Fleury Les Aubrais

Schizophrenia is a condition affecting about 0.7% of people and often involves poor insight, which can lead to poor medication adherence, relapse, and rehospitalization, negatively impacting quality of life. Psychoeducation has shown potential to improve treatment compliance and the therapeutic relationship. This trial evaluates an individual early psychoeducation program called PEPITS, designed to support patients during the initial hospitalization phase to improve insight, medication adherence, and reduce relapse. The PEPITS program is delivered by nurses and consists of three main phases: an introduction phase, a pathology and care phase, and a recovery and "stepping stone" phase. Each phase involves several sessions that provide patients with information, key knowledge, and new skills related to their illness and recovery process. Participants in the study will either receive the PEPITS program alongside usual psychiatric care or just the usual care without PEPITS. Participants will be followed for one year after randomization. Researchers will assess changes in patients' insight over this period as the primary outcome. Throughout the study, patient progress, relapse, and medication adherence will be monitored to evaluate the program's impact. The total participation lasts up to one year, allowing detailed observation of the program's long-term effects.

This research aims to improve treatment for adults with ADHD who also have addiction comorbidities by adding a cognitive remediation program to their medication with methylphenidate. The study focuses on targeting neuropsychological deficits through training, which may help improve daily functioning and produce lasting benefits. Although cognitive training has been used mainly with children, this study evaluates its effects in adults with both ADHD and addiction issues. Participants will either follow a cognitive remediation program using the PRESCO® software or a control program using the AUDITICO® software, both designed by the same company but targeting different functions. The cognitive remediation program lasts 16 weeks with two sessions per week—one with a neuropsychologist and one at home via an app. The control program stimulates auditory functions without targeting cognitive deficits and follows the same schedule. The neuropsychologist will monitor progress and provide support as needed. During the study, researchers will assess the immediate functional improvement in ADHD symptoms after the cognitive remediation program ends, about 9 months into the study. Participants will be evaluated through interviews and monitored for changes in their daily life and addiction symptoms. The study also includes follow-up through software tracking and phone contacts to ensure adherence and safety during treatment.