Cited by 49Schizophrenia research and treatmentPsychotherapy Techniques and ApplicationsCounseling, Therapy, and Family Dynamics

Cognitive–behavioural therapy for patients with schizophrenia: a multicentre randomized controlled trial in Beijing, China

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Li, Z.-J., Guo, Z.-H., Wang, N., Xu, Z.-Y., Qu, Y., Wang, X.-Q., Sun, J., Yan, L.-Q. +3 more·2015·Psychological Medicine

Abstract

Background: Meta-analyses support the efficacy of cognitive–behavioural therapy (CBT) for schizophrenia in western cultures. This study aimed to compare the efficacy of CBT and supportive therapy (ST) for patients with schizophrenia in China. Method: A multicentre randomized controlled, single-blinded, parallel-group trial enrolled a sample of 192 patients with schizophrenia. All patients were offered 15 sessions of either CBT or ST over 24 weeks and followed up for an additional 60 weeks. All measures used were standardized instruments with good reliability and validity. The Positive and Negative Syndrome Scale (PANSS) was used to assess symptoms of schizophrenia. The Schedule for Assessing Insight (SAI) was used to assess patients’ insight and the Personal and Social Performance Scale (PSP) was used to assess their social functioning. Results: Effect-size analysis showed that patients made rapid improvements in all symptoms, insight and social functioning as measured by the PANSS, SAI and PSP at 12 and 24 weeks and maintained these improvements over the course of the study to 84 weeks. Patients in the CBT group showed significantly greater and more durable improvement in PANSS total score (p = 0.045, between-group d = 0.48), positive symptoms (p = 0.018, between-group d = 0.42) and social functioning (p = 0.037, between-group d = 0.64), with significant differences emerging after completion of therapy. Conclusions: Both CBT and ST combined with medication had benefits on psychopathology, insight and social functioning of patients with schizophrenia. CBT was significantly more effective than ST on overall, positive symptoms and social functioning of patients with schizophrenia in the long term.

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  1. Drury, V., Birchwood, M., and Cochrane, R. (2000), 'Cognitive therapy and recovery from acute psychosis: a controlled trial. 3. Five-year follow-up', Br J Psychiatry, 177 (1), 8-14.
  2. Kay, S. R., Opler, L. A., and Lindenmayer, J. P. (1988), 'Reliability and validity of the positive and negative syndrome scale for schizophrenics', Psychiatry Res, 23 (1), 99-110.
  3. ---(2008), 'Cognitive Therapy of Schizophrenia (Guides to Individualized Evidence-Based Treatment)', (New York: Guilford Press).
  4. Kumari, V., Fannon, D., Peters, E.R., et al. (2011), 'Neural changes following cognitive behaviour therapy for psychosis: a longitudinal study', Brain, 134 (8), 2396-407.
  5. Lysaker, P.H., Glynn, S.M., Wilkniss, S.M., and Silverstein, S.M. (2010), 'Psychotherapy and recovery from schizophrenia: A review of potential applications and need for future study', Psychol Serv, 7 (2), 75-91.
  6. Rector, N.A. and Beck, A.T. (2012), 'Cognitive Behavioral Therapy for Schizophrenia: An Empirical Review', J Nerv Ment Dis, 200 (10), 832-39.
  7. Tianmei, Si, Liang, Shu, Yun'ai, Su, et al. (2011), 'The Chinese version of the Personal and Social Performance Scale (PSP): validity and reliability', Psychiatry Res, 185 (1-2), 275-79.
  8. van der Gaag, Mark, Hoffman, Tonko, Remijsen, Mila, et al. (2006), 'The five-factor model of the Positive and Negative Syndrome Scale II: a ten-fold cross-validation of a revised model', Schizophrenia research, 85 (1), 280-87.
  9. Wang, Y., Xiang, Y. T., Wang, C. Y., et al. (2011), 'Insight in Chinese schizophrenia patients: a 12- month follow-up', J Psychiatr Ment Health Nurs, 18 (9), 751-57.
  10. Zimmermann, G, Favrod, J, Trieu, VH, and Pomini, V (2005), 'The effect of cognitive behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: a meta-analysis', Schizophrenia research, 77 (1), 1-9. 57.03, 13.08 (54.23-59.83) 1.22 51.32, 13.25 (48.44-54.20) 48.79, 12.52* (46.04-51.54) 48.99, 12.84** (46.19-51.79) 46.71, 13.12** (43.85-49.57) 25.86, 17.26, 36.01% ST 72.19, 11.02 (69.96-74.42) 58.39, 11.92 (55.82-60.96) 1.20 52.23, 12.65 (49.45-55.01) 52.88, 13.64 (49.86-55.90) 54.71, 14.3 (51.57-57.85) 52.91, 14.45 (49.73-56.09) 19.04, 14.89, 26.71% PANSS_positive CBT 23.89, 5.76 (22.72-25.06) 17.13, 5.52 (15.95-18.31) 1.19 15.23, 5.78 (13.98-16.48) 14.17, 5.76 (12.90-15.44) 13.55, 5.41 (12.37-14.73) 13.18, 5.35 (12.03-14.33) 10.51, 7.79, 44.83% ST 22.96, 5.01 (21.94-23.98) 17.34, 4.82 (16.30-18.38) 1.14 15.04, 5.12 (13.92-16.16) 15.37, 5.32 (14.19-16.55) 15.67, 5.02 (14.57-16.77) 15.34, 5.67 (14.09-16.59) 7.44, 7.17, 33.19% PANSS_negative CBT 19.99, 5.96 (18.78-21.20) 16.66, 5.44

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Authors
Li, Z.-J., Guo, Z.-H., Wang, N., Xu, Z.-Y., Qu, Y., Wang, X.-Q., Sun, J., Yan, L.-Q., Ng, R. M. K., Turkington, D., & Kingdon, D.
Affiliations
  • Capital Medical University (CN)
  • Beijing HuiLongGuan Hospital (CN)
  • Peking University (CN)
  • Griffith University (AU)
  • Kowloon Hospital (CN)
  • Newcastle University (GB)
  • University of Southampton (GB)
Corresponding author
Li, Z.-J.
Venue
Psychological Medicine
Published
2014-12-23
Volume
45
Issue
9
Pages
1893-1905
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
OpenAlex
W2097718574
Cited by
49
References
39
Citations by year
2025: 5 · 2024: 2 · 2023: 3 · 2022: 9 · 2021: 1 · 2020: 5 · 2019: 4 · 2018: 7 · 2017: 7 · 2016: 5 · 2015: 1
FWCI
3.31
Type
journal article
Language
en
Open access
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • Griffith Research Online (submittedVersion)
  • Newcastle University ePrints (Newcastle Univesity)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
Keywords
cognitive behavioral therapy, schizophrenia, supportive therapy, treatment efficacy, insight, social functioning, positive symptoms, long-term outcomes
MeSH terms
Beijing, Adult, Combined Modality Therapy, Female, Humans, Male, Schizophrenia, Social Adjustment, Antipsychotic Agents, Cognitive Behavioral Therapy, Single-Blind Method, Treatment Outcome, Young Adult

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