Randomized Controlled Trial on Early Detection and Intervention for Women at‐risk of Psychosis in Hong Kong

Abstract

Cognitive-behavioral therapy for psychosis (CBTp) is the first-line psychological intervention for treating early psychosis. Following this line of intervention, different groups of researchers and clinicians have developed CBT for “At-risk mental states” (ARMS) with emphasis on normalization and adaptive interpretation of positive psychotic symptoms. Although the prevalence rate of psychosis did not show any gender bias, the age of onset for women is usually late. Instead of dopamine dysregulation in teenage psychosis, poor affective and cognitive functioning (such as mood disturbances, biased cognitive appraisal) and later life risks (such as social isolation, unemployment) are more likely to play a central role in the late onset of psychosis in women. Therefore, psychological intervention and tangible social support would be the viable seamless intervention for pre-psychotic phase in women of social disadvantage.Partnering with three local community non-government organizations, this study aims to minimize the risk of psychosis transition among women of incipient psychosis. Identification of the service recipients will take reference of the definition of ARMS. A multisite randomized controlled trial is conducted to evaluate the effectiveness of a group CBT protocol, which is designed to equip women at ARMS to handle their pre-psychotic thinking adaptively using a gender-specific evidence-based approach. Women participants of age 18-64 are randomized to receive either group CBTp plus tangible social support or to receive psychoeducation (PsyEd) plus tangible social support. Both the group CBTp and PsyEd consisted of 8 consecutive weekly sessions with a booster session 4 weeks after the last session.