ISRCTN ISRCTN50247539
DOI https://doi.org/10.1186/ISRCTN50247539
Secondary identifying numbers ABR 27146
Submission date
04/05/2009
Registration date
30/06/2009
Last edited
18/06/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Not provided at time of registration

Contact information

Prof Andre Aleman
Scientific

Department of Neurosciences
NeuroImaging Centre Groningen
Cognitive Neuropsychiatry
Ant. Deusinglaan 2
Groningen
9713 AW
Netherlands

Email a.aleman@med.umcg.nl

Study information

Study designMulti-centre randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleReflex
Study hypothesisCurrent information as of 10/12/09:
The preconditions of poor insight in schizophrenia, self-reflection, idiosyncratic self-certainty and stigma sensitivity, can be improved by a treatment aiming to stimulate perspective taking and to decrease of internalized stigma.

Initial information at time of registration:
Can poor insight with schizophrenia be improved with a treatment aimed at self-reflection and the decrease of internalized stigmata?

Please note that as f 10/12/09 this record has been extensively updated. All updates can be found under the relevant field with the above update date. In addition, please note that the target number of participants has been changed from 80 to 145. The anticipated start and end dates for this trial have been updated from 01/09/2009 and 01/09/2011 to 01/05/2010 and 01/10/2011.
Ethics approval(s)Added 10/12/09:
Approved by the Medical Ethical Testing Committee (METc) UMCG on 13th of October 2009
ConditionPsychic disorders; schizophrenia and other psychotic disorders
InterventionCurrent information as of 10/12/09:
Patients will have 12 one-hour group therapy sessions with a psychologist. The training consists of three modules, each module consists of four group sessions. During these sessions patients are stimulated to reflect upon their own thoughts, behavior and feelings and integrate changes that have occurred during their illness in the self-image. They are constantly encouraged to distinguishing factual information from opinions and to take the perspective of others. The active control condition consists of group wise drill and practice cognitive remediation training.The total duration of the intervention will be 12 hours.

Initial information at time of registration:
Patients will have 16 group therapy sessions with a psychologist. In these sessions, stigmatising beliefs are disputed and self-reflection is stimulated. On a daily basis SMS-messages will be sent to stimulate self-reflection. After a prompt patients are required to fill out a short form with short questions about their cognitions and emotions. Weekly group sessions will be based on the patients' responses.

Control condition: care as usual and additional befriending sessions with a therapist.

The total duration of interventions will be 16 hours. Follow-up assessments will take 3 x 90 minutes.

Added 03/01/2011:
Added to the trial is a fMRI/MRS evaluation for 40 of the 145 patients in the study (20 patients and 20 controls). For the 20 patients the fMRI/MRS will be added before and after the psychosocial intervention/training. Duration: 2x 1 hour.
Intervention typeOther
Primary outcome measureCurrent information as of 10/12/09:
Self-reflection, idiosyncratic self-certainty and stigma sensitivity:
1. Beck Cognitive Insight Scale (BCIS)
2. Selfreflection and Insight Scale (ZRIS)
3. Internalised Stigma: Internalized Stigma of Mental Illness Scale (ISMIS)

Initial information at time of registration
Insight, assessed by the following:
1. Beck Cognitive Insight Scale (BCIS)
2. Schedule for the Assessment of Insight - Expanded Version (SAI-E)
Secondary outcome measuresCurrent information as of 10/12/09:
Depression, symptoms, self-esteem and quality of life:
1. Insight (SAI-E)
2. Depression: Beck Depression Inventory (BDI-II)
3. Symptoms: Positive and Negative Syndrome Scale (PANSS)
4. Self-esteem
5. Quality of life: Manchester Short Assessment of Quality of Life (MANSA)

Initial information at time of registration:
Social functioning, depression, internalised stigma, quality of life and symptoms will be assessed by the following:
1. Community Functioning: Social Functioning Scale
2. Depression: Beck Depression Inventory (BDI-II)
3. Symptoms: Positive and Negative Syndrome Scale (PANSS)
4. Internalised Stigma: Internalized Stigma of Mental Illness Scale (ISMIS)
5. Self-esteem: Self-Esteem Rating Scale (SERS) SF-20 (Dutch version)
6. Quality of life: Manchester Short Assessment of Quality of Life (MANSA)
Overall study start date01/05/2010
Overall study end date01/10/2011

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsAdded 10/12/09: 145
Total final enrolment121
Participant inclusion criteria1. Both males and females, age: 18 years or older
2. A diagnosis of schizophrenia according to Diagnostic And Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria
3. Impaired insight (based on structured assessment) (PI< 9)
4. Internalized stigma (ISMIS items 6+13+17+18 <6 )
5. Able to give informed consent

Initial information at time of registration:
1. Both males and females, age between: 18-65
2. A diagnosis of schizophrenia according to Diagnostic And Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria
3. Impaired insight (based on structured assessment)
4. Willing to give written informed consent
Participant exclusion criteriaCurrent information as of 10/12/09:
1. Florid psychosis
2. Co-morbid neurological disorder

Initial information at time of registration:
1. Florid psychosis
2. Patients falling under the BOPZ law, or who are unable to give informed consent according to the ‘Wet op Geneeskundige Behandelovereenkomsten’
3. Co-morbid neurological disorder
4. IQ below 75
Recruitment start date01/05/2010
Recruitment end date01/10/2011

Locations

Countries of recruitment

  • Netherlands

Study participating centre

Department of Neurosciences
Groningen
9713 AW
Netherlands

Sponsor information

University Medical Center Groningen (UMCG) (Netherlands)
University/education

Hanzeplein 1
Groningen
9700 RB
Netherlands

Email a.aleman@med.umcg.nl
Website http://www.umcg.nl
ROR logo "ROR" https://ror.org/03cv38k47

Funders

Funder type

Research organisation

European Science Foundation/ The Netherlands Organization for Scientific Research (NWO) (Netherlands)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article study protocol 05/10/2011 Yes No
Results article results 01/04/2019 18/06/2020 Yes No

Editorial Notes

18/06/2020: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.
06/11/2019: Internal review.