LONDON EAST-ANGLIA RANDOMIZED CONTROLLED TRIAL OF COGNITIVE-BEHAVIORAL THERAPY FOR PSYCHOSIS - III - FOLLOW-UP AND ECONOMIC-EVALUATION AT 18 MONTHS

Background Arandomised controlled trial of cognitive-behavioural thera py (CBT)for people with medication-resistant psychosis showed improvem ents in overall symptomatology after nine months of treatment; good ou tcome was strongly predicted by a measure of cognitive flexibility con cerning delusions. The present paper presents a follow-up evaluation 1 8 months after baseline. Method Forty-seven (78% of original n=60) par ticipants were available for a follow-up at 18 months, and were reasse ssed on ail the original outcome measures (see Part 1). An economic ev aluation was also completed. Results Those in the CBT treatment group showed a significant and continuing improvement in Brief Psychiatric R ating Scale scores, whereas the control group did not change from base line. Delusional distress and the frequency of hallucinations were als o significantly reduced in the CBT group. The costs of CBT appear to h ave been offset by reductions in service utilisation and associated co sts during follow-up. Conclusions Improvement in overall symptoms was maintained in the CBT group 18 months after baseline and nine months a fter intensive therapy was completed.CBT may be a specific and cost-ef fective intervention in medication-resistant psychosis.