Do psychotic experiences act as effect modifiers in youths with common mental health problems allocated to transdiagnostic cognitive behavioural therapy versus management as usual? Secondary analyses of the Mind-My-Mind randomized trial
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Psychotic experiences (PEs) are common in help-seeking youths with non-psychotic mental health problems, yet the clinical importance of PEs as potential effect modifiers of psychotherapy interventions has been scarcely examined. We examined if PEs were associated with a differential response to transdiagnostic cognitive behavioural therapy (CBT) aimed at common emotional and behavioural problems.
Methods
We present secondary analyses from the Mind My Mind (MMM) trial that randomized 396, 6-16-year-old youths to either 9–13 sessions of transdiagnostic modular community-based CBT (MMM) or community-based management as usual (MAU). MMM was superior to MAU in reducing parent-reported impact of mental health problems according to the Strengths and Difficulties Questionnaire (SDQ). PEs were assessed by semi-structured screening interviews at baseline. The contrast between subgroups (presence/absence of PEs) was calculated to test if PEs are potential effect modifiers regarding the change in parent-reported SDQ-impact (primary outcome, rated 0[low]-10[high]) and other SDQ-related outcomes.
Results
Baseline PEs were present in 74 (19%) of youths. The superior effect of MMM on changes in SDQ-impact from baseline to week 18 was not effect modified by the presence of PEs (PEs[yes] −0.89 [95%CI −1.77;-0.01] vs. PEs[no] −1.10 [95%CI −1.52;-0.68], p-value for interaction .68). For secondary outcomes similar patterns were observed.
Limitations Statistical power was limited to show if PEs modified treatment response. Replication and meta-analytic evidence are needed.
Conclusions
The beneficial effects of MMM transdiagnostic CBT did not differ by PE-status, indicating that youths with emotional and behavioural problems could be offered such psychotherapy irrespective of co-occurring PEs.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Early Intervention in Psychiatry |
| Vol/bind | 18 |
| Udgave nummer | 1 |
| Sider (fra-til) | 26-33 |
| ISSN | 1751-7885 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:
The Mind My Mind project was initiated by Psykiatrifonden and sponsored through unrestricted grants from the Danish TrygFonden and the Lundbeckfonden. The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Funding Information:
Dr. Martin K. Rimvall has no conflicts of interest to declare. Dr. Ditte Vassard has no conflicts of interest to declare. Professor Robin Christensen reports that the Parker Institute, Bispebjerg and Frederiksberg Hospital, is supported by a core grant from the Oak Foundation (OCAY‐18‐774‐OFIL). Dr. Sabrina M. Nielsen has no conflicts of interest to declare. Professor Anne Katrine Pagsberg received grants from TrygFonden, Novo Nordisk fonden, Helsefonden and Læge SCE Friis og hustru OD Friis' Legat. Dr. Correll has been a consultant and/or advisor to or has received honoraria from AbbVie, Acadia, Alkermes, Allergan, Angelini, Aristo, Axsome, Cardio Diagnostics, CNX Therapeutics, Compass Pathways, Damitsa, Gedeon Richter, Hikma, Holmusk, IntraCellular Therapies, Janssen/J&J, Karuna, LB Pharma, Lundbeck, MedAvante‐ProPhase, MedInCell, Medscape, Merck, Mindpax, Mitsubishi Tanabe Pharma, Mylan, Neurocrine, Noven, Otsuka, Pfizer, Pharmabrain, Recordati, Relmada, Reviva, Rovi, Seqirus, Servier, SK Life Science, Sumitomo Dainippon, Sunovion, Sun Pharma, Supernus, Takeda, Teva, and Viatris. He provided expert testimony for Janssen and Otsuka. He served on a Data Safety Monitoring Board for Lundbeck, Relmada, Reviva, Rovi, and Teva. He has received grant support from Janssen and Takeda. He received royalties from UpToDate and is also a stock option holder of Cardio Diagnostics, Mindpax, and LB Pharma. Professor Pia Jeppesen received grants from the TrygFonden and Lundbeckfonden.
Publisher Copyright:
© 2023 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.
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