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EV1210

Andy's mind: a serious game co-produced with experts by experience. A randomized controlled trial in psychosis

ANDY'S MIND: A SERIOUS GAME CO-CREATED WITH LIVED EXPERIENCE. A RANDOMIZED CONTROLLED TRIAL IN PSYCHOSIS

A randomized controlled trial evaluating the effectiveness of an analog psychoeducational card game co-designed with a person with lived experience of psychosis is ongoing; only preliminary recruitment and feasibility data are currently being reported.

The primary aim of the study is to evaluate the effectiveness of Andy's Mind, a psychoeducational card game co-produced with a person with lived experience of psychosis, compared with traditional psychoeducation in adults with schizophrenia spectrum and other psychotic disorders; the secondary aim is to describe changes in psychopathological symptoms, group satisfaction, and engagement. The design is an open-label, two-arm, parallel-group randomized controlled trial conducted in psychiatric rehabilitation and forensic psychiatry units in Catalonia and subsequently expanded to community mental health services (CEIm PIC-29-23); phase 1, comprising co-design and usability testing, has been completed, and a usability pilot conducted in two forensic units (N=10; 47.8/50) supported progression to the trial. Inclusion criteria are age between 18 and 65 years, a diagnosis of a schizophrenia spectrum or other psychotic disorder, and informed consent; exclusion criteria are severe cognitive impairment (SCIP-S total score <Pc5 or any subscale score <Pc3), moderate to severe intellectual disability, active substance use (other than THC) or an acute psychotic episode, and a language barrier. The target sample of N=80 participants is being randomized at a 1:1 ratio; the intervention arm (n=40) receives eight weekly group sessions lasting approximately 45 minutes, delivered by mental health professionals trained using a facilitator manual, while the control arm (n=40) receives a traditional psychoeducation program in an equivalent format (eight 45-minute sessions). Primary outcome measures are awareness of illness (SUMD), medication adherence (DAI-10), and attitudes toward substance use (ESACAL, ESACDRO); secondary measures are psychopathological symptoms (PANSS), group satisfaction, and engagement; assessments are conducted at baseline, post-intervention, and the 2-month follow-up. According to the sensitivity analysis (ANCOVA), N=80 provides 80% power to detect an effect size of 0.63 at an alpha of 0.05. The trial is in its active implementation phase: 31 participants, representing 39% of the target sample, have been recruited, and five units are active; unit 1 (forensic) has completed the intervention and the baseline and post-intervention assessments, is awaiting the 2-month follow-up, and has had two voluntary withdrawals; unit 2 (rehabilitation) has completed baseline assessments and began group sessions in June 2026; recruitment is ongoing in units 3 through 5. No effectiveness analyses have yet been conducted. The game consists of 104 playing cards across seven categories, six summary cards, and 24 puzzle reward tokens, and is played in three languages (Spanish, English, Arabic) by two to six players over 25 to 35 minutes; its low-cost analog format requires no technology, making it feasible in settings with limited access to devices.

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