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Randomised controlled trial of cognitive-behavioural therapy in early schizophrenia: acute-phase outcomes
S Lewis1, N Tarrier, G Haddock
1School of Psychiatry and Behavioural Sciences, University of Manchester, Wythenshawe Hospital, Manchester M23 9LT, UK.
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 CBT v. 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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