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The first psychotic episodes are preceded by a pauci-symptomatic phase from 2 to 4 years during which the psychotic symptoms are present at a subliminal level in severity or in frequency. The clinical criteria "mental status with risk" (AR) identifies patients among whom 10 in 40 % will make a psychotic transition in the year.
Our hypothesis is that interventions to reduce reactivity to stress are effective in reducing the intensity of psychotic symptoms in subjects with prodromal psychotic symptoms. Our project is to evaluate a therapy for stress management in at risk patients, compared to a conventional monitoring, and implement a longitudinal follow-up concerning the reduction of psychotic symptoms in conjunction with other markers of stress. Nonstigmatizing, these interventions offer an alternative to antipsychotics all the more interesting since they should also reduce the risk of depression and suicide.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cognitive behavioral therapy group | Experimental | weekly group stress-management CBT (SM-CBT) - 1/week 3 months |
|
| Reference group | Active Comparator | weekly supportive therapy - 1/week 3 months |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cognitive behavioral therapy | Other |
| ||
| Supportive therapy |
| Measure | Description | Time Frame |
|---|---|---|
| The score at month 6 on the "positive" psychotic dimension of the CAARMS (first subscale including delusion, hallucination and disorganized thoughts). | Month 6 |
| Measure | Description | Time Frame |
|---|---|---|
| Score on CAARMS | Month 0 | |
| Score on CAARMS | Month 6 | |
| Score on CAARMS |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marie-Odile KREBS KREBS, MD, PhD | Contact | 0033145658646 | mo.krebs@ch-sainte-anne.fr | |
| Marie GODARD | Contact | 0033145657728 | m.godard@ch-sainte-anne.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Sainte Anne | Recruiting | Paris | 75014 | France |
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| Other |
|
| Month 12 |
| · Rate of conversion (as defined by CAARMS) | Month 6 |
| · Rate of conversion (as defined by CAARMS) | Month 12 |
| Score on BPRS | Month 0 |
| Score on BPRS | Month 6 |
| Score on BPRS | Month 12 |
| Score on MADRS | Month 0 |
| Score on MADRS | Month 6 |
| Score on MADRS | Month 12 |
| Score on YMRS | Month 0 |
| Score on YMRS | Month 6 |
| Score on YMRS | Month 12 |
| Score on SOFAS | Month 0 |
| Score on SOFAS | Month 6 |
| Score on SOFAS | Month 12 |
| Stress marker : saliva cortisol level | Month 0 |
| Stress marker : saliva cortisol level | Month 6 |
| Stress marker : saliva cortisol level | Month 12 |
| Stress marker : telomerase activity | Month 0 |
| Stress marker : telomerase activity | Month 6 |
| Stress marker : telomerase activity | Month 12 |
| Stress marker : epigenetic markers | Month 0 |
| Stress marker : epigenetic markers | Month 6 |
| Stress marker : epigenetic markers | Month 12 |
| Stress marker : genetic variants that modulate stress response | Month 0 |
| Stress marker : genetic variants that modulate stress response | Month 6 |
| Stress marker : genetic variants that modulate stress response | Month 12 |
| Stress marker : hippocampal volume | Month 0 |
| Stress marker : hippocampal volume | Month 12 |
| Performance score on autobiographic memory | Month 0 |
| Performance score on autobiographic memory | Month 12 |
| Performance score on sense of self tasks | Month 0 |
| Performance score on sense of self tasks | Month 12 |
| ID | Term |
|---|---|
| D015928 | Cognitive Behavioral Therapy |
| D010166 | Palliative Care |
| ID | Term |
|---|---|
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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