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Cognitive‐behaviour therapy for medication‐resistant positive symptoms in early psychosis: a case series
Author(s) -
Erickson David H.
Publication year - 2010
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/j.1751-7893.2010.00184.x
Subject(s) - psychosis , schizophrenia (object oriented programming) , randomized controlled trial , cognitive behaviour therapy , cognition , psychiatry , medicine , early psychosis , clinical psychology , psychology , physical therapy
Cognitive‐behaviour therapy (CBT) for psychosis reduces the severity of medication‐resistant positive symptoms in chronic schizophrenia, but its efficacy for early psychosis outpatients with a similar profile has not been established. Objective: This paper describes an uncontrolled evaluation of CBT, added to medication and comprehensive care in an early psychosis program, in a group of stable outpatients. Patients: The sample was drawn from 24 consecutive referrals. Fourteen were eligible, i.e. had positive symptom(s) and had been on the same medication regime for 3 months. Treatment: Patients received an average of 16 individual sessions with a senior psychologist. Measures: Symptom severity was assessed both by an independent rater, and by patient self‐report. Results: Eleven of 14 patients completed treatment. Both clinician and self‐report post‐treatment ratings of positive symptoms were significantly reduced following CBT. For positive symptom totals, effect sizes ranged from d = 1.0 to 1.3. Clinically significant changes were apparent in at least eight of 11 patients. Discussion: While case‐series studies have significant limitations, the large effect sizes described here suggest that CBT shows promise for effectiveness with early psychosis patients. A randomized trial is needed to establish both the effect size over and above a control condition, and the durability of gains of CBT for medication‐resistant symptoms in early psychosis.