AzTrials
AzTrials

SchizophreniaPhase 4NCT00333177

Psychosocial Therapy and Risperidone Treatment in Work Performance in Recent-Onset Schizophrenia

A Phase 4 study testing Cognitive remediation training (CT), Healthy behavior training (HBT) and Risperidone, administered orally (Oral Ris) in people with Schizophrenia, run by University of California, Los Angeles at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This study will determine the effectiveness of various combinations of psychosocial therapy and risperidone treatment in improving work or school performance in people with first-episode schizophrenia. Read more about this study

Who is it for?
Ages 18 to 45 yearsHealthy volunteers can take part
Conditions the study is for
Schizophrenia
What is being tested?
Cognitive remediation training (CT), Healthy behavior training (HBT) and Risperidone, administered orally (Oral Ris)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
92 participants
Where
1 siteUnited States
Study dates
Mar 2006to Jan 2013
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Diagnosis of schizophrenia, schizoaffective disorder (depressed type), or schizophreniform disorder
  • First major episode of psychotic symptoms occurred within 2 years prior to study entry

Who cannot join

  • Neurological disorder or injury (e.g., encephalitis, epilepsy, traumatic brain injury)
  • Mental retardation (e.g., premorbid intelligence quotient (IQ) less than 70)
  • Significant alcohol or substance use during last 6 months
  • Unable to complete research measures in English
  • Any condition that may make risperidone use medically inadvisable

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Semel Institute for Neuroscience and Human Behavior at UCLA

    Los Angeles, California, 90095

Other trials in United States

About this study

Official title: Developmental Processes in Schizophrenic Disorders: Cognitive Remediation, Medication Adherence, and Work Outcome in Recent-Onset Schizophrenia

This study will determine the effectiveness of various combinations of psychosocial therapy and risperidone treatment in improving work or school performance in people with first-episode schizophrenia.

Read the detailed description

Schizophrenia is a chronic, severe, and disabling brain disorder. People with schizophrenia often experience hallucinations, delusions, thought disorders, and movement disorders. These symptoms make it difficult to maintain a job, participate in school, and keep up self-care. Proper treatment of first-episode schizophrenia may increase the chances of controlling disease progression on a long-term basis. Antipsychotic medications, such as risperidone, and psychosocial treatments, such as cognitive enhancement training and health behavior training, are common, effective treatments for schizophrenia. This study will determine the effectiveness of various combinations of psychosocial therapy and risperidone treatment in improving work or school performance in people with first-episode schizophrenia.

Participants in this open label study will be randomly assigned to receive one of the following four combinations of an antipsychotic medication and a psychosocial treatment: cognitive enhancement training plus oral risperidone; cognitive enhancement training plus long-acting injectable risperidone; health behavior training plus oral risperidone; or health behavior training plus long-acting injectable risperidone. Cognitive enhancement training will entail 2 hours per week of computer-assisted training targeted at improving attention, memory, and problem-solving skills. Additionally, participants will attend a weekly 1-hour group meeting to learn how to apply these skills to work and school situations. Health behavior training will involve 3 hours per week of relaxation training, nutrition education, and physical exercise to enhance wellness. Participants assigned to receive oral risperidone will receive their medication in pill form at the dosage determined to be optimal by the study psychiatrist. Participants assigned to receive injectable risperidone will be given one injection every 2 weeks. Dosages will start at 25 mg per injection and will be adjusted as needed.

Treatment will continue for 1 year following dosage stabilization, which typically occurs 2 to 3 months following study entry. For the first 6 months, participants assigned to receive health behavior training will attend study visits once a week and participants assigned to receive cognitive enhancement training will attend study visits once a week. For the final 6 months, all participants will attend study visits twice weekly. At each visit, participants will receive their assigned psychosocial treatment; attend group therapy; meet with a case manager for counseling and assessment of symptoms, work functioning, and social functioning; and meet with a psychiatrist to monitor medication response. Additional cognitive and health behavior measures will be taken every 6 months to assess treatment effectiveness.

Conditions
Schizophrenia
Being tested
Cognitive remediation training (CT), Healthy behavior training (HBT), Risperidone, administered orally (Oral Ris), Risperidone, administered via injection (RLAI)
Keywords
Schizoaffective Disorder, Depressed Type, Schizophreniform Disorder, First-Episode Schizophrenia, Supported Employment, Cognitive Remediation, Health Behavior Training, Antipsychotic Medication
Medical subject headings
Schizophrenia, Psychotic Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cognitive remediation training (CT)Behavioural

    Cognitive remediation training includes computerized cognitive training plus learning skills group.

  • Healthy behavior training (HBT)Behavioural

    Healthy behavior training includes group skills training in nutrition, exercise, and relaxation.

  • Risperidone, administered orally (Oral Ris)Drug

    Also called Risperdal

    Oral risperidone at dosage judged optimal by treating psychiatrist

  • Risperidone, administered via injection (RLAI)Drug

    Also called Risperdal Consta

    Risperidone in injectable form every 2 weeks, starting with 25 mg and adjusted as needed

Study groups in NCT00333177
Study groupRoleWhat they receive
Cog Remediation, risperidone injectionExperimentalParticipants will receive cognitive remediation training plus risperidone, administered via injection.
Receives: Behavioral: Cognitive remediation training (CT); Drug: Risperidone, administered via injection (RLAI)
Healthy Behavior Training, risperidone injectionActive comparatorParticipants will receive health behavior training plus risperidone, administered via injection.
Receives: Behavioral: Healthy behavior training (HBT); Drug: Risperidone, administered via injection (RLAI)
Cog Remediation, oral risperidoneExperimentalParticipants will receive cognitive remediation training plus risperidone administered orally.
Receives: Behavioral: Cognitive remediation training (CT); Drug: Risperidone, administered orally (Oral Ris)
Healthy Behavior Training, oral risperidoneActive comparatorParticipants will receive health behavior training plus risperidone administered orally.
Receives: Behavioral: Healthy behavior training (HBT); Drug: Risperidone, administered orally (Oral Ris)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB)

    Values presented here are the changes in MCCB Overall Composite T scores from baseline to 12 months, with higher values representing better outcome. Raw test scores are used to generate T-scores and then the seven MCCB domains are combined to generate an Overall Composite T score. MCCB Overall Composite T scores have a mean in the general population of 50 with a standard deviation of 10. Thus, a positive change of 5 T scores is an improvement of half a standard deviation.

    Measured: Measured at baseline and 12 months

  2. Work/School Functioning (Global Functioning Scale: Role)

    Change in role functioning from baseline to the 6 month point (rated on a scale from 1= Extreme Role Dysfunction to 10 = Superior Role Functioning) is presented here.

    Measured: Baseline to 6 months

  3. Average Medication Non-adherence

    5-point scale (1 = best adherence, 5= nonadherent) based on pill counts, Medication Event Monitoring System (MEMS) cap readings, plasma assays, and psychiatrist judgements for oral risperidone and timing of injections for long-acting injectable risperidone. Averaged over medication study participation.

    Measured: Averaged over study participation (up to 12 months)

  4. Work/School Functioning (Global Functioning Scale: Role)

    Changes in role functioning from baseline to 12 months. Ratings on a 10-point scale with 10 being best.

    Measured: Baseline to 12 months

Secondary outcomes (7)
  1. Work Behavior Inventory (WBI) Quality of Work/School Performance

    Change in rating on quality of work/school performance based on patient, employer, and/or teacher reports. The Quality of Work rating at baseline was subtracted from the same rating at 12 mos. Higher scores are better outcome.

    Measured: Baseline to 1 year

  2. Maintenance of Work/School Attendance

    Modified Work Section of the Social Adjustment Scale (SAS) was used to calculate the total number of weeks in school or competitive work. Range of possible values is 0 to 52, with higher numbers being better outcome.

    Measured: 12 months

  3. Exacerbation or Relapse of Psychotic Symptoms

    Dichotomous measure: Presence of any of 3 psychotic relapse or exacerbation categories scored from the Brief Psychiatric Rating Scale (BPRS) occurring after randomization and until end of study participation (up to 12 months post baseline). BPRS was administered every two weeks throughout study participation.

    Measured: Occurence after randomization and until end of study participation (up to 12 mos.)

  4. Retention in Treatment

    Days after randomization that a participant continued to receive at least the assigned CT or HBT psychosocial treatment. If a participant needed to end the assigned medication condition (RLAI vs. Oral Ris), they continued in the psychosocial treatment so this outcome focused on the days in the assigned psychosocial treatment. Possible range is 1 to 365, with higher being a better outcome.

    Measured: 12 months

  5. Awareness of Illness, as Assessed by the Scale to Assess Unawareness of Mental Disorder, Revised Version (SUMD-R)

    Rating scale based on clinician's interview of patient to determine level of lack of awareness of having a mental disorder. Range is from 1 (Aware) to 5 (Unaware), so lower scores indicate better outcome.

    Measured: 12 months after randomization

  6. Change in Motivation for Work/School

    The Work Motivation scale is a factor score from the Work Personality Profile. The Work Personality Profile is a set of ratings based on interviewing the participant. Scores at each occasion can range from 8 to 32, with higher indicating better motivation. Scores reported here are changes from baseline to 12 months, which could range from -24 to 24 with higher being better.

    Measured: Baseline to 12 months

  7. Change in Coping Strategies

    Coping Response Inventory, which rates extent to which active coping strategies were used after a significant stressful life event. Range of possible scores is 1 to 4. Higher scores are better.

    Measured: Baseline to 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jun 2006 (estimated)
  2. Study startMar 2006
  3. Primary completionJan 2013
  4. Study completionJan 2013

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
92 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00333177
Sponsor's protocol ID
R01MH037705-06
Other IDs
R01MH037705, DAHBR AD-P
Status last verified
Mar 2020
First submitted
1 Jun 2006
Last updated
26 Mar 2020
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Novacek DM, Subotnik KL, Ventura J, Casaus LR, Whelan F, Sugar CA, Nuechterlein KH. Positive symptoms and medication adherence in response to oral versus long-acting injectable risperidone in black, latino, and white first-episode psychosis patients. Schizophr Res. 2025 Oct;284:160-166. doi: 10.1016/j.schres.2025.08.004. Epub 2025 Aug 7.

    PubMed 40779812
  • Nuechterlein KH, Ventura J, Subotnik KL, Gretchen-Doorly D, Turner LR, Casaus LR, Luo J, Boucher ML, Hayata JN, Bell MD, Medalia A. A randomized controlled trial of cognitive remediation and long-acting injectable risperidone after a first episode of schizophrenia: improving cognition and work/school functioning. Psychol Med. 2022 Jun;52(8):1517-1526. doi: 10.1017/S0033291720003335. Epub 2020 Sep 28.

    PubMed 32981534
  • Subotnik KL, Casaus LR, Ventura J, Luo JS, Hellemann GS, Gretchen-Doorly D, Marder S, Nuechterlein KH. Long-Acting Injectable Risperidone for Relapse Prevention and Control of Breakthrough Symptoms After a Recent First Episode of Schizophrenia. A Randomized Clinical Trial. JAMA Psychiatry. 2015 Aug;72(8):822-9. doi: 10.1001/jamapsychiatry.2015.0270.

    PubMed 26107752

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Cognitive remediation training (CT), Healthy behavior training (HBT) and Risperidone, administered orally (Oral Ris) in people with Schizophrenia, run by University of California, Los Angeles at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Mar 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) (time frame: Measured at baseline and 12 months). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00333177, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Mar 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in