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CBT effective for schizophrenia patients who refuse antipsychotics

Cognitive behavioural therapy (CBT) is a promising option for patients with schizophrenia who refuse to take antipsychotics, according to a UK study published today in The Lancet.

Researchers randomised 74 patients with schizophrenia – all of whom chose not to take an antipsychotic – to receive usual care alone or usual care plus CBT.

The primary outcome measure – after at least nine months of follow-up – was the Postive and Negative Syndrome Scale (PANSS). CBT was highly effective in reducing psychotic symptoms compared to usual care, with an estimate between-group difference of -6.52.

More specifically, CBT significantly improved personal and social functioning and some dimensions of delusional beliefs and voice hearing. But it did not significantly affect the amount of distress associated with delusional beliefs or voice hearing, or levels of depression, social anxiety, and self-rated recovery

The authors stress that the results cannot be generalised to the schizophrenia patients population as a whole. Inpatients were excluded from the study, and symptom severity at baseline was lower than that usually seen in drug trials.

But they insist the study provides proof of concept that CBT is an effective alternative to antipsychotics.

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