RANDOMIZED CONTROLLED TRIAL OF INTENSIVE COGNITIVE-BEHAVIOR THERAPY FOR PATIENTS WITH CHRONIC-SCHIZOPHRENIA

Objectives: To investigate whether intensive cognitive behaviour thera py results in significant improvement in positive psychotic symptoms i n patients with chronic schizophrenia. Design: Patients with chronic s chizophrenia were randomly allocated, stratified according to severity of symptoms and sex, to intensive cognitive behaviour therapy and rou tine care, supportive counselling and routine care, and routine care a lone. Setting: Adjunct treatments were carried out in outpatient clini cs or in the patient's home. Subjects: 87 patients with persistent pos itive symptoms who complied with medication; 72 completed treatment. O utcome measures: Assessments of positive psychotic symptoms before tre atment and 3 months after treatment. Number of patients who showed a 5 0% or more improvement in symptoms. Exacerbation of symptoms and rates of readmission to hospital. Results: Significant improvements were fo und 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 th eir symptoms (chi(2) = 5.18, df = 1; P = 0.02). Logistic regression in dicated 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 exacerba tions and days spent in hospital. Conclusions: Cognitive behaviour the rapy is a potentially useful adjunct treatment in the management of pa tients with chronic schizophrenia.