Introduction/Objective: This study aimed to investigate efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL), combining face-to-face therapy with an Ecological Momentary Intervention (EMI), in addition to treatment as usual (TAU) for psychotic distress, in comparison to TAU. Methods: Individuals aged 15–65 years with clinically established ultra-high risk or first episode of psychosis were randomly assigned to TAU or ACT-DL+TAU. ACT-DL+TAU consisted of 8 ACT-sessions augmented with an EMI-app. The primary outcome was psychotic distress assessed with the Comprehensive Assessment scale of At Risk Mental State (CAARMS) at post-intervention and 6- and 12-month follow-up. Secondary outcomes were functioning, symptom severity, and momentary psychotic distress. We performed multivariate mixed models according to intent-to-treat principles. Results: Between June 1, 2015 and December 31, 2018, 668 participants were referred, of whom 148 were randomized to ACT-DL+TAU (n = 71) or TAU (n = 77). One hundred and fifteen (78%) provided primary outcome data at least at one follow-up assessment. There was no evidence of greater reduction in the primary outcome measure CAARMS distress in ACT-DL+TAU compared to TAU (χ²(3) = 2.36; p = 0.50). However, out of the tested secondary outcomes, global functioning (χ²(3) = 9.05; p = 0.033), and negative symptoms (χ²(3) = 19.91; p#x3c;0.001) improved in ACT-DL+TAU compared to TAU, as did momentary psychotic distress (χ²(3) = 21.56; p #x3c; 0.001). Conclusions: INTERACT did not support a significant effect of ACT-DL over TAU on the primary outcome measure of psychotic distress as assessed with the CAARMS. Although significant improvements were found for some secondary outcome measures, further replication studies are needed to confirm the strength and specificity of these effects.
Psychother Psychosom

中文翻译：

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接受和承诺疗法在日常生活中对早期精神病的疗效：多中心 INTERACT 随机对照试验的结果

简介/目的：本研究旨在调查日常生活中接受和承诺疗法 (ACT-DL) 的疗效，将面对面疗法与生态瞬时干预 (EMI) 相结合，以及常规治疗 (TAU)与 TAU 相比，精神病性困扰。方法：年龄在 15-65 岁之间且具有临床确定的超高风险或首发精神病的个体被随机分配到 TAU 或 ACT-DL+TAU。ACT-DL+TAU 由 8 个 ACT 会话组成，并增加了一个 EMI 应用程序。主要结果是在干预后以及 6 个月和 12 个月的随访中使用风险精神状态综合评估量表 (CAARMS) 评估的精神病性困扰。次要结果是功能、症状严重程度和短暂的精神病性困扰。我们根据意向治疗原则进行了多变量混合模型。结果： 2015 年 6 月 1 日至 2018 年 12 月 31 日期间，转诊了 668 名参与者，其中 148 名被随机分配到 ACT-DL+TAU（n = 71）或 TAU（n= 77). 一百一十五 (78%) 人至少在一次随访评估中提供了主要结果数据。与 TAU 相比，没有证据表明 ACT-DL+TAU 的主要结果指标 CAARMS 痛苦减少更多（χ ² (3) = 2.36；p = 0.50）。然而，在测试的次要结果中，ACT-DL+TAU 改善了整体功能（χ ² (3) = 9.05；p = 0.033）和阴性症状（χ ² (3) = 19.91；p#x3c；0.001）与 TAU 相比，短暂的精神病性困扰也是如此 (χ ² (3) = 21.56; p #x3c; 0.001)。结论：INTERACT 不支持 ACT-DL 优于 TAU 对使用 CAARMS 评估的精神病困扰的主要结果测量的显着影响。虽然发现一些次要结果测量有显着改善，但需要进一步的复制研究来确认这些影响的强度和特异性。
心理医生