Cognitive-behavioural therapy for refractory psychotic symptoms of schizophrenia resistant to atypical antipsychotic medication. Randomised controlled trial.
BACKGROUND
There is increasing evidence that cognitive-behavioural therapy can be an effective intervention for patients experiencing drug-refractory positive symptoms of schizophrenia.


OBJECTIVE
To investigate the effects of cognitive-behavioural therapy on in-patients with treatment-refractory psychotic symptoms.


METHODS
Manualised therapy was compared with supportive counselling in a randomised controlled study. Both interventions were delivered by experienced psychologists over 16 sessions of treatment. Therapy fidelity was assessed by two independent raters. Participants underwent masked assessment at baseline, after treatment and at 6 months' follow-up. Main outcome measures were the Positive and Negative Syndrome Scale and the Psychotic Symptoms Rating Scale. The analysis was by intention to treat.


RESULTS
Participants receiving cognitive cognitive-behavioural therapy had improved with regard to auditory hallucinations and illness insight at the post-treatment assessment, but these findings were not maintained at follow-up.


CONCLUSIONS
Cognitive-behavioural therapy showed modest short-term benefits over supportive counselling for treatment-refractory positive symptoms of schizophrenia.
Valmaggia
Lucia R
LR
Department of Psychological Medicine, PO 67, Institute of Psychiatry, De Crespigny Park, London SE5 SE5 8AF, UK. L.Valmaggia@iop.kcl.ac.uk
van der Gaag
Mark
M
Tarrier
Nicholas
N
Pijnenborg
Marieke
M
Slooff
Cees J
CJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003376:Counseling; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012559:Schizophrenia / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
D014150:Antipsychotic Agents