Motivational Interviewing in Patients with Acute Psychosis: First Insights from a Pilot Randomized Controlled Trial.

Background and objective: Psychotic disorders are among the top causes of disability world-wide. Guidelines emphasizes the need for research to tailor psychotherapeutic approaches to the acute phase of this illness. Motivational Interviewing (MI) is highly suitable for establishing a therapeutic alliance wherein the patient’s intrinsic motivation can be strengthened to adhere ther-apy and overcome ambivalence towards treatment. Therefore, this pilot study aimed to investigate the feasibility and impact of a brief intervention with MI for patients with psychosis in an acute psychiatric inpatient setting.Method: This pilot study was conducted as single-centered, randomized control trial (RCT), com-paring a brief intervention with MI and supportive conversations. The sample size included 20 newly admitted inpatients. In both conditions they received two sessions per week. In line with CONSORT guidelines for pilot and feasibility studies, we measured various feasibility outcomes. Additionally, we assessed various clinical outcomes using Analysis of Covariance (ANCOVA), with baseline values used as covariates.Results: The recruitment target (N = 24) was achieved at 83% in a reasonable timeframe (8 months), with a retention rate of 87% and completion rate at 71%. Eligibility rate (82 %) was high, while the consent rate (48%) was moderate and dropout rate 13% was low as well as the missing data (0.3%). With regard to the clinical outcomes, a group difference was found for the severity of psychotic symptoms, with an advantage for the MI intervention (b = -12.0, 95% CI: [-18.7, -5.2], p < 0.01), although this must be interpreted with caution in view of the small sample.Conclusion: The study demonstrated the feasibility and acceptability of conducting a clinical trial with MI for patients with psychosis in an acute inpatient psychiatric facility. MI has also demon-strated potential for greater benefits compared to supportive conversations, particularly in ad-dressing the severity of psychotic symptoms. Nevertheless, to obtain more definitive conclusions regarding efficacy, a larger-scale study is planned based on these promising results.