Outcomes of an effectiveness trial of cognitive-behavioural intervention by mental health nurses in schizophrenia.
BACKGROUND
Little is known about the medium-term durability of cognitive-behavioural therapy (CBT) in a community sample of people with schizophrenia.


OBJECTIVE
To investigate whether brief CBT produces clinically important outcomes in relation to recovery, symptom burden and readmission to hospital in people with schizophrenia at 1-year follow-up.


METHODS
Participants (336 of 422 randomised at baseline) were followed up at a mean of 388 days (s.d. = 53) by raters masked to treatment allocation (CBT or usual care).


RESULTS
At 1-year follow-up, participants who received CBT had significantly more insight (P = 0.021) and significantly fewer negative symptoms (P = 0.002). Brief therapy protected against depression with improving insight and against relapse; significantly reduced time spent in hospital for those who did relapse and delayed time to admission. It did not improve psychotic symptoms or occupational recovery, nor have a lasting effect on overall symptoms or depression at follow-up.


CONCLUSIONS
Mental health nurses should be trained in brief CBT for schizophrenia to supplement case management, family interventions and expert therapy for treatment resistance.
Turkington
Douglas
D
School of Neurology, Neurosciences and Psychiatry, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne NE1 4LP. douglas.s.turkington@ncl.ac.uk
Kingdon
David
D
Rathod
Shanaya
S
Hammond
Katie
K
Pelton
Jeremy
J
Mehta
Raj
R
D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003152:Community Health Nursing / Q000379:methods; D003158:Community Psychiatry / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D010359:Patient Readmission; D011568:Psychiatric Nursing; D011614:Psychotherapy, Brief / Q000379:methods; D012008:Recurrence; D012559:Schizophrenia / Q000451:nursing / Q000628:therapy*; D012565:Schizophrenic Psychology; D016037:Single-Blind Method; D016896:Treatment Outcome