Schizophrenia Spectrum DisorderRISENCT02160249
RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia)
A study testing Community-based rehabilitation and Facility based care in people with Schizophrenia Spectrum Disorder and Schizophrenia, run by London School of Hygiene and Tropical Medicine at 1 site in Ethiopia.
Trial summary
The purpose of this study is to determine whether community-based rehabilitation plus facility-based care is superior to facility-based care alone in reducing disability related to schizophrenia in rural Ethiopia. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Schizophrenia Spectrum Disorder, Schizophrenia, Schizoaffective Disorder
- What is being tested?
- Community-based rehabilitation and Facility based care
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 166 participants
- Where
- 1 siteEthiopia
- Study dates
- Sep 2015to 8 May 2017
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥18 years
- Diagnosis of schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder or schizophreniform disorder) using (DSM-IV) criteria
- Evidence of severe, enduring or disabling illness
- Resident in kebele for >6 months and no immediate plans to leave the kebele
- Has a primary caregiver who is willing to participate in the study
Who cannot join
- No specific criteria
Trial locations and contacts
1 site in 1 country.
Ethiopia1 site
Department of Psychiatry, College of Health Sciences, Addis Ababa University
Addis Ababa
About this study
Official title: RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia): a Cluster-randomised Trial
The purpose of this study is to determine whether community-based rehabilitation plus facility-based care is superior to facility-based care alone in reducing disability related to schizophrenia in rural Ethiopia.
Read the detailed description
This is a cluster randomised trial set in rural Ethiopia with kebeles (villages) as the unit of randomisation. 54 kebeles will be included. 27 will be randomly allocated to the intervention arm (Facility based care (FBC) + Community-based Rehabilitation (CBR)) and 27 randomly allocated to the control arm (FBC alone).
The aim is to determine whether CBR + FBC is superior to FBC alone in reducing disability related to schizophrenia, measured by the WHO Disability Assessment Schedule version 2.0 (WHODAS 2.0) at 6 and 12 months.
- Conditions
- Schizophrenia Spectrum Disorder, Schizophrenia, Schizoaffective Disorder, Schizophreniform Disorder
- Being tested
- Community-based rehabilitation, Facility based care
- Keywords
- Schizophrenia, Psychotic disorders, Schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder or schizophreniform disorder) using DSM-IV criteria
- Medical subject headings
- Schizophrenia, Psychotic Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Community-based rehabilitationBehavioural
Facility based careOther
| Study group | Role | What they receive |
|---|---|---|
| Community-based rehabilitation and facility based care | Experimental | Community-based rehabilitation is delivered to participants and their caregivers at their home by a specialist CBR worker. It comprises psychoeducation, adherence support, rehabilitation (including self-care and social skills), family support groups and accessing existing community organisations. It also involves community awareness raising and education and mobilisation of community leaders.
Facility based care (usual care) consists of anti-psychotic medication prescribed by a nurse or clinical officer in a health centre and basic psycho-education. Receives: Behavioral: Community-based rehabilitation; Other: Facility based care |
| Facility-based care | Active comparator | Facility based care (usual care) consists of anti-psychotic medication prescribed by a nurse or clinical officer in a health centre and basic psycho-education. Receives: Other: Facility based care |
What is being measured
The primary outcome is the main question the study is designed to answer.
Disability (36-item WHODAS (World Health Organisation Disability Assessment Schedule) 2.0)
Measured: 12 months
Secondary outcomes (16)
Symptom severity (Brief Psychiatric Rating Scale- Expanded version (BPRS-E))
Measured: 6 and 12 months
Clinical Global Impression (CGI)
Measured: 6 and 12 months
Relapse (Longitudinal Interval Follow up Evaluation: DSM-IV version (LIFE))
Measured: 6 and 12 months
Disability (36-item WHODAS 2.0)
Measured: 6 months
Functioning (indigenous functioning scale)
Scale is currently under development. It is being designed and validated to measure functioning in people with severe mental illness in rural Ethiopia.
Measured: 6 and 12 months
Economic activity of patient (employment, income and household work)
Section includes current occupation (categories), employment status (categories), typical income (specific amount). Section also includes questions adapted from the WHO-DAS 12 and 36 relating to problems doing usual work task both generally and as a result of their mental illness (likert scale)
Measured: 6 and 12 months
Medication adherence (4 item Morisky Medication Adherence Scale)
Measured: 6 and 12 months
Engagement with facility based care
Potential mediator
Measured: 6 and 12 months
Proportion with human rights problems (chaining or restraint)- self-reported
The outcome is the proportion chained, restrained or confined within last one month. Additional data on who perpetrated the chaining i.e. traditional healer/ family member will be collected.
Measured: 6 and 12 months
Nutritional status (BMI)
Measured: 6 and 12 months
Serious adverse events
Measured: 6 and 12 months
Economic activity of caregiver
Section includes current occupation (categories), employment status (categories), typical income (specific amount). Section also includes questions adapted from the WHO-DAS 12 and 36 relating to problems doing usual work tasks (likert scale).
Measured: 6 and 12 months
Caregiver burden (WHO Family Interview Schedule Impact section)
Measured: 6 and 12 months
Caregiver depression (PHQ9 +1)
Measured: 6 and 12 months
Patient medication adherence
Measured: 6 and 12 months
Proportion with human rights problems (chaining or restraint)- Caregiver-reported
Caregiver to report presence of human rights problems relating to patient. The outcome is the proportion chained, restrained or confined within last one month. Additional data on who perpetrated the chaining i.e. traditional healer/ family member will be collected.
Measured: 6 and 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Jun 2014 (estimated)
- Study startSep 2015
- Primary completion26 Mar 2017
- Study completion8 May 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Schizophrenia Spectrum DisorderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 166 participants (actual)
Sponsor and investigators
- Lead sponsor
- London School of Hygiene and Tropical Medicine
- Sponsor type
- University, hospital or other
- Collaborators
- Addis Ababa University
- Responsible party
- Sponsor
- Investigators
- Mary De Silva, PhD MSc, Principal investigator, London School of Hygiene and Tropical MedicineAbebaw Fekadu, Principal investigator, Addis Ababa University Department of Psychiatry
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02160249
- Sponsor's protocol ID
- 7035
- Other IDs
- 100142/Z/12/Z
- Acronym
- RISE
- Status last verified
- May 2017
- First submitted
- 3 Jun 2014
- Last updated
- 10 May 2017
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Dijkstra LG, Weiss HA, Birhane R, Medhin G, de Silva M, Hanlon C, Fekadu A, Asher L. Effects of community-based rehabilitation on caregivers of people with schizophrenia in Ethiopia in the RISE trial. BMC Psychiatry. 2025 Mar 11;25(1):231. doi: 10.1186/s12888-025-06651-4.
PubMed 40069613Asher L, Birhane R, Weiss HA, Medhin G, Selamu M, Patel V, De Silva M, Hanlon C, Fekadu A. Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE): results of a 12-month cluster-randomised controlled trial. Lancet Glob Health. 2022 Apr;10(4):e530-e542. doi: 10.1016/S2214-109X(22)00027-4.
PubMed 35303462Asher L, Fekadu A, Teferra S, De Silva M, Pathare S, Hanlon C. "I cry every day and night, I have my son tied in chains": physical restraint of people with schizophrenia in community settings in Ethiopia. Global Health. 2017 Jul 11;13(1):47. doi: 10.1186/s12992-017-0273-1.
PubMed 28693614Asher L, De Silva M, Hanlon C, Weiss HA, Birhane R, Ejigu DA, Medhin G, Patel V, Fekadu A. Community-based Rehabilitation Intervention for people with Schizophrenia in Ethiopia (RISE): study protocol for a cluster randomised controlled trial. Trials. 2016 Jun 24;17(1):299. doi: 10.1186/s13063-016-1427-9.
PubMed 27342215De Silva MJ, Breuer E, Lee L, Asher L, Chowdhary N, Lund C, Patel V. Theory of Change: a theory-driven approach to enhance the Medical Research Council's framework for complex interventions. Trials. 2014 Jul 5;15:267. doi: 10.1186/1745-6215-15-267.
PubMed 24996765
Study at a glance
From the registry record, last updated by the sponsor on 10 May 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- RISE (Rehabilitation Intervention for People With Schizophrenia in Ethiopia): a Cluster-randomised Trial
- ClinicalTrials.gov ID
- NCT02160249
- Acronym / sponsor ID
- RISE / 7035
- Conditions
- Schizophrenia Spectrum Disorder, Schizophrenia, Schizoaffective Disorder, Schizophreniform Disorder
- Keywords
- Schizophrenia, Psychotic disorders, Schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder or schizophreniform disorder) using DSM-IV criteria
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 166 participants (actual)
- Lead sponsor
- London School of Hygiene and Tropical MedicineUniversity, hospital or other
- Collaborators
- Addis Ababa University
- Study start
- Sep 2015
- Primary completion
- 26 Mar 2017 (actual)
- Study completion
- 8 May 2017 (actual)
- First posted
- 10 Jun 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine whether community-based rehabilitation plus facility-based care is superior to facility-based care alone in reducing disability related to schizophrenia in rural Ethiopia.
Detailed description
This is a cluster randomised trial set in rural Ethiopia with kebeles (villages) as the unit of randomisation. 54 kebeles will be included. 27 will be randomly allocated to the intervention arm (Facility based care (FBC) + Community-based Rehabilitation (CBR)) and 27 randomly allocated to the control arm (FBC alone).
The aim is to determine whether CBR + FBC is superior to FBC alone in reducing disability related to schizophrenia, measured by the WHO Disability Assessment Schedule version 2.0 (WHODAS 2.0) at 6 and 12 months.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Community-based rehabilitation and facility based care | Experimental | Behavioral: Community-based rehabilitation, Other: Facility based careCommunity-based rehabilitation is delivered to participants and their caregivers at their home by a specialist CBR worker. It comprises psychoeducation, adherence support, rehabilitation (including self-care and social skills), family support groups and accessing existing community organisations. It also involves community awareness raising and education and mobilisation of community leaders. Facility based care (usual care) consists of anti-psychotic medication prescribed by a nurse or clinical officer in a health centre and basic psycho-education. |
| Facility-based care | Active comparator | Other: Facility based careFacility based care (usual care) consists of anti-psychotic medication prescribed by a nurse or clinical officer in a health centre and basic psycho-education. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Age ≥18 years
- Diagnosis of schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder or schizophreniform disorder) using (DSM-IV) criteria
- Evidence of severe, enduring or disabling illness
- Resident in kebele for >6 months and no immediate plans to leave the kebele
- Has a primary caregiver who is willing to participate in the study
Key exclusion criteria (1 listed)
- No specific criteria
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Community-based rehabilitation | Behavioural | Community-based rehabilitation and facility based care |
| Facility based care | Other | Community-based rehabilitation and facility based care, Facility-based care |
Primary outcome
Disability (36-item WHODAS (World Health Organisation Disability Assessment Schedule) 2.0)
Time frame: 12 months
16 secondary outcomes
Symptom severity (Brief Psychiatric Rating Scale- Expanded version (BPRS-E))
Time frame: 6 and 12 months
Clinical Global Impression (CGI)
Time frame: 6 and 12 months
Relapse (Longitudinal Interval Follow up Evaluation: DSM-IV version (LIFE))
Time frame: 6 and 12 months
Disability (36-item WHODAS 2.0)
Time frame: 6 months
Functioning (indigenous functioning scale)
Time frame: 6 and 12 months
Economic activity of patient (employment, income and household work)
Time frame: 6 and 12 months
Medication adherence (4 item Morisky Medication Adherence Scale)
Time frame: 6 and 12 months
Engagement with facility based care
Time frame: 6 and 12 months
Proportion with human rights problems (chaining or restraint)- self-reported
Time frame: 6 and 12 months
Nutritional status (BMI)
Time frame: 6 and 12 months
Serious adverse events
Time frame: 6 and 12 months
Economic activity of caregiver
Time frame: 6 and 12 months
Caregiver burden (WHO Family Interview Schedule Impact section)
Time frame: 6 and 12 months
Caregiver depression (PHQ9 +1)
Time frame: 6 and 12 months
Patient medication adherence
Time frame: 6 and 12 months
Proportion with human rights problems (chaining or restraint)- Caregiver-reported
Time frame: 6 and 12 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 May 2017.
- Derived from this study: PubMed 40069613Dijkstra LG, Weiss HA, Birhane R, Medhin G, de Silva M, Hanlon C, Fekadu A, Asher L. Effects of community-based rehabilitation on caregivers of people with schizophrenia in Ethiopia in the RISE trial. BMC Psychiatry. 2025 Mar 11;25(1):231. doi: 10.1186/s12888-025-06651-4.
- Derived from this study: PubMed 35303462Asher L, Birhane R, Weiss HA, Medhin G, Selamu M, Patel V, De Silva M, Hanlon C, Fekadu A. Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE): results of a 12-month cluster-randomised controlled trial. Lancet Glob Health. 2022 Apr;10(4):e530-e542. doi: 10.1016/S2214-109X(22)00027-4.
- Derived from this study: PubMed 28693614Asher L, Fekadu A, Teferra S, De Silva M, Pathare S, Hanlon C. "I cry every day and night, I have my son tied in chains": physical restraint of people with schizophrenia in community settings in Ethiopia. Global Health. 2017 Jul 11;13(1):47. doi: 10.1186/s12992-017-0273-1.
- Derived from this study: PubMed 27342215Asher L, De Silva M, Hanlon C, Weiss HA, Birhane R, Ejigu DA, Medhin G, Patel V, Fekadu A. Community-based Rehabilitation Intervention for people with Schizophrenia in Ethiopia (RISE): study protocol for a cluster randomised controlled trial. Trials. 2016 Jun 24;17(1):299. doi: 10.1186/s13063-016-1427-9.
- Derived from this study: PubMed 24996765De Silva MJ, Breuer E, Lee L, Asher L, Chowdhary N, Lund C, Patel V. Theory of Change: a theory-driven approach to enhance the Medical Research Council's framework for complex interventions. Trials. 2014 Jul 5;15:267. doi: 10.1186/1745-6215-15-267.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Mary De Silva, PhD MSc principal investigator
London School of Hygiene and Tropical Medicine
Abebaw Fekadu principal investigator
Addis Ababa University Department of Psychiatry
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Community-based rehabilitation and Facility based care in people with Schizophrenia Spectrum Disorder and Schizophrenia, run by London School of Hygiene and Tropical Medicine at 1 site in Ethiopia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 10 May 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Ethiopia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Disability (36-item WHODAS (World Health Organisation Disability Assessment Schedule) 2.0) (time frame: 12 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02160249, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 May 2017.