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Interventions in the initial prodromal states of psychosis in Germany: concept and recruitment^*

Department of Psychiatry and Psychotherapy, University of Cologne

MICHAEL WAGNER, PhD and KAI UWE KÜHN, MD

Department of Psychiatry and Psychotherapy, University of Bonn

BIRGIT JANSSEN, MD

Department of Psychiatry and Psychotherapy, University of Düsseldorf

RONALD BOTTLENDER, MD

Department of Psychiatry and Psychotherapy, University of Munich

ANKE WIENEKE and FRAUKE SCHULZE-LUTTER, PhD

Department of Psychiatry and Psychotherapy, University of Cologne

WOLFGANG MAIER, MD

Department of Psychotherapy, University of Bonn

JOACHIM KLOSTERKÖTTER, MD

Department of Psychiatry and Psychotherapy, University of Cologne, Germany

Correspondence: Dr Andreas Bechdolf, Early Recognition and Intervention Centre for Mental Crisis (FETZ), Department of Psychiatry and Psychotherapy, University of Cologne, Kerpenerstrasse 62, 50924 Cologne, Germany. Tel: +49 221 478 3869; fax: +49 221 478 6030; e-mail: andreas.bechdolf{at}uk-koeln.de

Declaration of interest The study on the late initial prodromal state is co-funded by a research grant from Sanofi–Synthelabo Germany.

^* Paper presented at the Third International Early Psychosis Conference, Copenhagen, Denmark, September 2002.

Background The Early Detection and Intervention Programme of the German Research Network on Schizophrenia (GRNS) investigates the initial prodromal phase of psychosis in a multidimensional approach. Two intervention strategies are being studied by two large-scale multicentre projects.

Aims To present the concept of the intervention studies, and to provide an interim report of the recruitment procedure.

Method Comprehensive cognitive–behavioural therapy has been developed for patients in the ‘early initial prodromal state’. For patients in the ‘late initial prodromal state’ the atypical neuroleptic amisulpride is explored. Both interventions are evaluated in randomised controlled trials using clinical management as the control condition.

Results Between January 2001 and March 2003, 1212 individuals seeking help for mental health problems were screened for putative prodromal symptoms at four university centres. More than 388 individuals fulfilled criteria for both interventions and 188 (48.5%) gave informed consent to participate in the trials.

Conclusions The screening procedure appears to be feasible and trial participation seems to be acceptable to a relevant proportion of people at increased risk of developing psychosis.