Saturday, January 05, 2013

Prof McGorry's pet theory loses battle with reality

I've only just found out about the online publication in late November of last year of a study by former Australian of the Year and influential psychiatrist Prof. Patrick McGorry and his research team, which tested the prof's pet theory that elevated risk for developing psychosis can be identified in young people and treated in an early intervention to prevent a conversion to mental illness.The subjects of the trial were 115 young clients of a PACE clinic in Melbourne. Two supposedly effective forms of intervention were tested: the neuroleptic antipsychotic drug risperidone and cognitive therapy. McGorry's team had planned a couple of years ago to trial a different antipsychotic drug, but that trial was abandoned after complaints from other mental health experts. In this trial only a low dose of the drug risperidone was trialed. Three different combinations of drug or placebo and talking interventions were trialed (check the details for yourself), one being only placebo with "supportive therapy". No significant difference in results was found between the three groups. The supposedly effective interventions apparently weren't found to be any more effective than placebo and a nice chat, and as any true expert in the field of trying to predict risk for developing psychosis could have predicted, a large majority of the youths that had been labelled as being at "ultra-high risk for psychosis" did not become psychotic within the year that the trial was run. Call that ultra-high risk? I certainly don't! The sky isn't falling Henny Penny, and your interventions aren't anything special.

Patrick D. McGorry, MD, PhD; Barnaby Nelson, PhD; Lisa J. Phillips, PhD; Hok Pan Yuen, MSc; Shona M. Francey, PhD; Annette Thampi, MRCPsych; Gregor E. Berger, MD; G. Paul Amminger, MD; Magenta B. Simmons, BA; Daniel Kelly, Grad Dip (Psych); Andrew D. Thompson, MD; and Alison R. Yung, MD (2012) Randomized Controlled Trial of Interventions for Young People at Ultra-High Risk of Psychosis: Twelve-Month Outcome. Journal of Clinical Psychiatry. Submitted: March 16, 2012; accepted September 13, 2012. Online ahead of print: November 27, 2012 (doi:10.4088/JCP.12m07785).

Thank you Neuroskeptic for the interesting blog post about the trial:

Neuroskeptic (2012) Neither Drugs Nor Therapy Prevent Psychosis. Neuroskeptic. December 15th 2012.

No comments: