Efficiency of a Composite Personalised Care on Functional Outcome in Early Psychosis
Status:
Not yet recruiting
Trial end date:
2028-04-15
Target enrollment:
Participant gender:
Summary
Chronic psychosis, including schizophrenia is now viewed as a progressive disorder where
cognitive deficits predate the clinical onset. Early intervention programs improve the
general outcome with staged care strategies, supporting the view that the period before and
around the first episode of psychosis is a window of opportunity for improving its functional
recovery.
Pioneering epigenetic analyses indicate that psychosis onset involves oxidative stress and
inflammation suggesting that neuroprotective strategies could limit or even prevent the onset
of or the transition into a chronic disorder. Several biological factors associated with the
emergence of psychosis can all be rectified by using safe and easily accepted supplements
including alterations folate deficiency/hyperhomocysteinemia; redox imbalance and deficit in
polyunsaturated fatty acids (PUFA). The prevalence of these anomalies (20-30%) justifies a
systematic detection and could guide personalised add-on strategy.
Cognitive remediation improves quality of life (QoL) and functional outcome in patients with
chronic psychosis. It would even be more efficacious in the early phase of psychosis by
tackling the negative impact of psychosis on education achievement and employment. However,
cognitive dysfunctions are often overlooked in patients at ultra-high risk (UHR) for
psychosis and patient with a first episode of psychosis (FEP) and cognitive remediation is
not always accessible. New technologies can provide us with youth-friendly, non-stigmatising
tools, such as applications with cognitive strategies, motivational tools and functioning
guidance personalised according to the need of each individual. Patients can have access to
it, wherever they live.
Early psychosis can be associated with inflammation, metabolic deficiency, as well as early
structural brain anomalies that reflect brain plasticity abilities and could influence the
prognosis and response to cognitive training.
The study hypothesis is that promoting neuroplasticity by cognitive training and personalised
virtual psychoeducation guidance could attenuate or reverse early cognitive deficits and
improve the overall functional outcome in young patients UHR or FEP and that this effect is
modulated by individual brain plasticity abilities. The overall objective of PsyCARE_trial is
to improve early intervention in psychosis by providing a composite personalised care (CPC)
that will enable personalised cognitive training and psychoeducation guidance, adapted to
individuals' needs, cognitive abilities and biological background.