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Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia

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Tarrier, Nicholas, Yusupoff, Lawrence, Kinney, Caroline, McCarthy, Eilis, Gledhill, Ann, Haddock, Gillian, Morris, Julie·1998·BMJ

Abstract

Objectives: To investigate whether intensive cognitive behaviour therapy results in significant improvement in positive psychotic symptoms in patients with chronic schizophrenia. Design: Patients with chronic schizophrenia were randomly allocated, stratified according to severity of symptoms and sex, to intensive cognitive behaviour therapy and routine care, supportive counselling and routine care, and routine care alone. Setting: Adjunct treatments were carried out in outpatient clinics or in the patient's home. Subjects: 87 patients with persistent positive symptoms who complied with medication; 72 completed treatment. Outcome measures: Assessments of positive psychotic symptoms before treatment and 3 months after treatment. Number of patients who showed a 50% or more improvement in symptoms. Exacerbation of symptoms and rates of readmission to hospital. Results: Significant improvements were found in the severity (F=5.42, df =2,86; P=0.006) and number (F=4.99, df=2,86; P=0.009) of positive symptoms in those treated with cognitive behaviour therapy. The supportive counselling group showed a non-significant improvement. Significantly more patients treated with cognitive behaviour therapy showed an improvement of 50% or more in their symptoms (χ 2 =5.18, df=1; P=0.02). Logistic regression indicated that receipt of cognitive behaviour therapy results in almost eight times greater odds (odds ratio 7.88) of showing this improvement. The group receiving routine care alone also experienced more exacerbations and days spent in hospital. Conclusions: Cognitive behaviour therapy is a potentially useful adjunct treatment in the management of patients with chronic schizophrenia.

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Research works printed but not linked: 12

  1. 10.1192/bjp.146.5.464 · DOI
  2. Tarrier N . Psychological treatment of positive schizophrenic symptoms. In: Kavanagh D, ed. Schizophrenia: an overview and practical handbook. London: Chapman and Hall, 1992. · DOI
  3. Haddock, 1994, Developments in cognitive behaviour therapy for persistent psychotic symptoms., Beh Change, 11, 200, 10.1017/S0813483900004472 · DOI
  4. Haddock G Tarrier N Spauldin, W Yusupoff L Kinney C McCarthy E . Individual cognitive-behavior therapy in the treatment of hallucinations and delusions: a review. Clin Psychol Rev (in press).
  5. 10.1192/bjp.162.4.524 · DOI · Paper page
  6. Garety, 1994, Cognitive behavioural therapy for drug resistant psychosis., Br J Med Psychol, 67, 259, 10.1111/j.2044-8341.1994.tb01795.x · DOI
  7. Haddock G Bentall R Slade P . Psychological treatment of auditory hallucinations: focusing or distraction? In: Haddock G, Slade P, eds. Cognitive behavioural interventions with psychotic disorders. London: Routledge, 1996:45-70. · DOI
  8. 10.1192/bjp.171.4.319 · DOI · Paper page
  9. 10.1192/bjp.169.5.593 · DOI · Paper page
  10. Krawieka, 1977, A standardised psychiatric assessment scale for rating chronic psychotic patients., Acta Psychiat Scand, 55, 299, 10.1111/j.1600-0447.1977.tb00174.x · DOI · Paper page
  11. Wing J Cooper J Sartorius N . Measurement and classification of psychiatric symptoms. Cambridge: Cambridge University Press, 1974.
  12. Lukoff, 1986, Symptom monitoring in the rehabilitation of schizophrenic patients., Schizophr Bull, 12, 578, 10.1093/schbul/12.4.578 · DOI · Paper page

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Metadata

Authors
Tarrier, N., Yusupoff, L., Kinney, C., McCarthy, E., Gledhill, A., Haddock, G., & Morris, J.
Venue
BMJ
Publisher
BMJ
Published
1998-08-01
Volume
317
Issue
7154
Pages
303-307
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
OpenAlex
W2049907076
Cited by
442
References
0
FWCI
17.88
Type
journal article
Language
en
Open access
bronze
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)

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