Background: The clinical outcomes in psychotic illness have not improved significantly over last 50 years. While early intervention has been a very promising development, initially recommended interventions including cognitive behavioural therapy, family therapy, and supported employment are broad treatment approaches and certain symptom domains or comorbidities may benefit from more targeted interventions. Negative symptoms are a cause of enduring disability, are largely resistant to antipsychotic medications and yet few interventions have been developed or trialled. Additionally many individuals with psychosis have comorbid cannabis dependence. This is an independent risk factor for poor outcomes, however no therapeutic interventions have been identified that reduce cannabis use and improve outcomes. Finally concern has been growing over the poor physical health status of those with psychosis and physical health interventions are recommended in the NICE 2014 guidelines.
Aims:
Our aim is to develop an Irish Clinical Trial Network for psychosis research. The primary objective is to undertake a large scale multi-centre, randomized controlled trials of interventions to target specific symptoms or comorbidities. The first of these will be a psychosocial intervention for comorbid cannabis dependence to determine if there is a treatment benefit on predefined core outcome measures. Method:
We will develop a Clinical Trial Network that will trial therapeutic interventions based on cohort, feasibility and pilot studies. We will undertake at least one multi-centre three arm randomised controlled trial in Irish Mental Health Catchment Areas over a five year period. Implications: This network builds on existing expertise and will produce a large network of Irish clinicians and researchers who will be international specialists and experts in the area of psychosis treatment and research. Both the clinical findings and trial results of these studies will lead to a strategic plan of future research and further clinical trials to improve outcomes for this population.
