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Arch Gen Psychiatry. 2000 Feb;57(2):165-72.
A randomized controlled trial of cognitive-behavioral therapy for
persistent symptoms in schizophrenia resistant to medication.
Sensky T, Turkington D, Kingdon D, Scott JL, Scott J, Siddle R,
O'Carroll M, Barnes TR.
BACKGROUND: Research evidence supports the efficacy of
cognitive-behavioral therapy in the treatment of drug-refractory
positive symptoms of schizophrenia. Although the cumulative evidence is
strong, early controlled trials showed methodological limitations.
METHODS: A randomized controlled design was used to compare the efficacy
of manualized cognitive-behavioral therapy developed particularly for
schizophrenia with that of a nonspecific befriending control
intervention. Both interventions were delivered by 2 experienced nurses
who received regular supervision. Patients were assessed by blind raters
at baseline, after treatment (lasting up to 9 months), and at a 9-month
follow-up evaluation. Patients continued to receive routine care
throughout the study. An assessor blind to the patients' treatment
groups rated the technical quality of audiotaped sessions chosen at
random. Analysis was by intention to treat. RESULTS: Ninety patients
received a mean of 19 individual treatment sessions over 9 months, with
no significant between-group differences in treatment duration. Both
interventions resulted in significant reductions in positive and
negative symptoms and depression. At the 9-month follow-up evaluation,
patients who had received cognitive therapy continued to improve, while
those in the befriending group did not. These results were not
attributable to changes in prescribed medication. CONCLUSION:
Cognitive-behavioral therapy is effective in treating negative as well
as positive symptoms in schizophrenia resistant to standard
antipsychotic drugs, with its efficacy sustained over 9 months of
follow-up.
A randomized controlled trial of cognitive-behavioral therapy for
persistent symptoms in schizophrenia resistant to medication.
Sensky T, Turkington D, Kingdon D, Scott JL, Scott J, Siddle R,
O'Carroll M, Barnes TR.
BACKGROUND: Research evidence supports the efficacy of
cognitive-behavioral therapy in the treatment of drug-refractory
positive symptoms of schizophrenia. Although the cumulative evidence is
strong, early controlled trials showed methodological limitations.
METHODS: A randomized controlled design was used to compare the efficacy
of manualized cognitive-behavioral therapy developed particularly for
schizophrenia with that of a nonspecific befriending control
intervention. Both interventions were delivered by 2 experienced nurses
who received regular supervision. Patients were assessed by blind raters
at baseline, after treatment (lasting up to 9 months), and at a 9-month
follow-up evaluation. Patients continued to receive routine care
throughout the study. An assessor blind to the patients' treatment
groups rated the technical quality of audiotaped sessions chosen at
random. Analysis was by intention to treat. RESULTS: Ninety patients
received a mean of 19 individual treatment sessions over 9 months, with
no significant between-group differences in treatment duration. Both
interventions resulted in significant reductions in positive and
negative symptoms and depression. At the 9-month follow-up evaluation,
patients who had received cognitive therapy continued to improve, while
those in the befriending group did not. These results were not
attributable to changes in prescribed medication. CONCLUSION:
Cognitive-behavioral therapy is effective in treating negative as well
as positive symptoms in schizophrenia resistant to standard
antipsychotic drugs, with its efficacy sustained over 9 months of
follow-up.
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