Cognitive-behaviour therapy for post-traumatic stress in schizophrenia. A randomized controlled trial

Area of Science:

• Psychiatry
• Clinical Psychology
• Mental Health Research

Background:

• Limited evidence exists for effective post-traumatic stress symptom (PTS) treatments in schizophrenia patients.
• Clinicians express concerns regarding the use of exposure-based therapies for this population.
• This study evaluated a cognitive restructuring program without direct exposure for PTS symptoms in schizophrenia.

Purpose of the Study:

• To assess the efficacy of a 16-session cognitive restructuring program for post-traumatic stress symptoms in individuals with schizophrenia.
• To determine if cognitive-behaviour therapy (CBT) offers additional benefits beyond routine clinical services for this patient group.

Main Methods:

• A multicentre, randomized controlled, single-blinded trial involving 61 participants with schizophrenia and PTS symptoms.
• Participants received up to 16 sessions of CBT (including cognitive restructuring) or routine clinical services over 6 months.
• Outcomes measured included clinician-rated PTS symptoms (primary) and psychotic symptoms (secondary) at 0, 6, and 12 months.

Main Results:

• Both CBT and control groups showed significant reductions in post-traumatic stress symptoms over time.
• The addition of CBT did not yield significant improvements in primary or secondary outcomes compared to routine care.
• No statistically significant difference was observed between the treatment and control groups.

Conclusions:

• The evaluated cognitive-behaviour therapy (CBT) program did not demonstrate a significant effect on post-traumatic stress symptoms in individuals with schizophrenia.
• Cognitive restructuring interventions may need further adaptation to effectively facilitate emotional processing of trauma in psychotic disorders.
• Further research is needed to develop tailored interventions for comorbid PTSD and schizophrenia.