UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA.
Healthcare and Science Division, Verily Life Sciences, South San Francisco, CA.
Schizophr Bull. 2018 Aug 20;44(5):1010-1020. doi: 10.1093/schbul/sby078.
The onset of schizophrenia occurs during a period critical for development of social relationships and functional independence. As such, interventions that target the early course of illness have the potential to stave off functional decline and restore functioning to pre-illness levels. In this entirely remote study, people with recent-onset schizophrenia spectrum disorders (SSDs) participated in a 12-week randomized controlled trial to determine the efficacy of PRIME (personalized real-time intervention for motivational enhancement), a mobile-based digital health intervention designed to improve motivation and quality of life. Participants were randomized into the PRIME (n = 22) or treatment-as-usual/waitlist (TAU/WL) condition (n = 21) and completed assessments at baseline, post-trial (12 wk), and for people in the PRIME condition, 3 months after the end of the trial. After 12-weeks, WL participants received PRIME, resulting in a total sample of 38 participants completing PRIME. In PRIME, participants worked towards self-identified goals with the support of a virtual community of age-matched peers with schizophrenia-spectrum disorders as well as motivation coaches. Compared to the WL condition, people in the PRIME condition had significantly greater improvements in self-reported depression, defeatist beliefs, self-efficacy, and a trend towards motivation/pleasure negative symptoms post-trial, and these improvements were maintained 3 months after the end of trial. We also found that people in the PRIME condition had significantly greater improvements in components of social motivation post-trial (anticipated pleasure and effort expenditure). Our results suggest that PRIME has the potential to be an effective mobile-based intervention for improving aspects of mood and motivation in young people with SSDs.
精神分裂症的发病发生在社会关系和功能独立性发展的关键时期。因此,针对疾病早期的干预措施有可能阻止功能下降,并使功能恢复到发病前的水平。在这项完全远程的研究中,患有近期发病的精神分裂症谱系障碍(SSDs)的人参加了一项为期 12 周的随机对照试验,以确定 PRIME(个性化实时动机增强干预)的疗效,这是一种基于移动的数字健康干预措施,旨在提高动机和生活质量。参与者被随机分为 PRIME(n=22)或常规治疗/候补(TAU/WL)组(n=21),并在基线、试验后(12 周)进行评估,对于 PRIME 组的参与者,在试验结束后 3 个月进行评估。12 周后,候补组参与者接受了 PRIME,因此共有 38 名参与者完成了 PRIME。在 PRIME 中,参与者在一个由年龄匹配的精神分裂症谱系障碍同龄人以及动机教练组成的虚拟社区的支持下,朝着自我确定的目标努力。与候补组相比,PRIME 组的参与者在自我报告的抑郁、失败信念、自我效能感以及动机/愉悦阴性症状方面有显著的改善,这些改善在试验结束后 3 个月仍保持。我们还发现,PRIME 组的参与者在社会动机的组成部分方面有显著的改善(预期的愉悦和努力支出)。我们的研究结果表明,PRIME 有可能成为一种有效的基于移动的干预措施,用于改善患有 SSD 的年轻人的情绪和动机方面。