Trial helps people with schizophrenia

19 December 2016

A large trial underway across Brisbane is helping improve the social skills of people with schizophrenia, as well as laying the groundwork to make South East Queensland a hub for research into mental illness. The randomized control trial of a new therapy called Social Cognition Interaction Training will determine how effective it is in helping people recover from psychosis. It’s one of a number of trials under the umbrella of the Brisbane Diamantina Health Partners, a collaboration of Brisbane hospitals and medical research institutes. “Schizophrenia not only impacts centres of our brain that affect how we process reality,” said Dr Frances Dark, director of the Rehabilitation Academic Clinical Unit at Brisbane Metro South Addiction and Mental Health Services, “but it also affects our core cognition, the building blocks of our understanding the world.” While psychosis can be treated with medication, people with schizophrenia still have a hard time socializing, because the disease also impairs part of the brain that recognizes emotion. That can make it difficult for people with schizophrenia to keep a job and live a normal social life. “Schizophrenia represents one of the top four illness burdens for the economy,” said Dr Dark. “There are effective treatments, but they tend to be a little bit complex to implement. We believe that it's possible to find even better ones, particularly if we partner well and have a systematic approach to research and implementation. We just need to educate people, even our hospital registrars, to recognize that there is hope.” The social cognition therapy helps people with schizophrenia to recognize emotions and gestures, respond appropriately, and then apply those skills in their day to day lives. It seems simple enough, but for people with schizophrenia it can change their lives. The social cognition therapy has been developed within universities, and until now there’s been no large multi-site randomized control trial to show how well it works in the community. The Brisbane trial is recruiting 128 people across two Hospital and Health Services (Metro South and Metro North) “We thought the recruitment would take two years,” said Dr Dark. “We’re very pleased with how it's been going so far. I think if things go to plan, we will have our last group at the end of next year and write up in 2018.” Apart from collecting data, the trial will train clinicians to use social cognition therapies and also lay the groundwork for future trials. “We've intentionally looked at this as being an implementation dissemination model, as well as being an effectiveness study, so where really looking at enhancing mental health services as well as contributing to the knowledge base for social cognition,” said Dr Dark. That means that people living in Brisbane can look forward to accessing more cutting edge therapies for mental illness. “We’re building a platform of skilled clinicians within Hospital and health Services that are going to gain experience in conducting effective clinical trials, for people who suffer from psychosis,” said Andrea Baker, a clinical nurse at the Queensland Centre for Mental Health Research and the research coordinator for the NHMRC funded Cadence clinical trials platform. “Both of the Hospital and Health Services involved are very large catchment areas, and so we will have skilled staff remaining in all of those sectors after the trial.” The Queensland Centre for Mental Health Research is internationally recognized for its epidemiology , genetics policy and neuroscience research, and it’s now educating staff in hospitals about the benefits of research and getting the entire Brisbane medical community more involved in clinical trials. “Were actually using the expertise in field, in the clinical services, to train staff,” said Andrea Baker. “When the research finishes there is a legacy left for the services.” “We know that sites that have embedded research deliver better care,” said Dr Frances Dark, “and so part of the outcome of this whole platform of research trials is an educated workforce. They're not all going to become researchers, but the research literacy will be high and researchers will be welcome. Our consumers will start to experience the benefits of being involved in research. So, overall, it will improve the quality of services. It's got to be service wide. “And this trial will also position us well for being able to establish the platform and resources needed to add on things like neuroscience and imaging to the research mix, which will take this research into psychosis to the next level.”

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