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Background Digital interventions have potential applications in promoting long-term recovery and improving outcomes in first-episode psychosis (FEP). This study aimed to evaluate the cost-effectiveness of Horyzons, a novel online social therapy to support young people aged 16–27 years following discharge from FEP services, compared with treatment as usual (TAU) from a healthcare sector and a societal perspective. Study design A cost-effectiveness analysis (CEA), based on the change in social functioning, and a cost-utility analysis (CUA) using quality-adjusted life years were undertaken alongside a randomized controlled trial. Intervention costs were determined from study records; resources used by patients were collected from a resource-use questionnaire and administrative data. Mean costs and outcomes were compared at 18 months and incremental cost-effectiveness ratios were calculated. Uncertainty analysis using bootstrapping and sensitivity analyses was conducted. Study results The sample included 170 participants: Horyzons intervention group (n = 86) and TAU (n = 84). Total costs were significantly lower in the Horyzons group compared with TAU from both the healthcare sector (–AU$4789.59; P <.001) and the societal perspective (–AU$5131.14; P <.001). In the CEA, Horyzons was dominant, meaning it was less costly and resulted in better social functioning. In the CUA, the Horyzons intervention resulted in fewer costs but also yielded fewer QALYs. However, group differences in outcomes were not statistically significant. When young people engaged more with the platform, costs were shown to decrease and outcomes improved. Conclusions The Horyzons intervention offers a cost-effective approach for improving social functioning in young people with FEP after discharge from early intervention services. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to determine whether naturalistic, interpersonal contact with persons with a severe mental illness (SMI) could reduce stigma. Participants from the agency Compeer (which pairs volunteers with people with SMI) were compared to volunteers from a control agency and to nonvolunteer participants from the community on stigma measures over a 6-month period. The quality of the relationship between the Compeer volunteer and consumer and its association with changes in stigmatizing attitudes was also assessed. The results provide preliminary evidence that naturalistic contact can reduce negative affective responses to individuals with SMI. Furthermore, changes in affective response were related to the quality of the contact between the Compeer volunteer and consumer. Implications for future research are discussed. (Contains 3 tables, 1 figure, and 1 footnote.)

Recent theoretical models suggest that perceived racism acts as a stressor for African Americans and may be associated with a variety of negative psychological consequences, notably paranoia. Paranoia among African Americans is believed to reflect the lower end of the paranoia continuum based on experiences with racism. Thus, it may be beneficial to measure paranoia on a continuum, but few studies have adopted this strategy. This study examined the relationship between perceived racism and paranoia across the continuum in 128 African American college students. Participants completed three measures of paranoia and measures of perceived racism, depression, anger, self-consciousness, and hostile perceptions. The continuum of paranoia included measures reflecting cultural, nonclinical, and clinical paranoia. Perceived racism predicted cultural mistrust and nonclinical paranoia (lower end of the paranoia continuum) but not clinical paranoia. The implications of perceived racism in the prediction of paranoia for African Americans are discussed. (Contains 4 tables.)