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Cognitive behaviour therapy for schizophrenia.
I Cormac1, C Jones, C Campbell
1General Adult Psychiatry, Coventry Mental Healthcare NHS Trust, Clifford Bridge Road, Coventry, UK, CV2 2TE.
The Cochrane Database of Systematic Reviews
|March 1, 2002
Summary
Cognitive behavioural therapy (CBT) shows promise for schizophrenia treatment, aiding hospital discharge and improving mental state in the short term. However, evidence for long-term relapse reduction remains inconclusive, warranting further research into its effectiveness alongside standard care.
Area of Science:
- Psychiatry
- Psychology
- Clinical Trials
Background:
- Medication is the primary treatment for schizophrenia, but many patients experience persistent symptoms and side effects.
- Cognitive behavioural therapy (CBT) is a talking therapy that helps individuals link feelings and thinking patterns to distress.
Purpose of the Study:
- To review the effectiveness of cognitive behavioural therapy (CBT) for schizophrenia compared to standard care, medication, other therapies, and no intervention.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through extensive electronic database searches.
- Included studies focused on schizophrenia-like illnesses, assessing outcomes like mental state, relapse, and well-being.
- Data were extracted and analyzed, with relative risks (RR) and number needed to treat (NNT) calculated where possible.
Main Results:
- CBT added to standard care did not significantly reduce relapse or hospital readmission rates.
- CBT significantly improved hospital discharge rates and 'no important improvement in mental state' at 13-26 weeks, but this effect diminished after one year.
- Data on continuous measures of mental state were not convincing, and effects on insight and attitudes to medication were unclear.
Conclusions:
- Cognitive behavioural therapy (CBT) is a promising intervention for schizophrenia, but current trial data are not conclusive for widespread use.
- More high-quality trials are needed, particularly comparing CBT with supportive therapies, to establish its clinical meaningfulness and applicability.
- Further research should focus on designing trials that are both clinically meaningful and widely applicable for individuals with schizophrenia.