Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia

Abstract

Objectives: To investigate whether intensive cognitive behaviour therapy results in significant improvement in positive psychotic symptoms in patients with chronic schizophrenia. Design: Patients with chronic schizophrenia were randomly allocated, stratified according to severity of symptoms and sex, to intensive cognitive behaviour therapy and routine care, supportive counselling and routine care, and routine care alone. Setting: Adjunct treatments were carried out in outpatient clinics or in the patient's home. Subjects: 87 patients with persistent positive symptoms who complied with medication; 72 completed treatment. Outcome measures: Assessments of positive psychotic symptoms before treatment and 3 months after treatment. Number of patients who showed a 50% or more improvement in symptoms. Exacerbation of symptoms and rates of readmission to hospital. Results: Significant improvements were found in the severity (F = 5.42, df = 2,86; P = 0.006) and number (F = 4.99, df = 2,86; P = 0.009) of positive symptoms in those treated with cognitive behaviour therapy. The supportive counselling group showed a non-significant improvement. Significantly more patients treated with cognitive behaviour therapy showed an improvement of 50% or more in their symptoms ( 2 = 5.18, df = 1; P = 0.02). Logistic regression indicated that receipt of cognitive behaviour therapy results in almost eight times greater odds (odds ratio 7.88) of showing this improvement. The group receiving routine care alone also experienced more exacerbations and days spent in hospital. Conclusions: Cognitive behaviour therapy is a potentially useful adjunct treatment in the management of patients with chronic schizophrenia.

Cognitive–behavioural therapy for patients with schizophrenia: a multicentre randomized controlled trial in Beijing, China

“…Our findings, showing an improvement in overall and positive symptoms during the course of treatment in the CBT group, are in line with Tarrier et al (Tarrier et al 1998). These researchers found significant improvements in the severity and number of positive symptoms for patients treated with CBT (Tarrier et al 1998). This was also in accordance with Zimmermann et al's meta-analysis (Zimmermann et al 2005).…”

“…This is consistent with findings in similar studies in the UK, in which there were positive benefits of both ST and CBT but the CBT continued to show improvements whereas the ST began to lose effectiveness after it had been discontinued (Sensky et al 2000). Our findings, showing an improvement in overall and positive symptoms during the course of treatment in the CBT group, are in line with Tarrier et al (Tarrier et al 1998). These researchers found significant improvements in the severity and number of positive symptoms for patients treated with CBT (Tarrier et al 1998).…”

Early intervention for relapse in schizophrenia: results of a 12-month randomized controlled trial of cognitive behavioural therapy

“…There is growing evidence that CBT is effective in reducing the severity of positive and negative symptoms associated with schizophrenia (Tarrier et al 1993(Tarrier et al , 1998Drury et al 1996 a, b;Kuipers et al 1997;Pinto et al 1999 ;Sensky et al 2000 ;Turkington et al 2002). Four trials provide post-treatment follow-up (Kuipers et al 1998 ;Drury et al 2000 ;Sensky et al 2000;Tarrier et al 1999Tarrier et al , 2000.…”

Family intervention in psychosis: who needs it?

“…It is also possible that, in order to achieve enduring effects with patients, it is more effective to use individual psychological treatments with them, for example, Cognitive Behaviour Therapy (CBT) (Drury et al, 1996;Kuipers et al, 1998, Tarrier et al, 1998. A high dropout rate (around a third) has always been a problem with family intervention and CBT certainly seems to engage clients more effectively.…”