Digital smartphone intervention to recognise and manage early warning signs in schizophrenia to prevent relapse : The EMPOWER feasibility cluster RCT

Journal article

Gumley, Andrew I., Bradstreet, Simon, Ainsworth, John, Allan, Stephanie, Alvarez-Jimenez, Mario, Birchwood, Maximillian, Briggs, Andrew, Bucci, Sandra, Cotton, Sue, Engel, Lidia, French, Paul, Lederman, Reeva, Lewis, Shôn, Machin, Matthew, MacLennan, Graeme, McLeod, Hamish, McMeekin, Nicola, Mihalopoulos, Cathy, Morton, Emma, ... Gleeson, John. (2022). Digital smartphone intervention to recognise and manage early warning signs in schizophrenia to prevent relapse : The EMPOWER feasibility cluster RCT. 26(27). https://doi.org/10.3310/HLZE0479
AuthorsGumley, Andrew I., Bradstreet, Simon, Ainsworth, John, Allan, Stephanie, Alvarez-Jimenez, Mario, Birchwood, Maximillian, Briggs, Andrew, Bucci, Sandra, Cotton, Sue, Engel, Lidia, French, Paul, Lederman, Reeva, Lewis, Shôn, Machin, Matthew, MacLennan, Graeme, McLeod, Hamish, McMeekin, Nicola, Mihalopoulos, Cathy, Morton, Emma, Norrie, John, Reilly, Frank, Schwannauer, Matthias, Singh, Swaran P., Sundram, Suresh, Thompson, Andrew, Williams, Chris, Yung, Alison, Aucott, Lorna, Farhall, John and Gleeson, John
Abstract

Background
Relapse is a major determinant of outcome for people with a diagnosis of schizophrenia. Early warning signs frequently precede relapse. A recent Cochrane Review found low-quality evidence to suggest a positive effect of early warning signs interventions on hospitalisation and relapse.

Objective
How feasible is a study to investigate the clinical effectiveness and cost-effectiveness of a digital intervention to recognise and promptly manage early warning signs of relapse in schizophrenia with the aim of preventing relapse?

Design
A multicentre, two-arm, parallel-group cluster randomised controlled trial involving eight community mental health services, with 12-month follow-up.

Settings
Glasgow, UK, and Melbourne, Australia.

Participants
Service users were aged > 16 years and had a schizophrenia spectrum disorder with evidence of a relapse within the previous 2 years. Carers were eligible for inclusion if they were nominated by an eligible service user.

Interventions
The Early signs Monitoring to Prevent relapse in psychosis and prOmote Wellbeing, Engagement, and Recovery (EMPOWER) intervention was designed to enable participants to monitor changes in their well-being daily using a mobile phone, blended with peer support. Clinical triage of changes in well-being that were suggestive of early signs of relapse was enabled through an algorithm that triggered a check-in prompt that informed a relapse prevention pathway, if warranted.

Main outcome measures
The main outcomes were feasibility of the trial and feasibility, acceptability and usability of the intervention, as well as safety and performance. Candidate co-primary outcomes were relapse and fear of relapse.

Results
We recruited 86 service users, of whom 73 were randomised (42 to EMPOWER and 31 to treatment as usual). Primary outcome data were collected for 84% of participants at 12 months. Feasibility data for people using the smartphone application (app) suggested that the app was easy to use and had a positive impact on motivations and intentions in relation to mental health. Actual app usage was high, with 91% of users who completed the baseline period meeting our a priori criterion of acceptable engagement (> 33%). The median time to discontinuation of > 33% app usage was 32 weeks (95% confidence interval 14 weeks to ∞). There were 8 out of 33 (24%) relapses in the EMPOWER arm and 13 out of 28 (46%) in the treatment-as-usual arm. Fewer participants in the EMPOWER arm had a relapse (relative risk 0.50, 95% confidence interval 0.26 to 0.98), and time to first relapse (hazard ratio 0.32, 95% confidence interval 0.14 to 0.74) was longer in the EMPOWER arm than in the treatment-as-usual group. At 12 months, EMPOWER participants were less fearful of having a relapse than those in the treatment-as-usual arm (mean difference –4.29, 95% confidence interval –7.29 to –1.28). EMPOWER was more costly and more effective, resulting in an incremental cost-effectiveness ratio of £3041. This incremental cost-effectiveness ratio would be considered cost-effective when using the National Institute for Health and Care Excellence threshold of £20,000 per quality-adjusted life-year gained.

Limitations
This was a feasibility study and the outcomes detected cannot be taken as evidence of efficacy or effectiveness.

Conclusions
A trial of digital technology to monitor early warning signs that blended with peer support and clinical triage to detect and prevent relapse is feasible.

Future work
A main trial with a sample size of 500 (assuming 90% power and 20% dropout) would detect a clinically meaningful reduction in relapse (relative risk 0.7) and improvement in other variables (effect sizes 0.3–0.4).

Trial registration
This trial is registered as ISRCTN99559262.

Funding
This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 27. See the NIHR Journals Library website for further project information. Funding in Australia was provided by the National Health and Medical Research Council (APP1095879).

Year2022
Journal citation26 (27)
PublisherNational Coordinating Centre for Health Technology Assessment
ISSN1366-5278
Digital Object Identifier (DOI)https://doi.org/10.3310/HLZE0479
PubMed ID35639493
Scopus EID2-s2.0-85131189606
PubMed Central IDPMC9376801
Page range1-173
FunderNational Institute for Health Research (NIHR)
National Health and Medical Research Council (NHMRC)
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
OnlineMay 2022
Publication process dates
Deposited17 Aug 2023
Grant ID1095879
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Gumley, Andrew, Bradstreet, Simon, Ainsworth, John, Allan, Stephanie, Alvarez-Jimenez, Mario, Beattie, Louise, Bell, Imogen, Birchwood, Max, Briggs, Andrew, Bucci, Sandra, Castagnini, Emily, Clark, Andrea, Cotton, Sue M., Engel, Lidia, French, Paul, Lederman, Reeva, Lewis, Shon, Machin, Matthew, MacLennan, Graeme, ... Gleeson, John. (2020). Early signs monitoring to prevent relapse in psychosis and promote well-being, engagement, and recovery : Protocol for a feasibility cluster randomized controlled trial harnessing mobile phone technology blended with peer support. JMIR Research Protocols. 9(1), p. e15058. https://doi.org/10.2196/15058
Blended digital and face-to-face care for first-episode psychosis treatment in young people : Qualitative study
Valentine, Lee, McEnery, Carla, Bell, Imogen, O'Sullivan, Shaunagh, Pryor, Ingrid, Gleeson, John, Bendall, Sarah and Alvarez-Jimenez, Mario. (2020). Blended digital and face-to-face care for first-episode psychosis treatment in young people : Qualitative study. JMIR Mental Health. 7(7), p. e18990. https://doi.org/10.2196/18990
The role of social relatedness and self-beliefs in social functioning in first-episode psychosis : Are we overestimating the contribution of illness-related factors?
González-Blanch, César, Medrano, Leonardo A., Bendall, Sarah, D’Alfonso, Simon, Cagliarini, Daniela, McEnery, Carla, O’Sullivan, Shaunagh, Valentine, Lee, Gleeson, John F. and Alvarez-Jimenez, Mario. (2020). The role of social relatedness and self-beliefs in social functioning in first-episode psychosis : Are we overestimating the contribution of illness-related factors? European Psychiatry. 63(1), pp. 1-8. https://doi.org/10.1192/j.eurpsy.2020.90
Neuroticism may not reflect emotional variability
Kalokerinos, Elise K., Murphy, Sean C., Koval, Peter, Bailen, Natasha H., Crombez, Geert, Hollenstein, Tom, Gleeson, John, Thompson, Renee J., Van Ryckeghem, Dimitri M. L., Kuppens, Peter and Bastian, Brock. (2020). Neuroticism may not reflect emotional variability. Proceedings of the National Academy of Sciences of USA. 117(17), pp. 9270-9276. https://doi.org/10.1073/pnas.1919934117
Leveraging the social network for treatment of social anxiety : Pilot study of a youth-specific digital intervention with a focus on engagement of young men
Rice, Simon, O'Bree, Bridget, Wilson, Michael, McEnery, Carla, Lim, Michelle H., Hamilton, Matthew, Gleeson, John, Bendall, Sarah, D'Alfonso, Simon, Russon, Penni, Valentine, Lee, Cagliarini, Daniela, Howell, Simmone, Miles, Christopher, Pearson, Marc, Nicholls, Laura, Garland, Nicola, Mullen, Edward, McGorry, Patrick D. and Alvarez-Jimenez, Mario. (2020). Leveraging the social network for treatment of social anxiety : Pilot study of a youth-specific digital intervention with a focus on engagement of young men. Internet Interventions. https://doi.org/10.1016/j.invent.2020.100323
Commentary on loneliness and its association with health service utilization in people with a psychotic disorder
Gleeson, J. F. M. and Lim, M. H.. (2020). Commentary on loneliness and its association with health service utilization in people with a psychotic disorder. Schizophrenia Research. 223, pp. 73-74. https://doi.org/10.1016/j.schres.2020.06.020
Adaptation of a digital health innovation to prevent relapse and support recovery in youth receiving services for first-episode psychosis : Results from the Horyzons-Canada Phase 1 Study
Lal, Shalini, Gleeson, John, Rivard, Lysanne, D'Alfonso, Simon, Joober, Ridha, Malla, Ashok and Alvarez-Jimenez, Mario. (2020). Adaptation of a digital health innovation to prevent relapse and support recovery in youth receiving services for first-episode psychosis : Results from the Horyzons-Canada Phase 1 Study. Journal of Medical Internet Research Formative Research. 4(10), p. e19887. https://doi.org/10.2196/19887
A novel multimodal digital service (Moderated Online Social Therapy+) for help-seeking young people experiencing mental ill-health : Pilot evaluation within a national youth e-mental health service
Alvarez-Jimenez, Mario, Rice, Simon, D'Alfonso, Simon, Leicester, Steven, Bendall, Sarah, Pryor, Ingrid, Russon, Penni, McEnery, Carla, Santesteban-Echarri, Olga, Da Costa, Gustavo, Gilbertson, Tamsyn, Valentine, Lee, Solves, Laia, Ratheesh, Aswin, McGorry, Patrick D. and Gleeson, John. (2020). A novel multimodal digital service (Moderated Online Social Therapy+) for help-seeking young people experiencing mental ill-health : Pilot evaluation within a national youth e-mental health service. Journal of Medical Internet Research. 22(8), p. e17155. https://doi.org/10.2196/17155
Modeling individual differences in emotion regulation repertoire in daily life with multilevel latent profile analysis
Grommisch, Gloria, Koval, Peter, Hinton, Jordan D. X., Gleeson, John, Hollenstein, Tom, Kuppens, Peter and Lischetzke, Tanja. (2020). Modeling individual differences in emotion regulation repertoire in daily life with multilevel latent profile analysis. Emotion. 20(8), pp. 1462-1474. https://doi.org/10.1037/emo0000669
Moderated online social therapy : Viewpoint on the ethics and design principles of a web-based therapy system
D'Alfonso, Simon, Phillips, Jessica, Valentine, Lee, Gleeson, John and Alvarez-Jimenez, Mario. (2019). Moderated online social therapy : Viewpoint on the ethics and design principles of a web-based therapy system. Journal of Medical Internet Research. 6(12), p. Article e14866. https://doi.org/10.2196/14866
Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial : Study protocol
Weller, Amber, Gleeson, John, Alvarez-Jimenez, Mario, McGorry, Patrick, Nelson, Barnaby, Allott, Kelly, Bendall, Sarah, Bartholomeusz, Cali, Koval, Peter, Harrigan, Susy, O'Donoghue, Brian, Fornito, Alex, Pantelis, Christos, Paul Amminger, G., Ratheesh, Aswin, Polari, Andrea, Wood, Stephen J., van der El, Kristi, Ellinghaus, Carli, ... Killackey, Eóin. (2019). Can antipsychotic dose reduction lead to better functional recovery in first-episode psychosis? A randomized controlled-trial of antipsychotic dose reduction. The reduce trial : Study protocol. Early Intervention in Psychiatry: the development, onset and treatment of emerging mental disorders. 13(6), pp. 1345-1356. https://doi.org/10.1111/eip.12769
Developing a hypothetical implementation framework of expectations for monitoring early signs of psychosis relapse using a mobile app : Qualitative study
Allan, Stephanie, Bradstreet, Simon, McLeod, Hamish, Farhall, John, Lambrou, Maria, Gleeson, John, Clark, Andrea and Gumley, Andrew. (2019). Developing a hypothetical implementation framework of expectations for monitoring early signs of psychosis relapse using a mobile app : Qualitative study. Journal of Medical Internet Research. 21(10), p. e14366. https://doi.org/10.2196/14366
Support for carers of young people with mental illness : Design and trial of a technology-mediated therapy
Lederman, Reeva, Gleeson, John, Wadley, Greg, D'Alfonso, Simon, Rice, Simon, Santesteban-Echarri, Olga and Alvarez-Jimenez, Mario. (2019). Support for carers of young people with mental illness : Design and trial of a technology-mediated therapy. ACM Transactions on Computer-Human Interaction. 26(1), p. 4. https://doi.org/10.1145/3301421
Development of a moderated online intervention to treat social anxiety in first-episode psychosis
McEnery, Carla, Lim, Michelle H., Knowles, Ann, Rice, Simon, Gleeson, John, Howell, Simmone, Russon, Penni, Miles, Chris, D’Alfonso, Simon and Alvarez-Jimenez, Mario. (2019). Development of a moderated online intervention to treat social anxiety in first-episode psychosis. Frontiers in Psychiatry. 10, p. 581. https://doi.org/10.3389/fpsyt.2019.00581
A pilot digital intervention targeting loneliness in youth mental health
Lim, Michelle H., Rodebaugh, Thomas L., Eres, Robert, Long, Katrina M., Penn, David L. and Gleeson, John F. M.. (2019). A pilot digital intervention targeting loneliness in youth mental health. Frontiers in Psychiatry (online). 10, p. 604. https://doi.org/10.3389/fpsyt.2019.00604
The “online brain” : How the internet may be changing our cognition
Firth, Joseph, Torous, John, Stubbs, Brendon, Firth, Josh A., Steiner, Genevieve Z., Smith, Lee, Alvarez-Jimenez, Mario, Gleeson, John, Vancampfort, Davy, Armitage, Christopher J. and Sarris, Jerome. (2019). The “online brain” : How the internet may be changing our cognition. World Psychiatry. 18(2), pp. 119-129. https://doi.org/10.1002/wps.20617
HORYZONS trial : Protocol for a randomised controlled trial of a moderated online social therapy to maintain treatment effects from firstepisode psychosis services
Alvarez-Jimenez, Mario, Bendall, Sarah, Koval, Peter, Rice, Simon, Cagliarini, Daniela, Valentine, Lee, D’Alfonso, Simon, Miles, Christopher, Russon, Penni, Penn, David L., Phillips, Jess, Lederman, Reeva, Wadley, Greg, Killackey, Eoin, Santesteban-Echarri, Olga, Mihalopoulos, Cathrine, Herrman, Helen, Gonzalez-Blanch, Cesar, Gilbertson, Tamsyn, ... Gleeson, John F.. (2019). HORYZONS trial : Protocol for a randomised controlled trial of a moderated online social therapy to maintain treatment effects from firstepisode psychosis services. BMJ Open. 9(2), p. e024104.
Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: Implications for eating disorder prevention
Linardon, Jake, Gleeson, John, Yap, Keong, Murphy, Kylie and Brennan, Leah. (2019). Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: Implications for eating disorder prevention. Cognitive Behaviour Therapy. 48(1), pp. 15 - 38. https://doi.org/10.1080/16506073.2018.1517389
Implementation of the Enhanced Moderated Online Social Therapy (MOST+) model within a national youth e-mental health service (eheadspace) : Protocol for a single group pilot study for help-seeking young people
Rice, Simon, Gleeson, John Francis Martin, Leicester, Steven, Bendall, Sarah, D'Alfonso, Simon, Gilbertson, Tamsyn, Killackey, Eoin, Parker, A, Lederman, Reeva, Wadley, Greg, Santesteban-Echarri, Olga, Pryor, Ingrid, Mawren, Daveena, Ratheesh, Aswin and Álvarez-Jiménez, Mario. (2018). Implementation of the Enhanced Moderated Online Social Therapy (MOST+) model within a national youth e-mental health service (eheadspace) : Protocol for a single group pilot study for help-seeking young people. JMIR Research Protocols. 7(2), p. Article e48. https://doi.org/10.2196/resprot.8813
Social media interventions for adolescents and young people with depression and psychosis
Santesteban-Echarri, Olga, Álvarez-Jiménez, Mario, Gleeson, John and Rice, Simon M.. (2018). Social media interventions for adolescents and young people with depression and psychosis. In In Moreno, Megan A. and Radovic, Ana (Ed.). Technology and adolescent mental health pp. 187-205 Springer. https://doi.org/10.1007/978-3-319-69638-6_14
Cultural and Contextual Adaptation of an eHealth Intervention for Youth Receiving Services for First-Episode Psychosis: Adaptation Framework and Protocol for Horyzons-Canada Phase 1
Shalini Lal, John Gleeson, Ashok Malla, Lysanne Rivard, Ridha Joober, Ranjith Chandrasena and Mario Álvarez-Jiménez. (2018). Cultural and Contextual Adaptation of an eHealth Intervention for Youth Receiving Services for First-Episode Psychosis: Adaptation Framework and Protocol for Horyzons-Canada Phase 1. Journal of Medical Internet Research. 20(4), pp. 1-10. https://doi.org/10.2196/resprot.8810
Enhancing social functioning in young people at Ultra High Risk (UHR) for psychosis: A pilot study of a novel strengths and mindfulness-based online social therapy
Alvarez-Jimenez, M., Gleeson, J., Bendall, S., Penn, D. L., Yung, A. R., Ryan, R. M., Eleftheriadis, D., D'Alfonso, S., Rice, S., Miles, C., Russon, P., Lederman, R., Chambers, R., Gonzalez-Blanch, C., Lim, M. H., Killackey, E., McGorry, P. D. and Nelson, B.. (2018). Enhancing social functioning in young people at Ultra High Risk (UHR) for psychosis: A pilot study of a novel strengths and mindfulness-based online social therapy. Schizophrenia Research. 202, pp. 369 - 377. https://doi.org/10.1016/j.schres.2018.07.022
Artificial intelligence-assisted online social therapy for youth mental health
Simon D'Alfonso, Olga Santesteban-Echarri, Simon Rice, Greg Wadley, Reeva Lederman, Christopher Miles, John Gleeson and Mario Álvarez-Jiménez. (2017). Artificial intelligence-assisted online social therapy for youth mental health. Frontiers in Psychology. 8, pp. 1-13. https://doi.org/10.3389/fpsyg.2017.00796
Moderated online social therapy for carers of young people recovering from firstepisode psychosis: study protocol for a randomised controlled trial
Gleeson, John, Lederman, Reeva, Herrman, Helen, Koval, Peter, Eleftheriadis, Dina, Bendall, Sarah, Cotton, Sue and Alvarez-Jimenez, Mario. (2017). Moderated online social therapy for carers of young people recovering from firstepisode psychosis: study protocol for a randomised controlled trial. Trials. 18, pp. 1 - 11. https://doi.org/10.1186/s13063-016-1775-5
Predictors of functional recovery in first-episode psychosis : A systematic review and meta-analysis of longitudinal studies
Santesteban-Echarri, Olga, Paino, Mercedes, Rice, Simon, González-Blanch, César, McGorry, Patrick, Gleeson, John and Alvarez-Jimenez, Mario. (2017). Predictors of functional recovery in first-episode psychosis : A systematic review and meta-analysis of longitudinal studies. Clinical Psychology Review. 58, pp. 59-75. https://doi.org/10.1016/j.cpr.2017.09.007
Moderated online social therapy: A model for reducing stress in carers of young people diagnosed with mental health disorders
Gleeson, John, Lederman, Reeva, Koval, Peter, Wadley, Greg, Bendall, Sarah, Cotton, Sue, Herrman, Helen, Crisp, Kingsley and Alvarez-Jimenez, Mario. (2017). Moderated online social therapy: A model for reducing stress in carers of young people diagnosed with mental health disorders. Frontiers in Psychology. 8, pp. 1 - 8. https://doi.org/10.3389/fpsyg.2017.00485
A next-generation social media-based relapse prevention intervention for youth depression: Qualitative data on user experience outcomes for social networking, safety, and clinical benefit
Santesteban-Echarri, Olga, Rice, Simon, Wadley, Greg, Lederman, Reeva, D'Alfonso, Simon, Russon, Penni, Chambers, Richard, Miles, Christopher J., Gilbertson, Tamsyn, Gleeson, John F., McGorry, Patrick D. and Álvarez-Jiménez, Mario. (2017). A next-generation social media-based relapse prevention intervention for youth depression: Qualitative data on user experience outcomes for social networking, safety, and clinical benefit. Internet Interventions. 9, pp. 65 - 73. https://doi.org/10.1016/j.invent.2017.06.002
Expressed emotion and the course of schizophrenia in Pakistan
Sadiq, Sarosh, Suhail, Kausar, Gleeson, John and Alvarez-Jimenez, Mario. (2017). Expressed emotion and the course of schizophrenia in Pakistan. Social Psychiatry and Psychiatric Epidemiology. 52(5), pp. 587 - 593. https://doi.org/10.1007/s00127-017-1357-1
Loneliness over time: The crucial role of social anxiety
Lim, Michelle H., Rodebaugh, Thomas L., Zyphur, Michael J. and Gleeson, John Francis Martin. (2016). Loneliness over time: The crucial role of social anxiety. Journal of Abnormal Psychology. 125(5), pp. 620 - 630. https://doi.org/10.1037/abn0000162
Online peer-to-peer support in youth mental health:seizing the opportunity
Álvarez-Jiménez, Mario, Gleeson, John, Rice, Simon M., Gonzalez-Blanch, Cesar and Bendall, Sarah. (2016). Online peer-to-peer support in youth mental health:seizing the opportunity. Epidemiology and Psychiatric Sciences. 25(2), pp. 123 - 136. https://doi.org/10.1017/S2045796015001092
Beyond Clinical Remission in First Episode Psychosis: Thoughts on Antipsychotic Maintenance vs. Guided Discontinuation in the Functional Recovery Era
Álvarez-Jiménez, Mario, O'Donoghue, B., Thompson, Andrew, Gleeson, John, Bendall, Sarah, Gonzalez-Blanch, Cesar, Killackey, Eoin, Wunderink, Lex and McGorry, Patrick. (2016). Beyond Clinical Remission in First Episode Psychosis: Thoughts on Antipsychotic Maintenance vs. Guided Discontinuation in the Functional Recovery Era. CNS Drugs. 30(5), pp. 357 - 368. https://doi.org/10.1007/s40263-016-0331-x
The wisdom to know the difference : Strategy-situation fit in emotion regulation in daily life is associated with well-being
Haines, Simon J., Gleeson, John, Kuppens, Peter, Hollenstein, Tom, Ciarrochi, Joseph, Labuschagne, Izelle, Grace, Caitlin and Koval, Peter. (2016). The wisdom to know the difference : Strategy-situation fit in emotion regulation in daily life is associated with well-being. Psychological Science. 27(12), pp. 1651-1659. https://doi.org/10.1177/0956797616669086
Moderated online social therapy for depression relapse prevention in young people: Pilot study of a 'next generation' online intervention
Rice, Simon, Gleeson, John, Davey, Christopher G., Hetrick, Sarah, Parker, Alexandra, Lederman, Reeva, Wadley, Greg, Murray, Greg, Herrman, Helen, Chambers, Richard, Russon, Penni, Miles, Christopher, D'Alfonso, Simon, Thurley, Melissa, Chinnery, Gina, Gilbertson, Tamsyn, Eleftheriadis, Dina, Barlow, Emma, Cagliarini, Daniella, ... Alvarez-Jimenez, Mario. (2016). Moderated online social therapy for depression relapse prevention in young people: Pilot study of a 'next generation' online intervention. Early Intervention in Psychiatry. https://doi.org/10.1111/eip.12354
Online and social media suicide prevention interventions for young people: A Focus on implementation and moderation
Rice, Simon, Robinson, John, Bendall, Sarah, Hetrick, Sarah, Cox, Georgina, Bailey, Eleanor, Gleeson, John and Álvarez-Jiménez, Mario. (2016). Online and social media suicide prevention interventions for young people: A Focus on implementation and moderation. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 25(2), pp. 80 - 86.
Social functioning trajectories of young first-episode psychosis patients with and without cannabis misuse: A 30-month follow-up study
González-Blanch, César, Gleeson, John, Koval, Peter, Cotton, Sue, McGorry, Patrick and Alvarez-Jimenez, Mario. (2015). Social functioning trajectories of young first-episode psychosis patients with and without cannabis misuse: A 30-month follow-up study. PLoS One (online). 10(4), pp. 1 - 14. https://doi.org/10.1371/journal.pone.0122404
Online social media : New data, new horizons in psychosis treatment [Letter]
Alvarez-Jimenez, M., Alcazar-Corcoles, M. A., Gonzalez-Blanch, C., Bendall, S., McGorry, P. D. and Gleeson, J.. (2015). Online social media : New data, new horizons in psychosis treatment [Letter] Elsevier B.V.. https://doi.org/10.1016/j.schres.2015.05.006
Towards a better understanding of caregiver distress in early psychosis : A systematic review of the psychological factors involved
Jansen, Jens, Gleeson, John and Cotton, Sue. (2015). Towards a better understanding of caregiver distress in early psychosis : A systematic review of the psychological factors involved. Clinical Psychology Review. 35, pp. 56 - 66. https://doi.org/10.1016/j.cpr.2014.12.002
The development and validation of the social networking experiences questionnaire : A measure of adolescent cyberbullying and its impact
Dredge, Rebecca, Gleeson, John and De la Piedad Garcia, Xochitl. (2015). The development and validation of the social networking experiences questionnaire : A measure of adolescent cyberbullying and its impact. Violence and Victims. 30(5), pp. 798 - 812. https://doi.org/10.1891/0886-6708.VV-D-14-00040
Longitudinal relationship between expressed emotion and cannabis misuse in young people with first-episode psychosis
Gonzalez-Blanch, Cesar, Gleeson, John, Cotton, Sue, Crisp, Kingsley, McGorry, Patrick and Alvarez-Jimenez, Mario. (2015). Longitudinal relationship between expressed emotion and cannabis misuse in young people with first-episode psychosis. European Psychiatry (print). 30(1), pp. 20 - 25. https://doi.org/10.1016/j.eurpsy.2014.07.002
Moderated online social therapy : Designing and evaluating technology for mental health
Lederman, Reeva, Wadley, Greg, Gleeson, John, Bendall, Sarah and Alvarez-Jimenez, Mario. (2014). Moderated online social therapy : Designing and evaluating technology for mental health. ACM Transactions on Computer-Human Interaction. 21(1), pp. 1 - 26. https://doi.org/10.1145/2513179
An investigation of gender differences in semantic processing in individuals with high schizotypy
Rossell, Susan, Chong, Derina, O'Connor, David and Gleeson, John F.. (2014). An investigation of gender differences in semantic processing in individuals with high schizotypy. Psychiatry Research. 215(2), pp. 491 - 493. https://doi.org/10.1016/j.psychres.2013.11.015
Online, social media and mobile technologies for psychosis treatment : A systematic review on novel user-led interventions
Alvarez-Jimenez, M., Alcazar-Corcoles, M. A., Gonzalez-Blanch, C., Bendall, S., McGorry, P. D. and Gleeson, J. F.. (2014). Online, social media and mobile technologies for psychosis treatment : A systematic review on novel user-led interventions. Schizophrenia Research. 156(1), pp. 96-106. https://doi.org/10.1016/j.schres.2014.03.021
Social relationships and quality of life moderate distress associated with delusional ideation
Lim, Michelle, Gleeson, John, Jackson, Henry and Fernandez, Katya. (2014). Social relationships and quality of life moderate distress associated with delusional ideation. Social Psychiatry and Psychiatric Epidemiology. 49(1), pp. 97 - 107. https://doi.org/10.1007/s00127-013-0738-3
Cyberbullying in social networking sites: An adolescent victim's perspective
Dredge, Rebecca, Gleeson, John and de la Piedad Garcia, Xochitl. (2014). Cyberbullying in social networking sites: An adolescent victim's perspective. Computers in Human Behavior. 36, pp. 13 - 20. https://doi.org/10.1016/j.chb.2014.03.026
Online and social networking interventions for the treatment of depression in young people : A systematic review
Rice, Simon, Goodall, Joanne, Hetrick, Sarah, Parker, Alexandra, Gilbertson, Tamsyn, Amminger, G, Davey, Christopher, McGorry, Patrick, Gleeson, John and Alvarez-Jimenez, Mario. (2014). Online and social networking interventions for the treatment of depression in young people : A systematic review. Journal of Medical Internet Research. 16(9), pp. 1 - 22. https://doi.org/10.2196/jmir.3304
Risk factors associated with impact severity of cyberbullying victimization : A qualitative study of adolescent online social networking
Dredge, Rebecca, Gleeson, John and De la Piedad Garcia, Xochitl. (2014). Risk factors associated with impact severity of cyberbullying victimization : A qualitative study of adolescent online social networking. CyberPsychology, Behavior and Social Networking. 17(5), pp. 287 - 291. https://doi.org/10.1089/cyber.2013.0541
Presentation on Facebook and risk of cyberbullying victimisation
Dredge, Rebecca, Gleeson, John and de la Piedad Garcia, Xochitl. (2014). Presentation on Facebook and risk of cyberbullying victimisation. Computers in Human Behavior. 40, pp. 16 - 22. https://doi.org/10.1016/j.chb.2014.07.035
Safety and privacy outcomes from a moderated online social therapy for young people with first-episode psychosis
Gleeson, John, Lederman, Reeva, Wadley, Greg, Bendall, Sarah, McGorry, Patrick and Alvarez-Jimenez, Mario. (2014). Safety and privacy outcomes from a moderated online social therapy for young people with first-episode psychosis. Psychiatric Services. 65(4), pp. 546 - 550. https://doi.org/10.1176/appi.ps.201300078
On the HORYZON : Moderated online social therapy for long-term recovery in first episode psychosis
Alvarez-Jimenez, Mario, Bendall, Sarah, Lederman, Reeva, Wadley, Greg, Chinnery, G, Vargas, S, Larkin, M, Killackey, Eoin, McGorry, Patrick and Gleeson, John. (2013). On the HORYZON : Moderated online social therapy for long-term recovery in first episode psychosis. Schizophrenia Research. https://doi.org/10.1016/j.schres.2012.10.009
A Randomized Controlled Trial of Bibliotherapy for Carers of Young People With First-Episode Psychosis
McCann, Terence, Lubmann, Dan, Cotton, Sue, Murphy, Brendan, Crisp, Kingsley, Catania, Lisa, Marck, Claudia and Gleeson, John. (2013). A Randomized Controlled Trial of Bibliotherapy for Carers of Young People With First-Episode Psychosis. Schizophrenia Bulletin. https://doi.org/10.1093/schbul/sbs121
Coping strategies in carers of young people with a first episode of psychosis : Outcome at 30-Month Follow-Up
Cotton, Sue, McCann, Terence, Gleeson, John, Crisp, Kingsley, Murphy, Brendan and Lubman, Dan. (2013). Coping strategies in carers of young people with a first episode of psychosis : Outcome at 30-Month Follow-Up. Schizophrenia Research. https://doi.org/10.1016/j.schres.2013.02.008
A randomized controlled trial of relapse prevention therapy for first-episode psychosis patients : Outcome at 30-month follow-up
Gleeson, John, Cotton, Sue, Alvarez-Jimenez, Mario, Wade, Darryl, Gee, Donna, Crisp, Kingsley, Pearce, Tracey, Spiliotacopoulos, Daniela, Newman, Belinda and McGorry, Patrick. (2013). A randomized controlled trial of relapse prevention therapy for first-episode psychosis patients : Outcome at 30-month follow-up. Schizophrenia Bulletin. https://doi.org/10.1093/schbul/sbr165
Differences between first episode schizophrenia and schizoaffective disorder
Cotton, Sue, Lambert, M, Schimmelmann, B, Mackinnon, Andrew, Gleeson, John, Berk, Michael, Hides, L, Chanen, Andrew, Scott, J and Schottle, D. (2013). Differences between first episode schizophrenia and schizoaffective disorder. Schizophrenia Research. https://doi.org/10.1016/j.schres.2013.02.036
Progress and limitations in the measurement of cyber bullying
Dredge, Rebecca Katherine, Gleeson, John Francis Martin and de la Piedad Garcia, Xochitl. (2013). Progress and limitations in the measurement of cyber bullying. In In R. Hanewald (Ed.). From cyber bullying to cyber safety: Issues and approaches in educational contexts pp. 271 - 288 Nova Science Publishers.
Participatory design of an online therapy for youth mental health
Wadley, Greg, Lederman, Reeva, Gleeson, John and Alvarez-Jimenez, Mario. (2013). Participatory design of an online therapy for youth mental health. 25th Australian Computer-Human Interaction Conference on Augmentation, Application, Innovation, Collaboration. United States: The Association for Computing Machinery. pp. 517 - 526 https://doi.org/10.1145/2541016.2541030
The jumping-to-conclusions bias in new religious movements
Lim, Michelle, Gleeson, John Francis Martin and Jackson, Henry. (2012). The jumping-to-conclusions bias in new religious movements. Journal of Nervous and Mental Disease. 200(10), pp. 868 - 875. https://doi.org/10.1097/NMD.0b013e31826b6eb4
Depressive symptoms in first episode schizophrenia spectrum disorder
Cotton, Sue, Lambert, M, Schimmelmann, B, Mackinnon, Andrew, Gleeson, John Francis Martin, Berk, Michael, Hides, L, Chanen, Andrew, McGorry, Patrick and Conus, P. (2012). Depressive symptoms in first episode schizophrenia spectrum disorder. Schizophrenia Research. 134(1), pp. 20 - 26. https://doi.org/10.1016/j.schres.2011.08.018
Internet-Based Interventions for Psychosis : A Sneak-Peek into the Future
Alvarez-Jimenez, Mario, Gleeson, John, Bendall, Sarah, Lederman, Reeva, Wadley, Greg, Killackey, Eoin and McGorry, Patrick. (2012). Internet-Based Interventions for Psychosis : A Sneak-Peek into the Future. Psychiatric Clinics of North America. 35(3), pp. 735 - 747. https://doi.org/10.1016/j.psc.2012.06.011
Road to full recovery: Longitudinal relationship between symptomatic remission and psychosocial recovery in first-episode psychosis over 7.5 years
Alvarez-Jimenez, Mario, Gleeson, John, Henry, L., Harrigan, Susan, Harris, M., Killackey, Eoin, Bendall, Sarah, Amminger, G., Yung, Alison and Herrman, H.. (2012). Road to full recovery: Longitudinal relationship between symptomatic remission and psychosocial recovery in first-episode psychosis over 7.5 years. Psychological Medicine. 42(3), pp. 595 - 606. https://doi.org/10.1017/S0033291711001504
Treating co-occurring first-episode psychosis and borderline personality : a pilot randomized controlled trial
Gleeson, John Francis Martin, Chanen, Andrew, Cotton, Sue, Pearce, Tracey, Newman, Belinda and McCutcheon, Louise. (2012). Treating co-occurring first-episode psychosis and borderline personality : a pilot randomized controlled trial. Early Intervention in Psychiatry. 6(1), pp. 21 - 29. https://doi.org/10.1111/j.1751-7893.2011.00306.x
Risk factors for relapse following treatment for first episode psychosis : A systematic review and meta-analysis of longitudinal studies
Alvarez-Jimenez, Mario, Priede, A., Hetrick, Sarah, Bendall, Sarah, Killackey, Eoin, Parker, Alexandra, McGorry, Patrick and Gleeson, John. (2012). Risk factors for relapse following treatment for first episode psychosis : A systematic review and meta-analysis of longitudinal studies. Schizophrenia Research. 139(1-3), pp. 116 - 128. https://doi.org/10.1016/j.schres.2012.05.007
The Jumping-to-Conclusions Bias in New Religious Movements
Lim, Michelle, Gleeson, John and Jackson, Henry J.. (2012). The Jumping-to-Conclusions Bias in New Religious Movements. The Journal of Nervous and Mental Disease. 200(10), pp. 868 - 875. https://doi.org/10.1097/NMD.0b013e31826b6eb4
The relationship between impulsivity and vocational outcome in outpatient youth with borderline personality features
Sio, I. T., Chanen, A., Killackey, E. and Gleeson, John. (2011). The relationship between impulsivity and vocational outcome in outpatient youth with borderline personality features. Early Intervention in Psychiatry (print version). 5(3), pp. 249 - 253. https://doi.org/10.1111/j.1751-7893.2011.00271.x
Prediction of a single psychotic episode :A 7.5-year, prospective study in first-episode psychosis
Alvarez-Jimenez, Mario, Gleeson, John, Henry, Lisa, Harrigan, Susan, Harris, Meredith, Amminger, G, Killackey, Eoin, Yung, Alison, Herrman, Helen, Jackson, Henry and McGorry, Patrick. (2011). Prediction of a single psychotic episode :A 7.5-year, prospective study in first-episode psychosis. Schizophrenia Research. 125(2/3), pp. 236 - 246. https://doi.org/10.1016/j.schres.2010.10.020
Selective attention to treat bias in delusion-prone individuals
Lim, Michelle H., Gleeson, John and Jackson, Henry J.. (2011). Selective attention to treat bias in delusion-prone individuals. Journal of Nervous and Mental Disease (print version). 199(10), pp. 765 - 772. https://doi.org/10.1097/NMD.0b013e31822fc9e9
Supporting young people with psychosis in the community :An ICT enabled repalse prevention tool
Lederman, Reeva, Wadley, Greg, Gleeson, John, Alvarez-Jimenez, Mario and Spiteri-Staines, Anneliese. (2011). Supporting young people with psychosis in the community :An ICT enabled repalse prevention tool. Pacific Asia Conference on Information Systems 2011. Australia: AIS Electronic Library. pp. 1 - 11
Supporting young people with psychosis in the community: An ICT enabled repalse prevention tool
Lederman, Reeva, Wadley, Greg, Gleeson, John, Alvarez-Jimenez, Mario and Spiteri-Staines, Anneliese. (2011). Supporting young people with psychosis in the community: An ICT enabled repalse prevention tool. Pacific Asia Conference on Information Systems 2011. Australia: AIS Electronic Library. pp. 1 - 11
Preventing the second episode :A systematic review and Meta-analysis of Psychosocial and Pharmacological Trials in First-Episode psychosis
Alvarez-Jimenez, Mario, Parker, Alexandra, Hetrick, Sarah, McGorry, Patrick and Gleeson, John Francis Martin. (2011). Preventing the second episode :A systematic review and Meta-analysis of Psychosocial and Pharmacological Trials in First-Episode psychosis. Schizophrenia Bulletin. 37(3), pp. 619 - 630. https://doi.org/10.1093/schbul/sbp129
Selective Attention to Threat Bias in Delusion-Prone Individuals
Lim, Michelle H., Gleeson, John and Jackson, Henry J.. (2011). Selective Attention to Threat Bias in Delusion-Prone Individuals. The Journal of Nervous and Mental Disease. 199(10), pp. 765 - 772. https://doi.org/10.1097/NMD.0b013e31822fc9e9
Group programmes in early intervention services
Cotton, Sue, Luxmoore, Marni, Woodhead, Gina, Albiston, Dianne, Gleeson, John and McGorry, Patrick. (2011). Group programmes in early intervention services. Early Intervention in Psychiatry. 5(3), pp. 259 - 266. https://doi.org/10.1111/j.1751-7893.2011.00277.x
Differential predictors of critical comments and emotional over-involvement in first-episode psychosis
Alvarez-Jimenez, Mario, Gleeson, John Francis Martin, Cotton, Sue, Wade, Darryl, Crisp, Kingsley, Yap, M and McGorry, Patrick. (2010). Differential predictors of critical comments and emotional over-involvement in first-episode psychosis. Psychological Medicine. 40(1), pp. 63 - 72. https://doi.org/10.1017/S0033291708004765
Family Outcomes From a Randomized Control Trial of Relapse Prevention Therapy in First-Episode Psychosis
Gleeson, John Francis Martin, Cotton, Sue, Alvarez-Jimenez, Mario, Wade, Darryl, Crisp, Kingsley, Newman, Belinda, Spiliotacopoulos, Daniela and McGorry, Patrick. (2010). Family Outcomes From a Randomized Control Trial of Relapse Prevention Therapy in First-Episode Psychosis. Journal of Clinical Psychiatry. 71(4), pp. 475 - 783. https://doi.org/10.4088/JCP.08m04672yel
Quality of life in patients who have remitted from their first episode of psychosis
Cotton, Sue, Gleeson, John Francis Martin, Alvarez-Jimenez, Mario and McGorry, Patrick. (2010). Quality of life in patients who have remitted from their first episode of psychosis. Schizophrenia Research. 121, pp. 259 - 265. https://doi.org/10.1016/j.schres.2010.05.027
A systematic review of relapse measurement in randomized controlled trials of relapse prevention in first-episode psychosis
Gleeson, John Francis Martin, Alvarez-Jimenez, Mario, Cotton, Sue, Parker, Alexandra and Hetrick, Sarah. (2010). A systematic review of relapse measurement in randomized controlled trials of relapse prevention in first-episode psychosis. Schizophrenia Research. 119(1-3), pp. 79 - 88. https://doi.org/10.1016/j.schres.2010.02.1073
A systematic review of relapse measurement in randomized controlled trials of relapse prevention in first-episode psychosis
Gleeson, John Francis Martin, Alvarez-Jimenez, Mario, Cotton, Sue, Parker, Alexandra and Hetrick, Sarah. (2010). A systematic review of relapse measurement in randomized controlled trials of relapse prevention in first-episode psychosis. Schizophrenia Research. 119(1-3), pp. 79 - 88. https://doi.org/10.1016/j.schres.2010.02.1073
The reliability and validity of the alcohol, smoking and substance involvement screening test (assist)
Hides, L., Cotton, Sue, Berger, G., Gleeson, John, O'Donnell, C., Proffitt, T., McGorry, Patrick and Lubman, Dan. (2009). The reliability and validity of the alcohol, smoking and substance involvement screening test (assist). Addictive Behaviors. 34(10), pp. 821 - 825. https://doi.org/10.1016/j.addbeh.2009.03.040
Predictors of adherence to cognitive-behavioural therapy in first-episode psychosis
Álvarez-Jiménez, Mario, Gleeson, John, Cotton, Sue, Wade, Darryl, Gee, Donna, Pearce, Tracey, Crisp, Kingsley, Spiliotacopoulos, Daniela, Newman, Belinda and McGorry, Patrick. (2009). Predictors of adherence to cognitive-behavioural therapy in first-episode psychosis. Journal of Clinical Psychiatry. 54(10), pp. 710 - 718. https://doi.org/10.1177/070674370905401008
One Ace and three faults don't win the set
Álvarez-Jiménez, Mario, Hetrick, Sarah, Gonzalez-Blanch, Cesar, Gleeson, John and McGorry, Patrick. (2009). One Ace and three faults don't win the set. British Journal of Psychiatry. 194(1), pp. 89 - 89. https://doi.org/10.1192/bjp.194.1.89
A randomized controlled trial of relapse prevention therapy for first-episode psychosis patients
Gleeson, John, Cotton, Sue, Álvarez-Jiménez, Mario, Wade, Darryl, Gee, Donna, Crisp, Kingsley, Pearce, Tracey, Newman, Belinda, Spiliotacopoulos, Daniela, Castle, David J. and McGorry, Patrick. (2009). A randomized controlled trial of relapse prevention therapy for first-episode psychosis patients. Journal of Clinical Psychiatry. 70(4), pp. 477 - 486. https://doi.org/10.4088/JCP.08m04407
The episode ii trial of cognitive and family therapy for relapse prevention in early psychosis: Rationale and sample characteristics
Gleeson, John, Wade, Darryl, Castle, David J., Gee, Donna, Crisp, Kingsley, Pearce, Tracey, Newman, Belinda, Cotton, Sue, Álvarez-Jiménez, Mario, Gilbert, Monica and McGorry, Patrick. (2008). The episode ii trial of cognitive and family therapy for relapse prevention in early psychosis: Rationale and sample characteristics. Journal of Mental Health. 17(1), pp. 19 - 32. https://doi.org/10.1080/09638230701504999
Small shifts in diurnal rhythms are associated with an increase in suicide: The effect of daylight saving
Berk, Michael, Dodd, Seetal, Hallam, Karen, Berk, Lesley, Gleeson, John and Henry, Margaret. (2008). Small shifts in diurnal rhythms are associated with an increase in suicide: The effect of daylight saving. Sleep and Biological Rhythm. 6(1), pp. 22 - 25. https://doi.org/10.1111/j.1479-8425.2007.00331.x
Non-pharmacological management of antipsychotic-induced weight gain: systematic review and meta-analysis of randomised controlled trials
Álvarez-Jiménez, Mario, Hetrick, Sarah, Gonzalez-Blanch, Cesar, Gleeson, John and McGorry, Patrick. (2008). Non-pharmacological management of antipsychotic-induced weight gain: systematic review and meta-analysis of randomised controlled trials. British Journal of Psychiatry. 193(2), pp. 101 - 107. https://doi.org/10.1192/bjp.bp.107.042853
Evidence of semantic processing abnormalities in schizotypy using an indirect semantic priming task
Johnston, Alana, Rossell, Susan and Gleeson, John. (2008). Evidence of semantic processing abnormalities in schizotypy using an indirect semantic priming task. Journal of Nervous and Mental Disease. 196(9), pp. 694 - 701. https://doi.org/10.1097/NMD.0b013e318183f882
Acute-phase and 1-year follow-up results of a randomized controlled trial of cbt versus befriending for first-episode psychosis: The ace project
Jackson, Henry, McGorry, Patrick, Killackey, Eoin, Bendall, Sarah, Allott, Kelly, Dudgeon, P., Gleeson, John, Johnson, Tracy and Harrigan, Susan. (2008). Acute-phase and 1-year follow-up results of a randomized controlled trial of cbt versus befriending for first-episode psychosis: The ace project. Psychological Medicine. 38(5), pp. 725 - 735. https://doi.org/10.1017/S0033291707002061
The Credibility and Acceptability of Befriending as a Control Therapy in a Randomized Controlled Trial of Cognitive Behaviour Therapy for Acute First Episode Psychosis
Bendall, Sarah, Jackson, Henry, Killackey, Eoin, Allott, Kelly, Johnson, Tracy, Harrigan, Susan, Gleeson, John and McGorry, Patrick. (2006). The Credibility and Acceptability of Befriending as a Control Therapy in a Randomized Controlled Trial of Cognitive Behaviour Therapy for Acute First Episode Psychosis. Behavioural and Cognitive Psychotherapy. 34(3), pp. 277 - 291. https://doi.org/10.1017/S1352465806002815
The need for the development and evaluation of preventive psychosocial forensic interventions in mainstream adult community mental health services
Gleeson, John, Nathan, Pamela and Bradley, Gail. (2006). The need for the development and evaluation of preventive psychosocial forensic interventions in mainstream adult community mental health services. Australasian Psychiatry. 14(2), pp. 180 - 185. https://doi.org/10.1111/j.1440-1665.2006.02278.x
Exciting career opportunity beckons! Early intervention and vocational rehabilitation in first-episode psychosis: Employing cautious optimism
Killackey, Eoin, Jackson, Henry, Gleeson, John, Hickie, Ian and McGorry, Patrick. (2006). Exciting career opportunity beckons! Early intervention and vocational rehabilitation in first-episode psychosis: Employing cautious optimism. Australian and New Zealand Journal of Psychiatry. 40(44176), pp. 951 - 962. https://doi.org/10.1111/j.1440-1614.2006.01918.x
Agreeableness and neuroticism as predictors of relapse after first-episode psychosis
Gleeson, John, Rawlings, David, Jackson, Henry and McGorry, Patrick. (2005). Agreeableness and neuroticism as predictors of relapse after first-episode psychosis. Journal of Nervous and Mental Disease. 193(3), pp. 160 - 169. https://doi.org/10.1097/01.nmd.0000154841.99550.d3
Implementing cognitive-behavioural therapy for first-episode psychosis
Addington, Jean and Gleeson, John. (2005). Implementing cognitive-behavioural therapy for first-episode psychosis. British Journal of Psychiatry. 13(4), pp. 384 - 387. https://doi.org/10.1192/bjp.187.48.s72
Early warning signs of relapse following a first episode of psychosis.
Gleeson, John, Rawlings, David, Jackson, Henry and McGorry, Patrick. (2005). Early warning signs of relapse following a first episode of psychosis. Schizophrenia Research. 80(1), pp. 107 - 111. https://doi.org/10.1016/j.schres.2005.07.019