The Super EDEN Project

The Super EDEN project

SUstaining Positive Engagement and Recovery – The next step after Early Intervention for Psychosis

The Super EDEN programme is a NIHR funded project which builds upon the DoH funded National EDEN Project. Super EDEN began in June 2010 and will continue to run until June 2015, following up all service users who consented to the original National EDEN project to provide the evidence base to develop the ‘next generation’ of early intervention in psychosis services (EIS). This will: ensure that the gains made during EIS are maintained once users are discharged; enable the development of a ‘stepped care’ model of EIS to improve targeting of interventions appropriate to the emerging needs, illness trajectories and user preference; and evaluate a new intervention to improve structured activity levels in those who show a poor recovery from the first psychotic episode.

The Super EDEN project encompasses 3 studies:

Study

Type

Objectives

Sample

Study 1

Maximising the impact, cost effectiveness and user experience of EIS

Quantitative

To determine the trajectories and outcomes for patients receiving EIS after 3 years.
To identify the destinations of those discharged from EIS; and whether outcomes achieved on discharge from EIS are maintained 2 years later
To identify predictors of any changes in trajectory post-EIS
To assess the cost and cost effectiveness of EIS at discharge and in the discharge services over 2 subsequent years

All those who consented to the National EDEN study (total n=1027)

Study 2

Perspectives in transition: A qualitative investigation of user, carer and staff views

Qualitative

To explore users’ and carers’ views of the process of discharge from a high to lower intensity service; and experience of care received in the various discharge services.
To explore the views of key staff in EIS and discharge services on the ability of the service to provide the specialist care and the process of transition

Service users who are a part of study 1; 80 SU’s
and 80 Carers who are nearing the end of their 2nd year in EIS. Focus
groups at each of the EIS sites (year 2) and focus groups in primary care,
CMHT’s and AOT’s (in years 2 and 3).

Study 3

Improving social recovery in young people with emerging severe social disability: A proof of principle randomised control trial

RCT

To assess the feasibility of ‘Social recovery-orientated cognitive behavioural therapy’ (SRCBT)
To assess whether SRCBT leads to improvements in the time spent in structured activities and constructive economic activity
Secondary hypothesis – to assess whether SRCBT will reduce levels of depression and hopelessness and whether it can improve negative symptoms

150 people with non-affective psychosis who are a) EIS clients b) show low level of structured activity after at least 1 year of treatment. Clients will be recruited between 1 and 2 years after entering EIS. Any clients who were a part of the original National EDEN study will be excluded. Recruitment will take place in 3 centres – B’ham, Norwich and Lancashire.

Participants who are allocated to the treatment group in Birmingham will also be invited to participate in fMRI scanning (n=25)

Summary MRI add-on study

Embedded within the trial, a functional MRI study will hopefully provide new insights into the underlying mechanisms supporting successful intervention. The study will recruit entrants to the SRCBT arm of the trial, and conduct scans pre and post intervention, with the aim of both predicted those who respond well to the SRCBT, and whether any improvement in structured activity is associated with significant change. A resting state functional scan and a task-based functional scan that activates the social cognition network will be used to confirm the neural basis of successful treatment.