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Cognitive behaviour therapy for psychotic symptoms: a randomized controlled effectiveness trial.
Bodil Kråkvik1, Rolf W Gråwe, Roger Hagen
1St. Olavs University Hospital, Trondheim, Norway.
Behavioural and Cognitive Psychotherapy
|May 3, 2013
Summary
Cognitive behavioural therapy for psychosis (CBTp) shows effectiveness in real-world settings, improving psychotic symptoms. Gains in functioning are maintained for up to one year, demonstrating CBTp
Area of Science:
- Psychiatry
- Clinical Psychology
- Psychosocial Interventions
Background:
- Cognitive behavioural therapy for psychosis (CBTp) is a recommended psychosocial treatment for persistent psychotic symptoms.
- Questions exist regarding the generalizability of efficacy study findings to routine clinical practice.
Purpose of the Study:
- To assess if expert-conducted CBTp trial results can be replicated in a heterogeneous clinical sample.
- To evaluate CBTp's effectiveness in a real-world clinical setting.
Main Methods:
- A randomized controlled trial comparing CBTp plus Treatment as Usual (TAU) against a TAU-only waiting list control group.
- 45 patients with psychotic disorders were assessed using the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS), and Psychotic Symptom Rating Scales (PSYRATS) at baseline, 6 months, and 12 months.
- The study involved 20 sessions of CBTp delivered by non-experts.
Main Results:
- CBTp+TAU significantly improved BPRS global scores, PSYRATS delusional scale scores, and GAF symptom scores compared to controls at 6 months post-treatment.
- At the 12-month follow-up, only the GAF symptom score remained significantly improved for the total sample.
- Improvements were observed in positive psychotic symptoms.
Conclusions:
- CBTp, when delivered by non-experts in routine clinical settings, can lead to improvements in positive psychotic symptoms.
- Some of the observed improvements in psychotic symptoms are maintained at one-year follow-up.
- The study supports the real-world applicability of CBTp for individuals with persistent psychotic disorders.
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