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; Chiara Bonetto; Jacopo Lenzi; Paola Rucci; Laura Iozzino; Massimo Cellini; Carla Comacchio; Doriana Cristofalo; Armando D'Agostino; Giovanni de Girolamo; Katia De Santi; Daniela Ghigi; Emanuela Leuci; Maurizio Miceli; Anna Meneghelli; Francesca Pileggi; Silvio Scarone; Paolo Santonastaso; Stefano Torresani; Sarah Tosato; Angela Veronese; Angelo Fioritti; Mirella Ruggeri; GET UP Group

doi:10.1192/bjp.bp.116.190058

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

Br J Psychiatry. 2017 May;210(5):342-349. doi: 10.1192/bjp.bp.116.190058. Epub 2017 Mar 16.

Authors

Antonio Lasalvia¹, Chiara Bonetto², Jacopo Lenzi², Paola Rucci², Laura Iozzino², Massimo Cellini², Carla Comacchio², Doriana Cristofalo², Armando D'Agostino², Giovanni de Girolamo², Katia De Santi², Daniela Ghigi², Emanuela Leuci², Maurizio Miceli², Anna Meneghelli², Francesca Pileggi², Silvio Scarone², Paolo Santonastaso², Stefano Torresani², Sarah Tosato², Angela Veronese², Angelo Fioritti², Mirella Ruggeri²; GET UP Group

Affiliations

¹ Antonio Lasalvia, MD PhD, UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona; Chiara Bonetto, PhD, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona; Jacopo Lenzi, PhD, Paola Rucci, PhD, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna; Laura Iozzino, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona; Massimo Cellini, Department of Mental Health, Az. USL Firenze, Firenze; Carla Comacchio, MD, Doriana Cristofalo, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona; Armando D'Agostino, MD, Department of Psychiatry, University of Milano, Milano; Giovanni de Girolamo, MD, IRCSS St John of God Clinical Research Centre of Brescia, Brescia; Katia De Santi, MD, UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona; Daniela Ghigi, MD, Department of Mental Health, Az. USL Rimini, Rimini; Emanuela Leuci, MD, Department of Mental Health, Az. USL Parma; Maurizio Miceli, MD, Department of Mental Health, Az. USL Firenze, Firenze; Anna Meneghelli, AO Ospedale Niguarda Ca' Granda Milano, MHD Programma2000, Milan; Francesca Pileggi, MD, Department of Mental Health, Az. USL Bologna, Bologna; Silvio Scarone, MD, Department of Psychiatry, University of Milano, Milano; Paolo Santonastaso, MD, Department of Neurosciences, University of Padova and Azienda Ospedaliera, Padova; Stefano Torresani, MD, Department of Mental Health, Az. USL Bolzano, Bolzano; Sarah Tosato, MD, PhD, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona; Angela Veronese, MD, Department of Neurosciences, University of Padova and Azienda Ospedaliera, Padova; Angelo Fioritti, MD, Department of Mental Health, Az.USL Bologna, Bologna; Mirella Ruggeri, MD, UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona and Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy antonio.lasalvia@univr.it.
² Antonio Lasalvia, MD PhD, UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona; Chiara Bonetto, PhD, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona; Jacopo Lenzi, PhD, Paola Rucci, PhD, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna; Laura Iozzino, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona; Massimo Cellini, Department of Mental Health, Az. USL Firenze, Firenze; Carla Comacchio, MD, Doriana Cristofalo, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona; Armando D'Agostino, MD, Department of Psychiatry, University of Milano, Milano; Giovanni de Girolamo, MD, IRCSS St John of God Clinical Research Centre of Brescia, Brescia; Katia De Santi, MD, UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona; Daniela Ghigi, MD, Department of Mental Health, Az. USL Rimini, Rimini; Emanuela Leuci, MD, Department of Mental Health, Az. USL Parma; Maurizio Miceli, MD, Department of Mental Health, Az. USL Firenze, Firenze; Anna Meneghelli, AO Ospedale Niguarda Ca' Granda Milano, MHD Programma2000, Milan; Francesca Pileggi, MD, Department of Mental Health, Az. USL Bologna, Bologna; Silvio Scarone, MD, Department of Psychiatry, University of Milano, Milano; Paolo Santonastaso, MD, Department of Neurosciences, University of Padova and Azienda Ospedaliera, Padova; Stefano Torresani, MD, Department of Mental Health, Az. USL Bolzano, Bolzano; Sarah Tosato, MD, PhD, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona; Angela Veronese, MD, Department of Neurosciences, University of Padova and Azienda Ospedaliera, Padova; Angelo Fioritti, MD, Department of Mental Health, Az.USL Bologna, Bologna; Mirella Ruggeri, MD, UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona and Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.

PMID: 28302703
DOI: 10.1192/bjp.bp.116.190058

Abstract

BackgroundThe 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.AimsTo 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).MethodSome 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)ResultsAnalyses 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.ConclusionsExcept 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.

Publication types

Multicenter Study
Pragmatic Clinical Trial
Randomized Controlled Trial

MeSH terms

Adolescent
Adult
Age of Onset
Cluster Analysis
Cognitive Behavioral Therapy / methods*
Female
Humans
Male
Middle Aged
Psychotic Disorders / therapy*
Treatment Outcome
Young Adult

Associated data

ClinicalTrials.gov/NCT01436331