Kavanagh 2004.
Methods | Allocation: randomised. Design: single‐centre (3 hospital sites, Royal Brisbane, Logan or Wolston Park). Duration: 12 months. Setting: hospital and community. Location: Brisbane, Qld, Australia. |
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Participants | Diagnosis: 100% DSM‐IV psychotic disorder with a current DSM‐IV substance use disorder (88% alcohol, 76% cannabis, 12% inhalants, 8% cocaine or heroin). N = 25. Age: 17‐31 years, mean: 23 years. Sex: 15 M, 10 F. Ethnicity: 84% Anglo‐Saxon. Inclusion criteria: 16‐35 years, consensus diagnosis of a DSM‐IV psychotic disorder; a current DSM‐IV substance use disorder; < 3 years since the first psychotic episode, less than 3 previous episodes of psychosis, able to converse in English without an interpreter, no diagnosis of developmental disability or amnesic disorder, not currently receiving other treatment for substance abuse, and, not currently taking heroin or methadone. | |
Interventions | 1. Psychosocial intervention: routine care plus Start Over and Survive (SOS). Brief motivational intervention comprising 3 hours of individual treatment over 6‐9 sessions usually completed within 7‐10 days as an inpatient. N = 13. 2. Standard care: comprised pharmacotherapy, access to in‐patient programmes and aftercare involving either case management or general practice consultations. N = 12. | |
Outcomes | Leaving the study early: lost to evaluation. Substance use: number of participants abstinent or improved on all substances at 12 months. | |
Notes | ITT analysis. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Permutations table for each site. |
Allocation concealment (selection bias) | Unclear risk | No details. |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Clinician‐/participant‐mediated and participants and personnel not blinded. It is not possible to blind a psychosocial intervention. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Raters blinded. |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Lost to follow‐up: 32% (8/25) 1 year. One SC participant had baseline data carried forward as missing data at 3, 6, and 12 month follow‐ups. |
Selective reporting (reporting bias) | Unclear risk | Pilot study, no protocol. Five SOS participants did not proceed beyond initial rapport building stage so two analyses were done; one with all SOS subjects (n=13) and another one including SOS treated (n=8) |
Other bias | Low risk | No evidence other bias occurring. |