A randomized controlled trial of relapse prevention therapy for first-episode psychosis patients

J Clin Psychiatry. 2009 Apr;70(4):477-86. doi: 10.4088/jcp.08m04407. Epub 2009 Mar 24.


Objective: Patients with first-episode psychosis are responsive to acute-phase treatments, but relapse rates are high. This study aimed to evaluate the effectiveness of a psychosocial treatment designed to prevent the second episode of psychosis compared with standardized early psychosis care.

Method: In a randomized controlled trial, conducted at the Early Psychosis Prevention and Intervention Centre and Barwon Health, Australia, a multimodal individual and family cognitive-behavioral therapy for relapse prevention was compared with standardized case management within a specialist early psychosis service. Patients aged 15 to 25 years with a first episode of a DSM-IV psychotic disorder were recruited between November 2003 and May 2005. The main outcome measures were the number of relapses and time to first relapse.

Results: Forty-one first-episode psychosis patients were randomly assigned to the relapse prevention therapy (RPT) and 40 to standardized case management. At the 7-month follow up, the relapse rate was significantly lower in the therapy condition compared to treatment as usual (p = .042) and time to relapse was significantly longer for the RPT condition (p = .03). The number needed to treat was 6 over 7 months.

Conclusions: Interim findings suggest that RPT provided within a specialist early psychosis program was effective in reducing relapse in early psychosis when compared with standardized early psychosis case management.

Trial registration: www.anzctr.org.au Identifier: ACTRN12605000514606.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / therapeutic use*
  • Brief Psychiatric Rating Scale
  • Cognitive Behavioral Therapy / methods*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Male
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / epidemiology
  • Quality of Life / psychology
  • Secondary Prevention
  • Severity of Illness Index
  • Substance-Related Disorders / epidemiology
  • Young Adult


  • Antipsychotic Agents