Schizophrenia
Conditions
Keywords
fatigue, schizophrenia, microbiota, cognitive behavioral therapy
Brief summary
Fatigue is commonly experienced in numerous pathologies, including schizophrenia. Research has shown that chronic fatigue can exacerbate clinical symptoms. Several evidence-based interventions for fatigue syndrome have been shown to be effective in other medical conditions, but up to this date no research has assessed interventions in fatigue management within psychotic populations. The aim of this study is to evaluate (in a multisite single blind randomized clinical trial) the efficacy of a cognitive-behavioral therapy (CBT) intervention of fatigue management in people diagnosed with schizophrenia. Secondary objectives include the examination of changes in fatigue scores as well as clinical symptoms, physical & cognitive functioning, quality of life at 9-month post CBT intervention. Another aim in this study is to assess - MICROBIATE The investigators hypothesize that following the CBT treatment intervention, patients will demonstrate reduced level of fatigue. No change in the severity of fatigue is expected in the group receiving treatment as usual.
Interventions
BEHAVIORALFatigue Management Therapy
14 sessions of 1h CBT intervention
No CBT intervention
Sponsors
Université Montpellier
Institut National de la Santé Et de la Recherche Médicale, France
University Hospital, Montpellier
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Aged between 18 and 60 years, 2. patients with a diagnosis of schizophrenia according to DSM 5 validated after a clinical evaluation by one psychiatrist investigators, 3. patients with a score at the 4th subscale of Multidimensional Fatigue Inventory greater or equal to 10 4. patients with a follow-up in a day hospital at inclusion, 5. subjects must be able to attend all scheduled visits and comply with all trial procedures, Non inclusion criteria: 1. subject unable to read or/and write French, 2. planned long-term stay outside of the study region that prevents compliance with the visit plan, 3. patients with a history of severe brain trauma, 4. patients with a history of neurological pathology, 5. patients pregnant or breast-feeding 6. patients deprived of liberty 7. patients participating in another ongoing biomedical study 8. patients not affiliated with a French social security scheme or beneficiary of such a scheme 9. Absence of signed informed consent form by the patient and the patient's tutor if he has one
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Multidimensional Fatigue Inventory (MFI) | Change between baseline and 3 months later (corresponding to the end of the treatment intervention) | MFI - self-assessment instrument with 20 items including 5 dimensions: General, Physical, and Mental Fatigue, Reduced Motivation and Reduced Activity |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Positive and Negative Syndrome Scale (PANSS) | baseline - 3 months - 9 months | PANSS - 30 item scale assessing level of symptomatology (positive, negative, general psychopathology) in psychotic disorders |
| Clinical Assessment Interview for Negative Symptoms (CAINS) | baseline - 3 months - 9 months | CAINS - semi-structured interview measuring level of severity of negative symptoms |
| Calgary Depression Scale for Schizophrenia (CDSS) | baseline - 3 months - 9 months | CDSS - 9 item scale assessing level of depressive symptomatology in schizophrenic populations |
| Berlin Questionnaire (BQ) | baseline - 3 months - 9 months | BQ- questionnaire consisting of 3 categories related to the risk of having sleep apnea; snoring (section 1), daytime somnolence (section 2), and hypertension and BMI (section 3 |
| Idiopathic Hypersomnia Severity Scale (IHSS) | baseline - 3 months - 9 months | IHSS - self-report measure of 14 items assessing - hypersomnolence symptoms, consequences, and responsiveness to treatment |
| Sleep Condition Indicator (SCI) | baseline - 3 months - 9 months | SCI - 8 item scale evaluating symptoms of insomnia based on DSM 5 criteria |
| International Physical Activity Questionnaire short form (IPAQ) | baseline - 3 months - 9 months | IPAQ - surveillance tool assessing levels of physical activity in patients with schizophrenia |
| Quality of life (S-QoL) | baseline - 3 months - 9 months | (S-QoL) - self-assessment questionnaire assessing health related quality of life in schizophrenic populations |
| Functional Remission of General Schizophrenia (FROGS) | baseline - 3 months - 9 months | FROGS - 19 item questionnaire assessing level of functional remission in schizophrenic populations |
| French National Adult Reading Test (fNART) | baseline - 9 months | fNART - test used in assessing intellectual levels within French speaking populations |
| California Verbal Learning Test (CVLT) | baseline - 9 months | CVLT - neuropsychological assessment evaluating episodic verbal learning and memory |
| Trail Making Test (TMT) | baseline - 9 months | TMT - neuropsychological assessment evaluating executive functioning (attention, visual exploration, speed, mental flexibility) |
| Pedometer | baseline - 3 months - 9 months (each time pedometer will be worn during one week) | Pedometer - electronic portable device - assessment of distance travelled - |
| Physical examinations (PE) and vital signs (VS) | baseline - 3 months - 9 months | PE includes - weight, BMI, abdominal perimeter VS includes: heart rate, and arterial blood pressure |
| Blood samples | baseline - 3 months - 9 months | lipids, glycaemia, CRP (C-reactive protein) |
| Microbial translocation | baseline - 3 months - 9 months | DNA extraction and analyze of LBP (Lipopolysaccharide Binding Protein), CD14s, l'I-FABP (fatty acid-binding proteins), zonulin, real-time PCR (polymerase chain reaction) analysis (DNA16s) |
| Inflammatory status | baseline - 3 months - 9 months | GM-CSF (granulocyte-macrophage colony-stimulating factor), IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, TNF-α |
| Letter-Number Sequencing subtest (LNS) | baseline - 9 months | good predictor of fluid intelligence and strongly correlates with laboratory working memory measures. |
| Intrinsic Motivation Inventory for Schizophrenia Research (IMI-SR) | baseline - 3 months - 9 months | IMI-SR - self-report scale with 21 items evaluating intrinsic motivation in schizophrenic populations |
Other
| Measure | Time frame | Description |
|---|---|---|
| Activity agenda | baseline - 3 months - 9 months | level of activities performed will be monitored through weekly agendas |
Contacts
Primary ContactDelphine Capdevielle
Backup ContactStéphane Raffard
Outcome results
None listed