Evidence map›Paper›PMID 39402517›Full record

Trial reportBMC psychiatry2024

Outcomes of an adapted prolonged exposure psychotherapy for people with early phase psychosis, substance misuse, and a history of adversity: the PE + trial.

Victoria C Patterson, Philip G Tibbo, Sherry H Stewart, Joel Town, Candice E Crocker, Zenovia Ursuliak, Siranda Lee, Jason Morrison, Sabina Abidi, Kara Dempster and 3 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04546178 (Implementation and Evaluation of Prolonged Exposure Psychotherapy for Adverse Events in Early Phase Psychosis With Comorbid Substance Misuse), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT04546178 nacompletednot on this map

Implementation and Evaluation of Prolonged Exposure Psychotherapy for Adverse Events in Early Phase Psychosis With Comorbid Substance Misuse

TypeinterventionalSponsorNova Scotia Health AuthorityRan2021 to 2023Enrolled19ConditionsPsychotic Disorders, Stress Disorders, Traumatic, Substance UseArmsProlonged exposure (PE)+ therapy, Treatment as usual (TAU)
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Victoria C PattersonDepartment of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada. vpatterson@dal.ca.
Philip G TibboDepartment of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada.
Sherry H StewartDepartment of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada.
Joel TownDepartment of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada.
Candice E CrockerDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Zenovia UrsuliakDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Siranda LeeMental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada.
Jason MorrisonDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Sabina AbidiDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Kara DempsterDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Maria AlexiadisDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada.
Neal HendersonMental Health and Addictions, Nova Scotia Health, Halifax, NS, Canada.
Alissa PencerDepartment of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada.

Funding

QEII Foundation 1025210Research Nova Scotia 2022-2410
6 · The paper itself

Abstract

backgroundSeveral adversity-focused treatment trials have reported improvements to adversity sequelae (e.g., PTSD symptoms) and decreases in psychotic symptoms among individuals with psychotic disorders. Yet, no trials have examined the impact of adversity-focused treatment on substance use or examined the outcomes among an early phase psychosis population. These gaps in both the research literature and clinical practice have resulted in less knowledge about the outcomes of adversity-focused treatment at this stage of illness, including the impact on substance use.

methodsThe outcomes of an adapted prolonged exposure protocol (PE+) among an early phase psychosis population were examined using a multiple-baseline design. Nineteen adults with a psychotic disorder, current substance misuse, and a history of adversity were recruited from an early psychosis program. Participants were randomized to treatment start time and participated in a 15-session course of PE + therapy. Ten assessments were completed focusing on primary outcomes (i.e., adversity sequelae, negative psychotic symptoms, substance misuse) and secondary outcomes (i.e., functioning, hopelessness, experiential avoidance). The Reliable Change Index (RCI) was used to establish whether there were clinically significant changes to primary or secondary outcomes.

resultsHalf or more of treatment completers experienced clinically significant changes to most domains of adversity sequelae, no participants experienced improvements in negative psychotic symptoms, and substance misuse increased for several participants. In terms of secondary outcomes, functioning and experiential avoidance were improved for a number of participants, while hopelessness decreased for only one participant. Participants reported high satisfaction with the PE + treatment, and exposure and coping skills were rated as the most helpful elements of treatment.

conclusionsReductions in adversity sequelae were observed following PE + treatment, suggesting that adversity-focused treatment may be beneficial for an early psychosis population. Yet, few positive changes to psychotic symptoms or substance use were observed. Further integrating treatment strategies for psychosis and substance use into PE + may be required to effectively treat the links between psychosis, adversity sequelae, and substance use. Future studies should make efforts to integrate substance use strategies into adversity treatment trials for people with psychotic disorders.

trial registrationClinicaltrials.gov, NCT04546178; registration posted 11/09/2020, https://clinicaltrials.gov/ct2/show/NCT04546178?term=NCT04546178&draw=2&rank=1 .

Indexed as

Implosive TherapyPsychotic DisordersSubstance-Related DisordersAdultFemaleHumansMaleOutcome Assessment, Health CareTreatment OutcomeYoung AdultAdversityCognitive-behavioural therapyEarly phase psychosisProlonged exposureSubstance misuse

Identifiers

PMID39402517
PMCPMC11479562

What OpenQuestion holds

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LicenceCC BY
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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.