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Understanding young peoples’ and family members’ views of treatment for first episode psychosis in a randomised controlled trial (MAPS)

Authors
  • Byrne, R.E.1, 2
  • Bird, J.C.3, 4
  • Reeve, S.5
  • Jones, W.1, 2
  • Shiers, D.1
  • Morrison, A.P.1, 2
  • Pyle, M.1, 2
  • Peters, S.2
  • 1 Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich M25 3BL, UK
  • 2 Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PL, UK
  • 3 Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
  • 4 Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX4 7JX, UK
  • 5 Department of Clinical, Educational, and Health Psychology, University College London, WC1E 6BT, UK
Type
Published Article
Journal
EClinicalMedicine
Publisher
Elsevier
Publication Date
Jul 07, 2020
Volume
24
Identifiers
DOI: 10.1016/j.eclinm.2020.100417
PMID: 32775967
PMCID: PMC7393652
Source
PubMed Central
Keywords
License
Unknown

Abstract

Background There is limited evidence to inform treatment decision-making in adolescents experiencing first episode psychosis (FEP). In the MAPS trial (Managing Adolescent first Episode Psychosis: a feasibility Study), adolescents with FEP received either antipsychotic medication (AP), psychological intervention (PI), or both. We investigated treatment views of young people and family members across each treatment arm of MAPS. Methods Thirteen adolescents participating in MAPS and eighteen family members attended in-depth audio-recorded interviews to discuss trial treatments. Interviews were analysed using inductive Thematic Analysis, identifying salient themes across these accounts. Findings Family members in particular reported an urgent need for treatment regardless of type. Both AP and PI were broadly viewed as acceptable treatment approaches, but for differing reasons which participants weighed against a range of concerns. AP were often seen to reduce symptoms of psychosis, though participants expressed concerns about side effects. PI were viewed as interactive treatment approaches that helped improve understanding of psychosis and enhanced coping, although some found PI emotionally and cognitively challenging. Combining treatments was seen to maximise benefits, with a perceived interaction whereby AP facilitated engagement with PI. Interpretation Acceptability of and engagement with treatments for FEP may differ between individual young people and their family/carers. In order to be able to offer fully informed choices, and determine an optimum treatment approach for young people with FEP, definitive trial evidence should be established to determine wanted and unwanted treatment impacts. Funding NIHR HTA programme (project number 15/31/04).

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