Research Bites: Antipsychotic medication versus psychological intervention

The EPION Research Working Group is excited to share the first in a series of new research bites that will feature and summarize emerging evidence of interest to EPI staff. The first Research Bite is about a study of antipsychotic medication versus psychological intervention versus a combination of both in adolescents with first-episode psychosis.

Antipsychotic medication versus psychological intervention versus a combination of both in adolescents with first-episode psychosis (MAPS): a multicentre, three-arm, randomised controlled pilot and feasibility study

Lancet Psychiatry,  July 2020. Open Access.
Authors: Anthony P. Morrison & the MAPS group

This randomised controlled pilot study compared the efficacy of antipsychotic medication, cognitive behavioural therapy for psychosis (CBTp) with optional family intervention, and a combination of both for the treatment of young people between 14-18 years old with schizophrenia-spectrum disorders. 61 participants were randomized to one of the three interventions. CBTp was delivered by trained therapists with weekly individual sessions for 6 months. 82% of participants randomized to receive CBTp completed the intervention, whereas only 65% of participants randomized to receive antipsychotic medication adhered to the prescribed medication. After 6 months of treatment 22% of individuals receiving medication, 31% of individuals receiving CBTp, and 29% of individuals receiving both, experienced significant reduction in psychiatric symptoms. No serious adverse events occurred related to trial participation. These results suggest that CBTp is a safe and effective monotherapy for young people with schizophrenia-spectrum disorders who are not taking antipsychotic medication. It should be noted, however, that the CBTp in the current trial was provided in weekly individual sessions for 6 months, by therapists with extensive training in CBTp and who met international criteria for CBTp competence. Thus, for effective CBTp to be delivered, appropriate training and supervision of therapists is required.