Study protocol for a randomised controlled trial of CBT vs antipsychotics vs both in 14-18-year-olds: Managing Adolescent first episode Psychosis: a feasibility study (MAPS).
Identifieur interne : 000700 ( Main/Exploration ); précédent : 000699; suivant : 000701Study protocol for a randomised controlled trial of CBT vs antipsychotics vs both in 14-18-year-olds: Managing Adolescent first episode Psychosis: a feasibility study (MAPS).
Auteurs : Melissa Pyle [Royaume-Uni] ; Matthew R. Broome [Royaume-Uni] ; Emmeline Joyce [Royaume-Uni] ; Graeme Maclennan [Royaume-Uni] ; John Norrie [Royaume-Uni] ; Daniel Freeman [Royaume-Uni] ; David Fowler [Royaume-Uni] ; Peter M. Haddad [Royaume-Uni, Qatar] ; David Shiers [Royaume-Uni] ; Chris Hollis [Royaume-Uni] ; Jo Smith [Royaume-Uni] ; Ashley Liew [Royaume-Uni] ; Rory E. Byrne [Royaume-Uni] ; Paul French [Royaume-Uni] ; Sarah Peters [Royaume-Uni] ; Jemma Hudson [Royaume-Uni] ; Linda Davies [Royaume-Uni] ; Richard Emsley [Royaume-Uni] ; Alison Yung [Royaume-Uni, Australie] ; Max Birchwood [Royaume-Uni] ; Eleanor Longden [Royaume-Uni] ; Anthony P. Morrison [Royaume-Uni]Source :
- Trials [ 1745-6215 ] ; 2019.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Angleterre (MeSH), Comportement de l'adolescent (effets des médicaments et des substances chimiques), Essais contrôlés randomisés comme sujet (MeSH), Facteurs temps (MeSH), Facteurs âges (MeSH), Femelle (MeSH), Humains (MeSH), Mâle (MeSH), Neuroleptiques (effets indésirables), Neuroleptiques (usage thérapeutique), Résultat thérapeutique (MeSH), Thérapie cognitive (MeSH), Thérapie familiale (MeSH), Troubles psychotiques (diagnostic), Troubles psychotiques (psychologie), Troubles psychotiques (thérapie), Études de faisabilité (MeSH), Études multicentriques comme sujet (MeSH), Études prospectives (MeSH).
- MESH :
- diagnostic : Troubles psychotiques.
- effets des médicaments et des substances chimiques : Comportement de l'adolescent.
- effets indésirables : Neuroleptiques.
- psychologie : Troubles psychotiques.
- thérapie : Troubles psychotiques.
- usage thérapeutique : Neuroleptiques.
- Adolescent, Angleterre, Essais contrôlés randomisés comme sujet, Facteurs temps, Facteurs âges, Femelle, Humains, Mâle, Résultat thérapeutique, Thérapie cognitive, Thérapie familiale, Études de faisabilité, Études multicentriques comme sujet, Études prospectives.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adolescent Behavior (drug effects), Age Factors (MeSH), Antipsychotic Agents (adverse effects), Antipsychotic Agents (therapeutic use), Cognitive Behavioral Therapy (MeSH), England (MeSH), Family Therapy (MeSH), Feasibility Studies (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Multicenter Studies as Topic (MeSH), Prospective Studies (MeSH), Psychotic Disorders (diagnosis), Psychotic Disorders (psychology), Psychotic Disorders (therapy), Randomized Controlled Trials as Topic (MeSH), Time Factors (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , adverse effects : Antipsychotic Agents.
- geographic : England.
- diagnosis : Psychotic Disorders.
- drug effects : Adolescent Behavior.
- psychology : Psychotic Disorders.
- chemical , therapeutic use : Antipsychotic Agents.
- therapy : Psychotic Disorders.
- Adolescent, Age Factors, Cognitive Behavioral Therapy, Family Therapy, Feasibility Studies, Female, Humans, Male, Multicenter Studies as Topic, Prospective Studies, Randomized Controlled Trials as Topic, Time Factors, Treatment Outcome.
Abstract
BACKGROUND
Adolescent-onset psychosis is associated with more severe symptoms and poorer outcomes than adult-onset psychosis. The National Institute for Clinical Excellence (NICE) recommend that adolescents with first episode psychosis (FEP) should be offered a combination of antipsychotic medication (APs), cognitive behavioural therapy (CBT) and family intervention (FI). The evidence for APs in treating psychosis is limited in adolescents compared to adults. Nevertheless, it indicates that APs can reduce overall symptoms in adolescents but may cause more severe side effects, including cardiovascular and metabolic effects, than in adults. CBT and FI can improve outcomes in adults, but there are no studies of psychological interventions (PI) in patients under 18 years old. Given this limited evidence base, NICE made a specific research recommendation for determining the clinical and cost effectiveness of APs versus PI versus both treatments for adolescent FEP.
METHODS/DESIGN
The current study aimed to establish the feasibility and acceptability of conducting such a trial by recruiting 14-18-year-olds with a first episode of psychosis into a feasibility prospective randomised open blinded evaluation (PROBE) design, three-arm, randomised controlled trial of APs alone versus PI alone versus a combination of both treatments. We aimed to recruit 90 participants from Early Intervention and Child and Adolescent Mental Health Teams in seven UK sites. APs were prescribed by participants' usual psychiatrists. PI comprised standardised cognitive behavioural therapy and family intervention sessions.
DISCUSSION
This is the first study to compare APs to PI in an adolescent population with FEP. Recruitment finished on 31 October 2018. The study faced difficulties with recruitment across most sites due to factors including clinician and service-user treatment preferences.
TRIAL REGISTRATION
Current controlled trial with ISRCTN, ISRCTN80567433 . Registered on 27 February 2017.
DOI: 10.1186/s13063-019-3506-1
PubMed: 31272477
PubMed Central: PMC6611021
Affiliations:
- Australie, Qatar, Royaume-Uni
- Angleterre, Grand Manchester, Midlands de l'Ouest, Nottinghamshire, Oxfordshire, Sussex de l'Est, Victoria (État)
- Birmingham, Brighton, Falmer, Manchester, Melbourne, Nottingham, Oxford
- Université d'Oxford, Université de Birmingham, Université de Manchester, Université de Melbourne, Université de Nottingham, Université du Sussex
Links toward previous steps (curation, corpus...)
Le document en format XML
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Broome</name><affiliation wicri:level="4"><nlm:affiliation>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. m.r.broome@bham.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK. m.r.broome@bham.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford 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Jo" uniqKey="Smith J" first="Jo" last="Smith">Jo Smith</name><affiliation wicri:level="1"><nlm:affiliation>School of Allied Health and Community, Bredon Building, University of Worcester, Worcester, WR2 6AJ, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Allied Health and Community, Bredon Building, University of Worcester, Worcester, WR2 6AJ</wicri:regionArea><wicri:noRegion>WR2 6AJ</wicri:noRegion></affiliation></author><author><name sortKey="Liew, Ashley" sort="Liew, Ashley" uniqKey="Liew A" first="Ashley" last="Liew">Ashley Liew</name><affiliation wicri:level="4"><nlm:affiliation>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT</wicri:regionArea><orgName type="university">Université de 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type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="French, Paul" sort="French, Paul" uniqKey="French P" first="Paul" last="French">Paul French</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building, Liverpool, L69 3BX, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building, Liverpool, L69 3BX</wicri:regionArea><wicri:noRegion>L69 3BX</wicri:noRegion></affiliation></author><author><name sortKey="Peters, Sarah" sort="Peters, Sarah" uniqKey="Peters S" first="Sarah" last="Peters">Sarah Peters</name><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Hudson, Jemma" sort="Hudson, Jemma" uniqKey="Hudson J" first="Jemma" last="Hudson">Jemma Hudson</name><affiliation wicri:level="1"><nlm:affiliation>Centre for Healthcare Randomised Trials, Health Services Research Unit, University of Aberdeen, 3rd Floor Health Sciences Building, Aberdeen, AB25 2ZD, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Healthcare Randomised Trials, Health Services Research Unit, University of Aberdeen, 3rd Floor Health Sciences Building, Aberdeen, AB25 2ZD</wicri:regionArea><wicri:noRegion>AB25 2ZD</wicri:noRegion></affiliation></author><author><name sortKey="Davies, Linda" sort="Davies, Linda" uniqKey="Davies L" first="Linda" last="Davies">Linda Davies</name><affiliation wicri:level="4"><nlm:affiliation>Division of Population Health, Health Services Research & Primary Care, University of Manchester, Jean MacFarlane Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Population Health, Health Services Research & Primary Care, University of Manchester, Jean MacFarlane Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Emsley, Richard" sort="Emsley, Richard" uniqKey="Emsley R" first="Richard" last="Emsley">Richard Emsley</name><affiliation wicri:level="1"><nlm:affiliation>Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, SE5 8AZ, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, SE5 8AZ</wicri:regionArea><wicri:noRegion>SE5 8AZ</wicri:noRegion></affiliation></author><author><name sortKey="Yung, Alison" sort="Yung, Alison" uniqKey="Yung A" first="Alison" last="Yung">Alison Yung</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Centre for Youth Mental Health, Faculty of Medicine, University of Melbourne, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Youth Mental Health, Faculty of Medicine, University of Melbourne, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Birchwood, Max" sort="Birchwood, Max" uniqKey="Birchwood M" first="Max" last="Birchwood">Max Birchwood</name><affiliation wicri:level="1"><nlm:affiliation>Warwick Medical School-Mental Health and Wellbeing, University of Warwick, Coventry, CV4 7AL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Warwick Medical School-Mental Health and Wellbeing, University of Warwick, Coventry, CV4 7AL</wicri:regionArea><wicri:noRegion>CV4 7AL</wicri:noRegion></affiliation></author><author><name sortKey="Longden, Eleanor" sort="Longden, Eleanor" uniqKey="Longden E" first="Eleanor" last="Longden">Eleanor Longden</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Morrison, Anthony P" sort="Morrison, Anthony P" uniqKey="Morrison A" first="Anthony P" last="Morrison">Anthony P. Morrison</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2019">2019</date><idno type="RBID">pubmed:31272477</idno><idno type="pmid">31272477</idno><idno type="doi">10.1186/s13063-019-3506-1</idno><idno type="pmc">PMC6611021</idno><idno type="wicri:Area/Main/Corpus">000808</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000808</idno><idno type="wicri:Area/Main/Curation">000808</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000808</idno><idno type="wicri:Area/Main/Exploration">000808</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Study protocol for a randomised controlled trial of CBT vs antipsychotics vs both in 14-18-year-olds: Managing Adolescent first episode Psychosis: a feasibility study (MAPS).</title><author><name sortKey="Pyle, Melissa" sort="Pyle, Melissa" uniqKey="Pyle M" first="Melissa" last="Pyle">Melissa Pyle</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Broome, Matthew R" sort="Broome, Matthew R" uniqKey="Broome M" first="Matthew R" last="Broome">Matthew R. Broome</name><affiliation wicri:level="4"><nlm:affiliation>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. m.r.broome@bham.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK. m.r.broome@bham.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, OX3 7JX</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Centre for Human Brain Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. m.r.broome@bham.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Human Brain Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX4 7JX, UK. m.r.broome@bham.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX4 7JX</wicri:regionArea><wicri:noRegion>OX4 7JX</wicri:noRegion></affiliation></author><author><name sortKey="Joyce, Emmeline" sort="Joyce, Emmeline" uniqKey="Joyce E" first="Emmeline" last="Joyce">Emmeline Joyce</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation></author><author><name sortKey="Maclennan, Graeme" sort="Maclennan, Graeme" uniqKey="Maclennan G" first="Graeme" last="Maclennan">Graeme Maclennan</name><affiliation wicri:level="1"><nlm:affiliation>Centre for Healthcare Randomised Trials, Health Services Research Unit, University of Aberdeen, 3rd Floor Health Sciences Building, Aberdeen, AB25 2ZD, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Healthcare Randomised Trials, Health Services Research Unit, University of Aberdeen, 3rd Floor Health Sciences Building, Aberdeen, AB25 2ZD</wicri:regionArea><wicri:noRegion>AB25 2ZD</wicri:noRegion></affiliation></author><author><name sortKey="Norrie, John" sort="Norrie, John" uniqKey="Norrie J" first="John" last="Norrie">John Norrie</name><affiliation wicri:level="1"><nlm:affiliation>Edinburgh Clinical Trials Unit, Centre for Population Health Sciences, Usher Institute, Nine Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Edinburgh Clinical Trials Unit, Centre for Population Health Sciences, Usher Institute, Nine Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX</wicri:regionArea><wicri:noRegion>EH16 4UX</wicri:noRegion></affiliation></author><author><name sortKey="Freeman, Daniel" sort="Freeman, Daniel" uniqKey="Freeman D" first="Daniel" last="Freeman">Daniel Freeman</name><affiliation wicri:level="4"><nlm:affiliation>Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, OX3 7JX</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX4 7JX, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX4 7JX</wicri:regionArea><wicri:noRegion>OX4 7JX</wicri:noRegion></affiliation></author><author><name sortKey="Fowler, David" sort="Fowler, David" uniqKey="Fowler D" first="David" last="Fowler">David Fowler</name><affiliation wicri:level="4"><nlm:affiliation>School of Psychology, Pevensey Building, University of Sussex, Falmer, BN1 9QH, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Psychology, Pevensey Building, University of Sussex, Falmer, BN1 9QH</wicri:regionArea><orgName type="university">Université du Sussex</orgName><placeName><settlement type="city">Brighton</settlement><settlement type="town">Falmer</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Sussex de l'Est</region></placeName></affiliation></author><author><name sortKey="Haddad, Peter M" sort="Haddad, Peter M" uniqKey="Haddad P" first="Peter M" last="Haddad">Peter M. Haddad</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.</nlm:affiliation><country xml:lang="fr">Qatar</country><wicri:regionArea>Department of Psychiatry, Hamad Medical Corporation, PO Box 3050, Doha</wicri:regionArea><wicri:noRegion>Doha</wicri:noRegion></affiliation></author><author><name sortKey="Shiers, David" sort="Shiers, David" uniqKey="Shiers D" first="David" last="Shiers">David Shiers</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Hollis, Chris" sort="Hollis, Chris" uniqKey="Hollis C" first="Chris" last="Hollis">Chris Hollis</name><affiliation wicri:level="4"><nlm:affiliation>NIHR MindTech MedTech Co-operative, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>NIHR MindTech MedTech Co-operative, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Innovation Park, Triumph Road, Nottingham, NG7 2TU</wicri:regionArea><orgName type="university">Université de Nottingham</orgName><placeName><settlement type="city">Nottingham</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Nottinghamshire</region></placeName></affiliation></author><author><name sortKey="Smith, Jo" sort="Smith, Jo" uniqKey="Smith J" first="Jo" last="Smith">Jo Smith</name><affiliation wicri:level="1"><nlm:affiliation>School of Allied Health and Community, Bredon Building, University of Worcester, Worcester, WR2 6AJ, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Allied Health and Community, Bredon Building, University of Worcester, Worcester, WR2 6AJ</wicri:regionArea><wicri:noRegion>WR2 6AJ</wicri:noRegion></affiliation></author><author><name sortKey="Liew, Ashley" sort="Liew, Ashley" uniqKey="Liew A" first="Ashley" last="Liew">Ashley Liew</name><affiliation wicri:level="4"><nlm:affiliation>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT</wicri:regionArea><orgName type="university">Université de Birmingham</orgName><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, CV4 7AL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, CV4 7AL</wicri:regionArea><wicri:noRegion>CV4 7AL</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Forward Thinking Birmingham, Birmingham Women's and Children's NHS Foundation Trust, Finch Road, Lozells, B19 1HS, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Forward Thinking Birmingham, Birmingham Women's and Children's NHS Foundation Trust, Finch Road, Lozells, B19 1HS</wicri:regionArea><wicri:noRegion>B19 1HS</wicri:noRegion></affiliation></author><author><name sortKey="Byrne, Rory E" sort="Byrne, Rory E" uniqKey="Byrne R" first="Rory E" last="Byrne">Rory E. Byrne</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="French, Paul" sort="French, Paul" uniqKey="French P" first="Paul" last="French">Paul French</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building, Liverpool, L69 3BX, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building, Liverpool, L69 3BX</wicri:regionArea><wicri:noRegion>L69 3BX</wicri:noRegion></affiliation></author><author><name sortKey="Peters, Sarah" sort="Peters, Sarah" uniqKey="Peters S" first="Sarah" last="Peters">Sarah Peters</name><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Hudson, Jemma" sort="Hudson, Jemma" uniqKey="Hudson J" first="Jemma" last="Hudson">Jemma Hudson</name><affiliation wicri:level="1"><nlm:affiliation>Centre for Healthcare Randomised Trials, Health Services Research Unit, University of Aberdeen, 3rd Floor Health Sciences Building, Aberdeen, AB25 2ZD, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Healthcare Randomised Trials, Health Services Research Unit, University of Aberdeen, 3rd Floor Health Sciences Building, Aberdeen, AB25 2ZD</wicri:regionArea><wicri:noRegion>AB25 2ZD</wicri:noRegion></affiliation></author><author><name sortKey="Davies, Linda" sort="Davies, Linda" uniqKey="Davies L" first="Linda" last="Davies">Linda Davies</name><affiliation wicri:level="4"><nlm:affiliation>Division of Population Health, Health Services Research & Primary Care, University of Manchester, Jean MacFarlane Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Population Health, Health Services Research & Primary Care, University of Manchester, Jean MacFarlane Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Emsley, Richard" sort="Emsley, Richard" uniqKey="Emsley R" first="Richard" last="Emsley">Richard Emsley</name><affiliation wicri:level="1"><nlm:affiliation>Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, SE5 8AZ, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, SE5 8AZ</wicri:regionArea><wicri:noRegion>SE5 8AZ</wicri:noRegion></affiliation></author><author><name sortKey="Yung, Alison" sort="Yung, Alison" uniqKey="Yung A" first="Alison" last="Yung">Alison Yung</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Centre for Youth Mental Health, Faculty of Medicine, University of Melbourne, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Youth Mental Health, Faculty of Medicine, University of Melbourne, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Birchwood, Max" sort="Birchwood, Max" uniqKey="Birchwood M" first="Max" last="Birchwood">Max Birchwood</name><affiliation wicri:level="1"><nlm:affiliation>Warwick Medical School-Mental Health and Wellbeing, University of Warwick, Coventry, CV4 7AL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Warwick Medical School-Mental Health and Wellbeing, University of Warwick, Coventry, CV4 7AL</wicri:regionArea><wicri:noRegion>CV4 7AL</wicri:noRegion></affiliation></author><author><name sortKey="Longden, Eleanor" sort="Longden, Eleanor" uniqKey="Longden E" first="Eleanor" last="Longden">Eleanor Longden</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Morrison, Anthony P" sort="Morrison, Anthony P" uniqKey="Morrison A" first="Anthony P" last="Morrison">Anthony P. Morrison</name><affiliation wicri:level="1"><nlm:affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL</wicri:regionArea><wicri:noRegion>M25 3BL</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL</wicri:regionArea><orgName type="university">Université de Manchester</orgName><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author></analytic><series><title level="j">Trials</title><idno type="eISSN">1745-6215</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adolescent Behavior (drug effects)</term><term>Age Factors (MeSH)</term><term>Antipsychotic Agents (adverse effects)</term><term>Antipsychotic Agents (therapeutic use)</term><term>Cognitive Behavioral Therapy (MeSH)</term><term>England (MeSH)</term><term>Family Therapy (MeSH)</term><term>Feasibility Studies (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Multicenter Studies as Topic (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Psychotic Disorders (diagnosis)</term><term>Psychotic Disorders (psychology)</term><term>Psychotic Disorders (therapy)</term><term>Randomized Controlled Trials as Topic (MeSH)</term><term>Time Factors (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Angleterre (MeSH)</term><term>Comportement de l'adolescent (effets des médicaments et des substances chimiques)</term><term>Essais contrôlés randomisés comme sujet (MeSH)</term><term>Facteurs temps (MeSH)</term><term>Facteurs âges (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Neuroleptiques (effets indésirables)</term><term>Neuroleptiques (usage thérapeutique)</term><term>Résultat thérapeutique (MeSH)</term><term>Thérapie cognitive (MeSH)</term><term>Thérapie familiale (MeSH)</term><term>Troubles psychotiques (diagnostic)</term><term>Troubles psychotiques (psychologie)</term><term>Troubles psychotiques (thérapie)</term><term>Études de faisabilité (MeSH)</term><term>Études multicentriques comme sujet (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antipsychotic Agents</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>England</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Troubles psychotiques</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Adolescent Behavior</term></keywords><keywords scheme="MESH" qualifier="effets des médicaments et des substances chimiques" xml:lang="fr"><term>Comportement de l'adolescent</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Neuroleptiques</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Troubles psychotiques</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antipsychotic Agents</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Troubles psychotiques</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Neuroleptiques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Age Factors</term><term>Cognitive Behavioral Therapy</term><term>Family Therapy</term><term>Feasibility Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Multicenter Studies as Topic</term><term>Prospective Studies</term><term>Randomized Controlled Trials as Topic</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Angleterre</term><term>Essais contrôlés randomisés comme sujet</term><term>Facteurs temps</term><term>Facteurs âges</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Thérapie cognitive</term><term>Thérapie familiale</term><term>Études de faisabilité</term><term>Études multicentriques comme sujet</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Adolescent-onset psychosis is associated with more severe symptoms and poorer outcomes than adult-onset psychosis. The National Institute for Clinical Excellence (NICE) recommend that adolescents with first episode psychosis (FEP) should be offered a combination of antipsychotic medication (APs), cognitive behavioural therapy (CBT) and family intervention (FI). The evidence for APs in treating psychosis is limited in adolescents compared to adults. Nevertheless, it indicates that APs can reduce overall symptoms in adolescents but may cause more severe side effects, including cardiovascular and metabolic effects, than in adults. CBT and FI can improve outcomes in adults, but there are no studies of psychological interventions (PI) in patients under 18 years old. Given this limited evidence base, NICE made a specific research recommendation for determining the clinical and cost effectiveness of APs versus PI versus both treatments for adolescent FEP.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS/DESIGN</b></p><p>The current study aimed to establish the feasibility and acceptability of conducting such a trial by recruiting 14-18-year-olds with a first episode of psychosis into a feasibility prospective randomised open blinded evaluation (PROBE) design, three-arm, randomised controlled trial of APs alone versus PI alone versus a combination of both treatments. We aimed to recruit 90 participants from Early Intervention and Child and Adolescent Mental Health Teams in seven UK sites. APs were prescribed by participants' usual psychiatrists. PI comprised standardised cognitive behavioural therapy and family intervention sessions.</p></div><div type="abstract" xml:lang="en"><p><b>DISCUSSION</b></p><p>This is the first study to compare APs to PI in an adolescent population with FEP. Recruitment finished on 31 October 2018. The study faced difficulties with recruitment across most sites due to factors including clinician and service-user treatment preferences.</p></div><div type="abstract" xml:lang="en"><p><b>TRIAL REGISTRATION</b></p><p>Current controlled trial with ISRCTN, ISRCTN80567433 . Registered on 27 February 2017.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">31272477</PMID><DateCompleted><Year>2020</Year><Month>02</Month><Day>24</Day></DateCompleted><DateRevised><Year>2020</Year><Month>03</Month><Day>11</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1745-6215</ISSN><JournalIssue CitedMedium="Internet"><Volume>20</Volume><Issue>1</Issue><PubDate><Year>2019</Year><Month>Jul</Month><Day>04</Day></PubDate></JournalIssue><Title>Trials</Title><ISOAbbreviation>Trials</ISOAbbreviation></Journal><ArticleTitle>Study protocol for a randomised controlled trial of CBT vs antipsychotics vs both in 14-18-year-olds: Managing Adolescent first episode Psychosis: a feasibility study (MAPS).</ArticleTitle><Pagination><MedlinePgn>395</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13063-019-3506-1</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Adolescent-onset psychosis is associated with more severe symptoms and poorer outcomes than adult-onset psychosis. The National Institute for Clinical Excellence (NICE) recommend that adolescents with first episode psychosis (FEP) should be offered a combination of antipsychotic medication (APs), cognitive behavioural therapy (CBT) and family intervention (FI). The evidence for APs in treating psychosis is limited in adolescents compared to adults. Nevertheless, it indicates that APs can reduce overall symptoms in adolescents but may cause more severe side effects, including cardiovascular and metabolic effects, than in adults. CBT and FI can improve outcomes in adults, but there are no studies of psychological interventions (PI) in patients under 18 years old. Given this limited evidence base, NICE made a specific research recommendation for determining the clinical and cost effectiveness of APs versus PI versus both treatments for adolescent FEP.</AbstractText><AbstractText Label="METHODS/DESIGN" NlmCategory="METHODS">The current study aimed to establish the feasibility and acceptability of conducting such a trial by recruiting 14-18-year-olds with a first episode of psychosis into a feasibility prospective randomised open blinded evaluation (PROBE) design, three-arm, randomised controlled trial of APs alone versus PI alone versus a combination of both treatments. We aimed to recruit 90 participants from Early Intervention and Child and Adolescent Mental Health Teams in seven UK sites. APs were prescribed by participants' usual psychiatrists. PI comprised standardised cognitive behavioural therapy and family intervention sessions.</AbstractText><AbstractText Label="DISCUSSION" NlmCategory="CONCLUSIONS">This is the first study to compare APs to PI in an adolescent population with FEP. Recruitment finished on 31 October 2018. The study faced difficulties with recruitment across most sites due to factors including clinician and service-user treatment preferences.</AbstractText><AbstractText Label="TRIAL REGISTRATION" NlmCategory="BACKGROUND">Current controlled trial with ISRCTN, ISRCTN80567433 . Registered on 27 February 2017.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Pyle</LastName><ForeName>Melissa</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Broome</LastName><ForeName>Matthew R</ForeName><Initials>MR</Initials><AffiliationInfo><Affiliation>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. m.r.broome@bham.ac.uk.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK. m.r.broome@bham.ac.uk.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Human Brain Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. m.r.broome@bham.ac.uk.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX4 7JX, UK. m.r.broome@bham.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Joyce</LastName><ForeName>Emmeline</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>MacLennan</LastName><ForeName>Graeme</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Centre for Healthcare Randomised Trials, Health Services Research Unit, University of Aberdeen, 3rd Floor Health Sciences Building, Aberdeen, AB25 2ZD, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Norrie</LastName><ForeName>John</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Edinburgh Clinical Trials Unit, Centre for Population Health Sciences, Usher Institute, Nine Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Freeman</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX4 7JX, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fowler</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>School of Psychology, Pevensey Building, University of Sussex, Falmer, BN1 9QH, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Haddad</LastName><ForeName>Peter M</ForeName><Initials>PM</Initials><AffiliationInfo><Affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Psychiatry, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shiers</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hollis</LastName><ForeName>Chris</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>NIHR MindTech MedTech Co-operative, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Smith</LastName><ForeName>Jo</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>School of Allied Health and Community, Bredon Building, University of Worcester, Worcester, WR2 6AJ, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liew</LastName><ForeName>Ashley</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, CV4 7AL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Forward Thinking Birmingham, Birmingham Women's and Children's NHS Foundation Trust, Finch Road, Lozells, B19 1HS, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Byrne</LastName><ForeName>Rory E</ForeName><Initials>RE</Initials><AffiliationInfo><Affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>French</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building, Liverpool, L69 3BX, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Peters</LastName><ForeName>Sarah</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hudson</LastName><ForeName>Jemma</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Centre for Healthcare Randomised Trials, Health Services Research Unit, University of Aberdeen, 3rd Floor Health Sciences Building, Aberdeen, AB25 2ZD, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Davies</LastName><ForeName>Linda</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Division of Population Health, Health Services Research & Primary Care, University of Manchester, Jean MacFarlane Building, Manchester, M13 9PL, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Emsley</LastName><ForeName>Richard</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, SE5 8AZ, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yung</LastName><ForeName>Alison</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Youth Mental Health, Faculty of Medicine, University of Melbourne, 35 Poplar Rd, Parkville, Melbourne, VIC, 3052, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Birchwood</LastName><ForeName>Max</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Warwick Medical School-Mental Health and Wellbeing, University of Warwick, Coventry, CV4 7AL, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Longden</LastName><ForeName>Eleanor</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morrison</LastName><ForeName>Anthony P</ForeName><Initials>AP</Initials><AffiliationInfo><Affiliation>The Psychosis Research Unit, Department of Psychology, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Psychology and Mental Health, University of Manchester, Zochonis Building, Manchester, M13 9PL, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>HSRU1</GrantID><Acronym>CSO_</Acronym><Agency>Chief Scientist Office</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>HTA/15/31/04</GrantID><Acronym>DH_</Acronym><Agency>Department of Health</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>15/31/04</GrantID><Agency>Health Technology Assessment Programme</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D000078325">Clinical Trial Protocol</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>07</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Trials</MedlineTA><NlmUniqueID>101263253</NlmUniqueID><ISSNLinking>1745-6215</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014150">Antipsychotic Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000294" MajorTopicYN="N">Adolescent Behavior</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="Y">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000367" MajorTopicYN="N">Age Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014150" MajorTopicYN="N">Antipsychotic Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015928" MajorTopicYN="Y">Cognitive Behavioral Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004739" MajorTopicYN="N" Type="Geographic">England</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005196" MajorTopicYN="Y">Family Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005240" MajorTopicYN="N">Feasibility Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015337" MajorTopicYN="N">Multicenter Studies as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011618" MajorTopicYN="N">Psychotic Disorders</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016032" MajorTopicYN="N">Randomized Controlled Trials as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Adolescent psychosis</Keyword><Keyword MajorTopicYN="N">Antipsychotic medication</Keyword><Keyword MajorTopicYN="N">Cognitive behavioural therapy</Keyword><Keyword MajorTopicYN="N">Family intervention</Keyword><Keyword MajorTopicYN="N">First-episode psychosis</Keyword><Keyword MajorTopicYN="N">Psychological intervention</Keyword><Keyword MajorTopicYN="N">Randomised controlled trial</Keyword><Keyword MajorTopicYN="N">Schizophrenia</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>10</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>06</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>7</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>7</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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Nottingham</li><li>Université du Sussex</li></orgName></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Pyle, Melissa" sort="Pyle, Melissa" uniqKey="Pyle M" first="Melissa" last="Pyle">Melissa Pyle</name></noRegion><name sortKey="Birchwood, Max" sort="Birchwood, Max" uniqKey="Birchwood M" first="Max" last="Birchwood">Max Birchwood</name><name sortKey="Broome, Matthew R" sort="Broome, Matthew R" uniqKey="Broome M" first="Matthew R" last="Broome">Matthew R. Broome</name><name sortKey="Broome, Matthew R" sort="Broome, Matthew R" uniqKey="Broome M" first="Matthew R" last="Broome">Matthew R. Broome</name><name sortKey="Broome, Matthew R" sort="Broome, Matthew R" uniqKey="Broome M" first="Matthew R" last="Broome">Matthew R. Broome</name><name sortKey="Broome, Matthew R" sort="Broome, Matthew R" uniqKey="Broome M" first="Matthew R" last="Broome">Matthew R. Broome</name><name sortKey="Byrne, Rory E" sort="Byrne, Rory E" uniqKey="Byrne R" first="Rory E" last="Byrne">Rory E. Byrne</name><name sortKey="Byrne, Rory E" sort="Byrne, Rory E" uniqKey="Byrne R" first="Rory E" last="Byrne">Rory E. Byrne</name><name sortKey="Davies, Linda" sort="Davies, Linda" uniqKey="Davies L" first="Linda" last="Davies">Linda Davies</name><name sortKey="Emsley, Richard" sort="Emsley, Richard" uniqKey="Emsley R" first="Richard" last="Emsley">Richard Emsley</name><name sortKey="Fowler, David" sort="Fowler, David" uniqKey="Fowler D" first="David" last="Fowler">David Fowler</name><name sortKey="Freeman, Daniel" sort="Freeman, Daniel" uniqKey="Freeman D" first="Daniel" last="Freeman">Daniel Freeman</name><name sortKey="Freeman, Daniel" sort="Freeman, Daniel" uniqKey="Freeman D" first="Daniel" last="Freeman">Daniel Freeman</name><name sortKey="French, Paul" sort="French, Paul" uniqKey="French P" first="Paul" last="French">Paul French</name><name sortKey="French, Paul" sort="French, Paul" uniqKey="French P" first="Paul" last="French">Paul French</name><name sortKey="Haddad, Peter M" sort="Haddad, Peter M" uniqKey="Haddad P" first="Peter M" last="Haddad">Peter M. Haddad</name><name sortKey="Hollis, Chris" sort="Hollis, Chris" uniqKey="Hollis C" first="Chris" last="Hollis">Chris Hollis</name><name sortKey="Hudson, Jemma" sort="Hudson, Jemma" uniqKey="Hudson J" first="Jemma" last="Hudson">Jemma Hudson</name><name sortKey="Joyce, Emmeline" sort="Joyce, Emmeline" uniqKey="Joyce E" first="Emmeline" last="Joyce">Emmeline Joyce</name><name sortKey="Liew, Ashley" sort="Liew, Ashley" uniqKey="Liew A" first="Ashley" last="Liew">Ashley Liew</name><name sortKey="Liew, Ashley" sort="Liew, Ashley" uniqKey="Liew A" first="Ashley" last="Liew">Ashley Liew</name><name sortKey="Liew, Ashley" sort="Liew, Ashley" uniqKey="Liew A" first="Ashley" last="Liew">Ashley Liew</name><name sortKey="Longden, Eleanor" sort="Longden, Eleanor" uniqKey="Longden E" first="Eleanor" last="Longden">Eleanor Longden</name><name sortKey="Longden, Eleanor" sort="Longden, Eleanor" uniqKey="Longden E" first="Eleanor" last="Longden">Eleanor Longden</name><name sortKey="Maclennan, Graeme" sort="Maclennan, Graeme" uniqKey="Maclennan G" first="Graeme" last="Maclennan">Graeme Maclennan</name><name sortKey="Morrison, Anthony P" sort="Morrison, Anthony P" uniqKey="Morrison A" first="Anthony P" last="Morrison">Anthony P. Morrison</name><name sortKey="Morrison, Anthony P" sort="Morrison, Anthony P" uniqKey="Morrison A" first="Anthony P" last="Morrison">Anthony P. Morrison</name><name sortKey="Norrie, John" sort="Norrie, John" uniqKey="Norrie J" first="John" last="Norrie">John Norrie</name><name sortKey="Peters, Sarah" sort="Peters, Sarah" uniqKey="Peters S" first="Sarah" last="Peters">Sarah Peters</name><name sortKey="Pyle, Melissa" sort="Pyle, Melissa" uniqKey="Pyle M" first="Melissa" last="Pyle">Melissa Pyle</name><name sortKey="Shiers, David" sort="Shiers, David" uniqKey="Shiers D" first="David" last="Shiers">David Shiers</name><name sortKey="Shiers, David" sort="Shiers, David" uniqKey="Shiers D" first="David" last="Shiers">David Shiers</name><name sortKey="Smith, Jo" sort="Smith, Jo" uniqKey="Smith J" first="Jo" last="Smith">Jo Smith</name><name sortKey="Yung, Alison" sort="Yung, Alison" uniqKey="Yung A" first="Alison" last="Yung">Alison Yung</name><name sortKey="Yung, Alison" sort="Yung, Alison" uniqKey="Yung A" first="Alison" last="Yung">Alison Yung</name></country><country name="Qatar"><noRegion><name sortKey="Haddad, Peter M" sort="Haddad, Peter M" uniqKey="Haddad P" first="Peter M" last="Haddad">Peter M. Haddad</name></noRegion></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Yung, Alison" sort="Yung, Alison" uniqKey="Yung A" first="Alison" last="Yung">Alison Yung</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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