Randomised controlled trial of cognitive-behavioural therapy in early schizophrenia: Acute-phase outcomes

Authors:
  • NTN Tarrier
    N Tarrier
  • GHG Haddock
    G Haddock
  • RBR Bentall
    R Bentall
  • PKP Kinderman
    P Kinderman
  • DKD Kingdon
    D Kingdon
  • RSR Siddle
    R Siddle
  • JEJ Everitt
    J Everitt
  • KLK Leadley
    K Leadley
  • ABA Benn
    A Benn
  • KGK Grazebrook
    K Grazebrook
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Abstract
Background: Cognitive–behavioural therapy (CBT) improves persistent psychotic symptoms.Aims: To test the effectiveness of added CBT in accelerating remission from acute psychotic symptoms in early schizophrenia.Method: A 5-week CBT programme plus routine care was compared with supportive counselling plus routine care and routine care alone in a multi-centre trial randomising 315 people with DSM–IV schizophrenia and related disorders in their first (83%) or second acute admission. Outcome assessments were blinded.Results: Linear regression over 70 days showed predicted trends towards faster improvement in the CBT group. Uncorrected univariate comparisons showed significant benefits at 4 but not 6 weeks for CBTv. routine care alone on Positive and Negative Syndrome Scale total and positive sub-scale scores and delusion score and benefits v. supportive counselling for auditory hallucinations score.Conclusions: CBT shows transient advantages over routine care alone or supportive counselling in speeding remission from acute symptoms in early schizophrenia.

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