Cognitive Therapy Improves Symptoms in Schizophrenia Spectrum Disorder Patients not Taking Antipsychotic Drugs

According to a new study published in The Lancet, Cognitive Therapy (CT) has been shown to reduce the severity of psychiatric symptoms among schizophrenia spectrum disorder patients not taking antipsychotic drugs. In this first study of its kind, researchers performed a single-blind randomized control trial at two UK Centers between 2010 and 2013. Participants included 74 schizophrenia spectrum disorders patients, aged 16-65 years, who had chosen not to take antipsychotic medication. They were randomly assigned to receive either CT plus treatment as usual (n=37) or the control, treatment as usual (n=37). In the CT group, participants received 26 weekly sessions for a maximum of 9 months, plus up to four boosters in the subsequent 9 months that followed. Therapy focused on normalization and evaluation of patients’ own appraisals, behavioral experiments to test appraisals, and helping patients to identify and modify unhelpful cognitive and behavioral responses. The Positive and Negative Syndrome Scale (PANSS), the primary outcome measure, was utilized to evaluate treatment at baseline, and at 3, 6, 9, 12, 15, and 18 months. Results showed that PANSS total scores were significantly and consistently less in the cognitive therapy group than in the control group. On secondary outcomes, CT was also shown to improve personal and social functioning, and some dimensions of delusional beliefs and voice hearing. These findings offer hope for individuals who decline pharmacological treatment, and while further research is necessary, evidence based treatment should be available to this population.

Morrison, A. P., Turkington, D., Pyle, M., Spencer, H., Brabban, A., Dunn, G., Christodoulides, T., … Hutton, P. (February 01, 2014). Cognitive therapy for people with schizophrenia spectrum disorders not taking antipsychotic drugs: a single-blind randomised controlled trial. The Lancet.

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