Early Detection, Intervention, and Prevention of Psychosis Program: Rationale, Design, and Sample Description
William R. McFarlane, William L. Cook, Donna Downing, Anita Ruff, Sarah Lynch, Steven Adelsheim, Roderick Calkins, Cameron S. Carter, Barbara Cornblatt and Karen Milner
Affiliation: Center for Psychiatric Research, Maine Medical Center, 22 Bramhall Street, Portland, Maine 04102, USA.
Objective: To describe the rationale, design, intervention, and sample characteristics of the Early Detection, Intervention, and Prevention of Psychosis Program (EDIPPP), a multi-site study of the effectiveness of Family-Aided Assertive Community Treatment (FACT) in preventing the onset of psychosis in a nationally representative sample of atrisk young people.
Methods: Young people (age 12 - 25) and their families are assigned to a clinical high risk (CHR) group or a low risk group based on severity of positive symptoms of psychosis. Treatment families (CHR group) receive minimally 1 year of FACT and comparison families (low risk group) receive community care and monthly assessments. Initial betweengroups differences on key variables are statistically controlled according to procedures of the regression discontinuity design (RDD), so any emerging between-group differences in outcomes can be attributed to treatments.
Results: 337 young people (mean age 16.6) were assigned to the treatment group (n = 250) or comparison group (n = 87). 86% of the CHR sample met DSM-IV criteria for an Axis I disorder. The RDD procedure successfully removed between groups differences in baseline scores on all but one of the key outcome variables.
Conclusion: Six sites located in 4 distinct regions of the U. S. have successfully collaborated in the initial phase of a largesample test of FACT in preventing the onset of psychosis. Treatment outcome findings and other research initiated at individual sites will significantly increase our knowledge of the early phases of psychotic illness and the factors that may prevent it.
Keywords: Adolescents, psychosis, prevention, early intervention, risk, prodromal psychosis
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