Cognitive behavior therapy for schizophrenia: A meta-analytical review of randomized controlled trials
Abstract
BACKGROUND: In the UK and in Sweden, cognitive behavior therapy (CBT) has been recommended for schizophrenia. The two recent meta-analyses examined results soon after treatment and not at follow-up. AIM: To determine the effectiveness of CBT in people with schizophrenia, both after treatment and at follow-up, and to compare it with treatment as usual (TAU) and other psychological treatments. METHODS: The search was carried in the databases CENTRAL (Cochrane Central Register of Controlled Trials), PsycINFO and PubMed (Medline). Inclusion criteria were randomized controlled trials (RCTs) with low risk of bias. Two reviewers, working independently, extracted data. The results were analyzed using risk ratio (RR), risk difference (RD), mean difference (MD), or standardized mean difference (SMD). Outcome measures were symptoms, use of medication, relapse and clinically important improvement. RESULTS: When CBT was compared with other psychological treatments at follow-up, there was strong evidence (with small treatment effect) that intervention has an effect with positive symptoms (P = 0.02), negative symptoms (P = 0.03) and general symptoms (P = 0.003). After treatment, there was a trend in favor of CBT, but not statistically significantly so. CONCLUSION: It appears that the effect of CBT is delayed; it could be seen a few months after the treatment had terminated. Therapies for patients with schizophrenia that were 20 sessions long or more had better outcomes than those that were shorter.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
CBTp is a psychological treatment for individuals who, after pharmacological treatment, still live with symptoms of psychosis.
“Cognitive Behavior Therapy for psychosis (CBTp) is a psychological treatment for individuals who, after pharmacological treat ment, still live with symptoms of psychosis (Mehl et al., 2015; Sarin et al., 2011).”
From Acceptance and Commitment Therapy for inpatients with psychosis –an acceptability and feasibility single case AB designed study (2022) · cites this paper as Sarin et al., 2011
Cites
The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) · Schizophrenia Bulletin · doi:10.1093/schbul/13.2.261 · Cited by 21,378 · see citing works
An inventory for measuring clinical anxiety: Psychometric properties.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.893 · Cited by 14,407 · see citing works
Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation
Beck, A. T., Steer, R. A., & Carbin, M. G. (1988) · Clinical Psychology Review · doi:10.1016/0272-7358(88)90050-5 · Cited by 11,696 · see citing works
Hao (2015) · doi:10.1002/14651858 · Cited by 11,321 · see citing works
(2008) · Cited by 3,790 · see citing works
Assessing Risk of Bias in Included Studies
Higgins, J. P., & Altman, D. G. (2008) · Cochrane Handbook for Systematic Reviews of Interventions · doi:10.1002/9780470712184.ch8 · Cited by 3,396 · see citing works
Chapter 9: Analysing Data and Undertaking Meta-Analyses
Deeks, J. J., Higgins, J. P. T., & Altman, D. G. (2008) · Cited by 2,782 · see citing works
Chlorpromazine Equivalent Doses for the Newer Atypical Antipsychotics
Woods, S. W. (2003) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v64n0607 · Cited by 2,056 · see citing works
Lipsey, M. W., & Wilson, D. B. (1993) · American Psychologist · doi:10.1037/0003-066x.48.12.1181 · Cited by 2,033 · see citing works
Analysing Data and Undertaking Meta‐Analyses
Deeks, J. J., Higgins, J. P., & Altman, D. G. (2008) · Cochrane Handbook for Systematic Reviews of Interventions · doi:10.1002/9780470712184.ch9 · Cited by 1,800 · see citing works
Ellsworth, P. D. (1980) · American Journal of Occupational Therapy · doi:10.5014/ajot.34.12.819a · Cited by 1,712 · see citing works
HADDOCK, G., McCARRON, J., TARRIER, N., & FARAGHER, E. B. (1999) · Psychological Medicine · doi:10.1017/s0033291799008661 · Cited by 1,461 · see citing works
A COMPREHENSIVE PSYCHOPATHOLOGICAL RATING SCALE
Åsberg, M., Montgomery, S., Perris, C., Schalling, D., & Sedvall, G. (1978) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1978.tb02357.x · Cited by 1,327 · see citing works
Statistics Notes: Detecting skewness from summary information: Table 1
Altman, D. G., & Bland, J. M. (1996) · BMJ · doi:10.1136/bmj.313.7066.1200 · Cited by 1,278 · see citing works
Therapeutic Songwriting in Music Therapy
Baker, F. A., Wigram, T., Stott, D., & McFerran, K. S. (2008) · Nordic Journal of Music Therapy · doi:10.1080/08098130809478203 · Cited by 1,140 · see citing works
Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2007) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm114 · Cited by 1,029 · see citing works
PILLING, S., BEBBINGTON, P., KUIPERS, E., GARETY, P., GEDDES, J., ORBACH, G., & MORGAN, C. (2002) · Psychological Medicine · doi:10.1017/s0033291702005895 · Cited by 887 · cited 1× · see citing works
“The knowledge is conveyed not only to the patients but to their whole family (10).”
BackgroundChapter 12: Interpreting results and drawing conclusions
Schünemann, H. J., Oxman, A. D., Jonathan, J., & Glasziou, P. (2011) · Cited by 873 · see citing works
Chapter 16: Special Topics in Statistics
Higgins, J. P. T., Deeks, J. J., & Altman, D. (2008) · Cited by 702 · see citing works
Sensky, T., Turkington, D., Kingdon, D., Scott, J. L., Scott, J., Siddle, R., O'Carroll, M., & Barnes, T. R. E. (2000) · Archives of General Psychiatry · doi:10.1001/archpsyc.57.2.165 · Cited by 691 · see citing works
Lefebvre, C., Manheimer, E. W., & Glanville, J. (2008) · doi:10.1002/9780470712184.ch6 · Cited by 599 · see citing works
Higgins, J. P., Deeks, J. J., & Altman, D. G. (2008) · Cochrane Handbook for Systematic Reviews of Interventions · doi:10.1002/9780470712184.ch16 · Cited by 475 · see citing works
Selecting Studies and Collecting Data
Higgins, J. P., & Deeks, J. J. (2008) · Cochrane Handbook for Systematic Reviews of Interventions · doi:10.1002/9780470712184.ch7 · Cited by 467 · see citing works
Tarrier, N., Yusupoff, L., Kinney, C., McCarthy, E., Gledhill, A., Haddock, G., & Morris, J. (1998) · BMJ · doi:10.1136/bmj.317.7154.303 · Cited by 442 · see citing works
Cognitive therapy for psychosis in schizophrenia: An effect size analysis
Gould, R. A., Mueser, K. T., Bolton, E., Mays, V., & Goff, D. (2001) · Schizophrenia Research · doi:10.1016/s0920-9964(00)00145-6 · Cited by 389 · see citing works
Cognitive-behavioral therapy for schizophrenia: An empirical review
RECTOR, N. A., & BECK, A. T. (2001) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200105000-00002 · Cited by 387 · see citing works
Lewis, S. W., Tarrier, N., Haddock, G., Bentall, R. P., Kinderman, P., Kingdon, D., Siddle, R., Drake, R., Everitt, J., Leadley, K., et al. (2002) · The British Journal of Psychiatry · doi:10.1192/bjp.181.43.s91 · Cited by 374 · see citing works
Zimmermann, G., Favrod, J., Trieu, V. H., & Pomini, V. (2005) · Schizophrenia Research · doi:10.1016/j.schres.2005.02.018 · Cited by 371 · see citing works
Interpreting Results and Drawing Conclusions
Schünemann, H. J., Oxman, A. D., Vist, G. E., Higgins, J. P., Deeks, J. J., Glasziou, P., & Guyatt, G. H. (2008) · Cochrane Handbook for Systematic Reviews of Interventions · doi:10.1002/9780470712184.ch12 · Cited by 366 · see citing works
Turkington, D., Kingdon, D., & Turner, T. (2002) · British Journal of Psychiatry · doi:10.1192/bjp.180.6.523 · Cited by 350 · see citing works
Lynch, D., Laws, K. R., & McKenna, P. J. (2010) · Psychological Medicine · doi:10.1017/s003329170900590x · Cited by 317 · see citing works
Tarrier, N., & Wykes, T. (2004) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.06.020 · Cited by 301 · see citing works
Garety, P. A., Fowler, D. G., Freeman, D., Bebbington, P., Dunn, G., & Kuipers, E. (2008) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.043570 · Cited by 296 · see citing works
(2008) · Sage eBooks · doi:10.4135/9781412963978.n256 · Cited by 281 · see citing works
Cognitive–behavioural therapy in first-episode and early schizophrenia
Tarrier, N., Lewis, S. W., Haddock, G., Bentall, R. P., Drake, R., Kinderman, P., Kingdon, D., Siddle, R., Everitt, J., Leadley, K., et al. (2004) · The British Journal of Psychiatry · doi:10.1192/bjp.184.3.231 · Cited by 269 · see citing works
Cognitive therapy for command hallucinations: randomised controlled trial
Trower, P., Birchwood, M., Meaden, A., Byrne, S., Nelson, A., & Ross, K. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.184.4.312 · Cited by 268 · see citing works
GUMLEY, A., O'GRADY, M., MCNAY, L., REILLY, J., POWER, K., & NORRIE, J. (2003) · Psychological Medicine · doi:10.1017/s0033291703007323 · Cited by 229 · see citing works
Tarrier, N., Witttkowskj, A., Kinney, C., McCarthy, E., Morris, J., & Humphreys, L. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.174.6.500 · Cited by 179 · see citing works
Chlorpromazine equivalents: a consensus of opinion for both clinical and research applications
Atkins, M., Burgess, A., Bottomley, C., & Riccio, M. (1997) · Psychiatric Bulletin · doi:10.1192/pb.21.4.224 · Cited by 170 · see citing works
Valmaggia, L., van der Gaag, M., Tarrier, N., Pijnenborg, G. H. M., & Slooff, C. J. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.186.4.324 · Cited by 163 · see citing works
Baker, A., Bucci, S., Lewin, T. J., Kay-Lambkin, F., Constable, P. M., & Carr, V. J. (2006) · British Journal of Psychiatry · doi:10.1192/bjp.188.5.439 · Cited by 159 · see citing works
Haddock, G., Tarrier, N., Morrison, A. P., Hopkins, R., Drake, R., & Lewis, S. W. (1999) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s001270050141 · Cited by 158 · see citing works
Durham, R. C., Guthrie, M., Morton, R. V., Reid, D. A., Treliving, L. R., Fowler, D. G., & Macdonald, R. R. (2003) · The British Journal of Psychiatry · doi:10.1192/bjp.182.4.303 · Cited by 156 · see citing works
Turkington, D., Kingdon, D., Rathod, S., Hammond, K., Pelton, J., & Mehta, R. (2006) · British Journal of Psychiatry · doi:10.1192/bjp.bp.105.010884 · Cited by 151 · see citing works
Jackson, H. J., McGorry, P. D., Killackey, E. J., Bendall, S., Allott, K., Dudgeon, P., Gleeson, J., Johnson, T., & Harrigan, S. (2007) · Psychological Medicine · doi:10.1017/s0033291707002061 · Cited by 149 · see citing works
Cognitive therapy for schizophrenia: a preliminary randomized controlled trial
Rector, N. A., Seeman, M. V., & Segal, Z. V. (2002) · Schizophrenia Research · doi:10.1016/s0920-9964(02)00308-0 · Cited by 146 · see citing works
Tarrier, N., Kinney, C., McCarthy, E., Humphreys, L., Wittkowski, A., & Morris, J. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.5.917 · Cited by 137 · see citing works
Bechdolf, A., Knost, B., Kuntermann, C., Schiller, S., Klosterkötter, J., Hambrecht, M., & Pukrop, R. (2004) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2004.00300.x · Cited by 133 · see citing works
Turkington, D., Sensky, T., Scott, J. L., Barnes, T. R. E., Nur, U., Siddle, R., Hammond, K., Samarasekara, N., & Kingdon, D. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2007.09.026 · Cited by 132 · see citing works
Haddock, G., Barrowclough, C., Shaw, J. J., Dunn, G., Novaco, R. W., & Tarrier, N. (2009) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.039859 · Cited by 131 · see citing works
Group cognitive-behavioural therapy for schizophrenia
Barrowclough, C., Haddock, G., Lobban, F. A., Jones, S. H., Siddle, R., Roberts, C., & Gregg, L. (2006) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.106.021386 · Cited by 130 · see citing works
Greenwood, K., Sweeney, A., Williams, S., Garety, P. A., Kuipers, E., Scott, J. L., & PETERS, E. R. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp117 · Cited by 128 · see citing works
Fowler, D., Hodgekins, J., Painter, M., Reilly, T., Crane, C., Macmillan, I., Mugford, M., Croudace, T., & Jones, P. B. (2009) · Psychological Medicine · doi:10.1017/s0033291709005467 · Cited by 125 · see citing works
Lecomte, T., Leclerc, C., Corbière, M., Wykes, T., Wallace, C. J., & Spidel, A. L. (2008) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e31818ee231 · Cited by 123 · see citing works
Penn, D. L., Meyer-Kalos, P., Evans, E., Wirth, R. J., Cai, K., & Burchinal, M. (2009) · Schizophrenia Research · doi:10.1016/j.schres.2008.12.009 · Cited by 120 · see citing works
Bridging the gap between best evidence and best practice in mental health
Newnham, E. A., & Page, A. C. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.10.004 · Cited by 114 · see citing works
A pilot study of functional Cognitive Behavioral Therapy (fCBT) for schizophrenia
Cather, C., Penn, D. L., Otto, M. W., Yovel, I., Mueser, K. T., & GOFF, D. C. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2004.05.002 · Cited by 113 · see citing works
Jackson, C., Trower, P., Reid, I., Smith, J., Hall, M., Townend, M., Barton, K., Jones, J., Ross, K., Russell, R., et al. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.02.009 · Cited by 86 · see citing works
Bechdolf, A., Köhn, D., Knost, B., Pukrop, R., & Klosterkötter, J. (2005) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2005.00581.x · Cited by 80 · see citing works
Influence of age on outcome of psychological treatments in first-episode psychosis
Haddock, G., Lewis, S. W., Bentall, R. P., Dunn, G., Drake, R., & Tarrier, N. (2006) · The British Journal of Psychiatry · doi:10.1192/bjp.188.3.250 · Cited by 71 · see citing works
Remission and relapse in psychosis: operational definitions based on case-note data
Bebbington, P., Craig, T., Garety, P. A., Fowler, D. G., Dunn, G., Colbert, S., Fornells‐Ambrojo, M., & Kuipers, E. (2006) · Psychological Medicine · doi:10.1017/s0033291706008579 · Cited by 57 · see citing works
ARE SOME TYPES OF PSYCHOTIC SYMPTOMS MORE RESPONSIVE TO COGNITIVE-BEHAVIOUR THERAPY?
Tarrier, N., Kinney, C., McCarthy, E., Wittkowski, A., Yusupoff, L., Gledhill, A., Morris, J., & Humphreys, L. (2001) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465801001060 · Cited by 57 · see citing works
COGNITIVE THERAPY IN EARLY PSYCHOSIS: A PILOT RANDOMIZED CONTROLLED TRIAL
Jolley, S., Garety, P. A., Craig, T., Dunn, G., White, J., & Aitken, M. (2003) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465803004107 · Cited by 47 · see citing works
Naeem, F., Kingdon, D., & Turkington, D. (2005) · Cognitive Behaviour Therapy · doi:10.1080/16506070510010684 · Cited by 35 · see citing works
Samarasekera, N., Kingdon, D., Siddle, R., O'Carroll, M., Scott, J. L., Sensky, T., Barnes, T. R. E., & Turkington, D. (2006) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608306x108998 · Cited by 21 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Cognitive-behavioral therapy for medication-resistant psychosis: A meta-analytic review
Burns, A. M. N., Erickson, D. H., & Brenner, C. A. (2014) · Psychiatric Services · doi:10.1176/appi.ps.201300213 · Cited by 199 · see citing works
Mehl, S., Werner, D., & Lincoln, T. M. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01450 · Cited by 129 · see citing works
Metacognitive and cognitive-behavioral interventions for psychosis: new developments.
Moritz, S., Klein, J. P., Lysaker, P. H., & Mehl, S. (2019) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2019.21.3/smoritz · Cited by 101 · see citing works
Mindfulness-and acceptance-based interventions for psychosis: A systematic review and meta-analysis
Cramer, H., Lauche, R., Haller, H., Langhorst, J., & Dobos, G. (2016) · Global Advances in Health and Medicine · doi:10.7453/gahmj.2015.083 · Cited by 96 · see citing works
Naeem, F., Khoury, B., Munshi, T., Ayub, M., Lecomte, T., Kingdon, D., & Farooq, S. (2016) · International Journal of Cognitive Therapy · doi:10.1521/ijct_2016_09_04 · Cited by 80 · see citing works
Witt, K., de Moraes, D. P., Salisbury, T. T., Arensman, E., Gunnell, D., Hazell, P., Townsend, E., van Heeringen, K., & Hawton, K. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.04.025 · Cited by 31 · see citing works
Larsson, C., Fatouros-Bergman, H., Isaksson, A., Johansson, M., Kaldo, V., Parling, T., & Lundgren, T. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.05.008 · Cited by 5 · see citing works
- Authors
- Sarin, F., Wallin, L., & Widerlöv, B.
- Affiliations
- Praktikertjänst (SE)
- Uppsala University (SE)
- Corresponding author
- Sarin, Freddy
- Venue
- Nordic Journal of Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2011-05-13
- Volume
- 65
- Issue
- 3
- Pages
- 162-174
- ISSN
- 0029-1455 (ISSN-L)
- 0803-9488
- 1502-4725
- OpenAlex
- W2149361395
- Cited by
- 97
- References
- 65
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 13 · 2021: 5 · 2020: 6 · 2019: 11 · 2018: 6 · 2017: 5 · 2016: 8 · 2015: 9 · 2014: 12 · 2013: 8 · 2012: 4
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nordic Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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, treatment effectiveness, relapse, symptom relief, positive symptoms, negative symptoms, usual care, psychological intervention, follow-up outcomes, treatment duration
- MeSH terms
- Humans, Psychiatric Status Rating Scales, Recurrence, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
