Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia.
OBJECTIVE
To investigate whether intensive cognitive behaviour therapy results in significant improvement in positive psychotic symptoms in patients with chronic schizophrenia.


METHODS
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.


METHODS
Adjunct treatments were carried out in outpatient clinics or in the patient's home.


METHODS
87 patients with persistent positive symptoms who complied with medication; 72 completed treatment.


METHODS
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 (chi2=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.
Department of Clinical Psychology, School of Psychiatry and Behavioural Sciences, University of Manchester, Withington Hospital, Manchester M20 8LR, UK. ntarrier@fs1.with.man.ac.uk
N
N
Tarrier
L
L
Yusupoff
C
C
Kinney
E
E
McCarthy
A
A
Gledhill
G
G
Haddock
J
J
Morris
D000328:Adult; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D012008:Recurrence; D012559:Schizophrenia / Q000628:therapy*; D012944:Social Support; D016896:Treatment Outcome