News
20 June 2023
Summary of findings from the STEP Study
The STEP study aimed to test the effect of a sequential treatment approach for young people at risk of developing a psychotic disorder. This involved providing help-seeking young people with a sequence of three treatments, depending on whether the person had a good response to each stage of treatment. The three treatments involved support and problem solving (SPS), cognitive-behaviour therapy (CBT), and an antidepressant medication (Fluoxetine). Treatment was provided for up to 12 months.
342 young people participated in the study. Sustained improvement in symptoms and functioning (‘remission’) was lower than expected, at 9%, 10% and 11% at the end of each step. 27% remitted at the end of at least one step. Across the whole sample, there were improvements on symptoms and functioning at 6 and 12 months into treatment (small to medium effect sizes), particularly for depression and quality of life. However, there were no differences in clinical outcomes between the treatment groups – CBT was not superior to SPS, and the antidepressant medication was not superior to placebo. Those who remitted in response to treatment also showed high relapse rates (62% after Step 1, 43% after Step 2).
Overall, the findings show that the addition of sequentially more specialised psychosocial and antidepressant treatment for non-remitters did not lead to superior clinical outcomes. This means that while current treatments should certainly continue to be provided, new treatments are urgently required for this clinical group. An extended duration of specialist care is also required to achieve remission/recovery and to reduce the risk of relapse and transition to psychosis.
The study team extends their gratitude to the young people and families who took part in this landmark study, and to the clinicians who delivered the treatments.
11 December 2019
The STEP study treatment phase will come to a close in January 2020. The final follow up interviews will continue until January 2021. Thank you to all of the young people who have participated in the study treatment and research interviews so far. Later this year, we will start to look at the results and learn more about the effectiveness of the different types of treatment in this group.
The STEP team wishes you Happy New Year and hope you have a lovely holiday break!
17 January 2019
337 participants have now been recruited into the STEP study since the first client was enrolled in PACE in April 2016. A few more participants are now completing their initial assessments to be enrolled in the study before recruitment ends on 31 January 2019. We would like to thank all participants past, present and future for their immeasurable contribution to the study and to research in the field of mental health.
23 December 2018
As we come to the end of another year, the team would like to extend an enormous thank you to the young people who have participated in the STEP study so far. By participating, you have contributed to vital research into the treatment of emerging symptoms as well as potential factors that might contribute to such symptoms becoming more severe over time. This is an incredibly important study that you have been part of and largest that has yet been conducted in the world.
Happy holidays! Have a wonderful new year!
10 October 2018
An enormous thank you to the young people who have participated in the STEP study so far. By participating, you have contributed to vital research into the treatment of emerging symptoms as well as potential factors that might contribute to such symptoms becoming more severe over time. This is an incredibly important study that you have been part of and the largest trial of its kind in the world.