ArticleEarly intervention in psychiatry2018
Staged Treatment in Early Psychosis: A sequential multiple assignment randomised trial of interventions for ultra high risk of psychosis patients.
Article in Early intervention in psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- Psychological interventions for psychosis in adolescents.The Cochrane database of systematic reviews · 2020Pooled it
- Effects of 6-months of SSRI use on DNA-methylation and gene expression in blood.Brain, behavior, and immunity · 2026Trial
- Therapy process factors in early psychosis: The effect of working alliance on clinical symptoms and cognitive biases in Ultra High Risk young people.Schizophrenia research · 2025Trial
- Web-based interpretation bias training to reduce anxiety: A sequential, multiple-assignment randomized trial.Journal of consulting and clinical psychology · 2024Trial
- Demonstration of a 'leapfrog' randomized controlled trial as a method to accelerate the development and optimization of psychological interventions.Psychological medicine · 2023Trial
- Trial
- Baseline data of a sequential multiple assignment randomized trial (STEP study).Early intervention in psychiatry · 2022Trial
- A review of use of external data and update on reporting standards in Sequential Multiple-Assignment Randomised Trials.Clinical trials (London, England) · 2026Review
- Feasibility of a Stepped-Care Intervention for Those at Clinical High Risk for Psychosis in the United States.Early intervention in psychiatry · 2026Article
- Stepped care involving cognitive behavioral therapy for young people at clinical high-risk for psychosis in community settings: longitudinal intervention study protocol.BMC psychiatry · 2025Article
- Characterizing the Clinical Trajectory and Predicting Persistence and Deterioration of Attenuated Psychotic Symptoms in Ultra-High-Risk Individuals.Schizophrenia bulletin · 2025Article
- White Blood Cell Proportions Are Associated With Response to Psychosocial Therapy in Young People at Ultra-High Risk for Psychosis.Biological psychiatry global open science · 2025Article
- Transdiagnostic Symptom Dimensions in Individuals at Ultra-High Risk for Psychosis: Towards Dimensional Representations of Pluripotent Risk.Early intervention in psychiatry · 2025Article
- The influence of complex psychiatric comorbidities on treatment for clinical high-risk for psychosis: A preliminary study.Early intervention in psychiatry · 2024Article
- Development and temporal validation of a clinical prediction model of transition to psychosis in individuals at ultra-high risk in the UHR 1000+ cohort.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- A network analysis of anxiety, depressive, and psychotic symptoms and functioning in children and adolescents at clinical high risk for psychosis.Frontiers in psychiatry · 2022Article
- Distress Related to Attenuated Psychotic Symptoms: Static and Dynamic Association With Transition to Psychosis, Nonremission, and Transdiagnostic Symptomatology in Clinical High-Risk Patients in an International Intervention Trial.Schizophrenia bulletin open · 2022Article
- The reality of at risk mental state services: a response to recent criticisms.Psychological medicine · 2021Article
- Cognitive Behavior Therapy at the Crossroads.International journal of cognitive therapy · 2021Review
- Transcending false dichotomies and diagnostic silos to reduce disease burden in mental disorders.Social psychiatry and psychiatric epidemiology · 2020Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 2 countries.
Funding
Abstract
aimPrevious research indicates that preventive intervention is likely to benefit patients "at risk" of psychosis, in terms of functional improvement, symptom reduction and delay or prevention of onset of threshold psychotic disorder. The primary aim of the current study is to test outcomes of ultra high risk (UHR) patients, primarily functional outcome, in response to a sequential intervention strategy consisting of support and problem solving (SPS), cognitive-behavioural case management and antidepressant medication. A secondary aim is to test biological and psychological variables that moderate and mediate response to this sequential treatment strategy.
methodsThis is a sequential multiple assignment randomised trial (SMART) consisting of three steps: Step 1: SPS (1.5 months); Step 2: SPS vs Cognitive Behavioural Case Management (4.5 months); Step 3: Cognitive Behavioural Case Management + Antidepressant Medication vs Cognitive Behavioural Case Management + Placebo (6 months). The intervention is of 12 months duration in total and participants will be followed up at 18 months and 24 months post baseline.
conclusionThis paper reports on the rationale and protocol of the Staged Treatment in Early Psychosis (STEP) study. With a large sample of 500 UHR participants this study will investigate the most effective type and sequence of treatments for improving functioning and reducing the risk of developing psychotic disorder in this clinical population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.