ruggeri (a14) and the GET UP Group...
Abstract
Background

The GET UP multi-element psychosocial intervention proved to be superior to treatment as usual in improving outcomes in patients with first-episode psychosis (FEP). However, to guide treatment decisions, information on which patients may benefit more from the intervention is warranted.

Aims

To identify patients' characteristics associated with (a) a better treatment response regardless of treatment type (non-specific predictors), and (b) a better response to the specific treatment provided (moderators).

Method

Some demographic and clinical variables were selected a priori as potential predictors/moderators of outcomes at 9 months. Outcomes were analysed in mixed-effects random regression models. (Trial registration: ClinicalTrials.gov, NCT01436331.)

Results

Analyses were performed on 444 patients. Education, duration of untreated psychosis, premorbid adjustment and insight predicted outcomes regardless of treatment. Only age at first contact with the services proved to be a moderator of treatment outcome (patients aged ≥35 years had greater improvement in psychopathology), thus suggesting that the intervention is beneficial to a broad array of patients with FEP.

Conclusions

Except for patients aged over 35 years, no specific subgroups benefit more from the multi-element psychosocial intervention, suggesting that this intervention should be recommended to all those with FEP seeking treatment in mental health services.

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Copyright
Corresponding author
Antonio Lasalvia, U.O.C. Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Policlinicô G.B. Rossi€, P.le Scuro, 10 37134 – Verona, Italy. Email: antonio.lasalvia@univr.it
Footnotes
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*

The full list of authors included in the GET UP Group appears in the online supplement to this paper.

Declaration of interest

None.

Footnotes
References
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Predictors and moderators of treatment outcome in patients receiving multi-element psychosocial intervention for early psychosis: Results from the GET UP pragmatic cluster randomised controlled trial

  • Antonio Lasalvia (a1), Chiara Bonetto (a2), Jacopo Lenzi (a3), Paola Rucci (a3), Laura Iozzino (a2), Massimo Cellini (a4), Carla Comacchio (a2), Doriana Cristofalo (a2), Armando D'Agostino (a5), Giovanni de Girolamo (a6), Katia De Santi (a1), Daniela Ghigi (a7), Emanuela Leuci (a8), Maurizio Miceli (a4), Anna Meneghelli (a9), Francesca Pileggi (a10), Silvio Scarone (a5), Paolo Santonastaso (a11), Stefano Torresani (a12), Sarah Tosato (a2), Angela Veronese (a11), Angelo Fioritti (a13), Mirella Ruggeri (a14) and the GET UP Group...
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