A pilot study evaluating the effectiveness of individual inpatient cognitive-behavioural therapy in early psychosis

Background: Recent research indicates that cognitive-behaviour therapy (CBT ) can be effective in ameliorating persistent positive symptoms in chronic psychotic patients. The effectiveness of CBT in acute and recent-onset psyc hosis has been little explored, although a recent pilot study indicated tha t CBT could significantly improve recovery in acutely psychotic inpatients. Method: Short-term individual CBT was compared to supportive counselling/p sychoeducation (SC) as an adjunct to standard inpatient hospital care and m edication in 21 inpatients experiencing a recent-onset acute schizophrenic episode. Results: Both groups showed significant reductions in Brief Psychi atric Rating Scale (BPRS) scores following treatment, although there were n o group differences. Time to discharge did not differ significantly between the groups, although there was a greater variance for the SC patients. Two -year follow-up showed no significant differences between the groups, altho ugh the number of patients who relapsed, the number of relapses and the tim e to recurrence of psychotic symptoms was lower in the CBT group than the S C group. Interestingly, the time to readmission was shorter in the CBT grou p. Conclusions: CBT and SC are acceptable treatments for recent-onset acute ly psychotic inpatients. A larger randomised controlled trial over multiple hospital sites is warranted.