A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service

Peters, Emmanuelle; Landau, Sabine; McCrone, Paul; Cooke, Michael A.; Fisher, Peter; Steel, Craig; Evans, Rachel; Carswell, Kenneth; Kp, Dawson; Williams, Sally; Howard, Alexandra; Kuipers, Elizabeth

doi:10.1111/j.1600-0447.2010.01572.x

Cited by 76 publications

(82 citation statements)

References 57 publications

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“…This idea is supported by studies that compared psychosocial treatment in combination with medication with treatment with medication alone (Pijnenborg et al, 2012). These studies show that that insight improved with medication alone in the early phase of treatment (Guo et al, 2010), but not in chronic samples (Merinder et al, 1999;Peters et al, 2010;Turkington et al,2006;Granholm et al, 2005;Chan et al, 2007Chan et al, , 2009) and by studies finding significant improvement of insight over the first two months of antipsychotic treatment in newly admitted patients (Kim et al, 2011) and in individuals with an at risk mental state treated with aripiprazole for three months (Kobayashi et al, 2009). In line with this, our results show that the effects of medication on illness decreases after the first three months of treatment.…”

Section: Discussionsupporting

confidence: 88%

Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST)

Pijnenborg¹,

Timmerman²,

Derks³

et al. 2015

European Neuropsychopharmacology

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Section: Discussionsupporting

confidence: 88%

Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST)

Pijnenborg¹,

Timmerman²,

Derks³

et al. 2015

European Neuropsychopharmacology

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“…Of the 14 psychological treatment trials, nine used a randomised controlled design. All drop-out rates from therapy were below 30%, although two studies had lost more that this proportion of participants by the final follow-up assessment (Addington et al, 2011;Peters et al, 2010).…”

Section: Methodological Characteristicsmentioning

confidence: 99%

Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.

Vorontsova¹,

Garety²,

Freeman³

2013

Journal of Abnormal Psychology

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Depression is common in people with schizophrenia, but how it might directly contribute to the persistence of psychotic symptoms has rarely been tested. The key aim of the present study was to test whether depression and associated cognitive processes predict the maintenance of persecutory delusions. Three groups of participants were tested at baseline: 60 patients with persecutory delusions in the context of a schizophrenia spectrum diagnosis, 30 patients with depression, and 30 nonclinical controls. They completed interviewer and self-report assessments of depression and paranoia, and measures of six cognitive factors (schematic beliefs, experiential avoidance, autobiographical memory, problem solving, rumination, worry style). The patients with persecutory delusions were then assessed again, six months later. It was found that 50% of the patients with persecutory delusions met diagnostic criteria for major depression. Cognitive processes found to be associated with depression across the groups were negative schematic beliefs about the self, experiential avoidance and rumination, but not autobiographical memory or problem solving. The severity of initial depression in patients with persecutory delusions predicted the persistence of paranoia over six months. A number of cognitive factors also predicted the persistence of persecutory delusions, including negative schematic beliefs about the self, worry, and problem-solving difficulties. In conclusion, depression is common in patients with current persecutory delusions, and it shows similar cognitive features to major depressive disorder. The results of this study indicate that depression and related processes may contribute to the maintenance of paranoia. Trials are warranted of depression-related therapeutic techniques for people with persecutory delusions.

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“…Indeed the proportion of time spent addressing voices in CBTp trials can be small. 28 Furthermore, while some individual trials that have included voices measures have observed improvements, 29,30 including a recent trial with people not taking antipsychotic mediation, 31 most have been insufficiently powered to be conclusive, due to their small sample sizes 32–34 or delivery of therapy during acute relapse when substantial reductions in symptoms arise from routine care alone. 23,35 Nonetheless, a recent meta-analysis 6 (although limited by combining trials delivered during chronic and acute psychosis, and including trials not directly targeting positive symptoms), observed a significant effect of CBTp on posttreatment voice severity vs any control (Hedge’s g = 0.34, 15 studies).…”

Section: Empirical Findings For Psychological Interventions For Voicesmentioning

confidence: 99%

Psychological Therapies for Auditory Hallucinations (Voices): Current Status and Key Directions for Future Research

Thomas

Hayward

Peters

et al. 2014

Schizophrenia Bulletin

Self Cite

161

165

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This report from the International Consortium on Hallucinations Research considers the current status and future directions in research on psychological therapies targeting auditory hallucinations (hearing voices). Therapy approaches have evolved from behavioral and coping-focused interventions, through formulation-driven interventions using methods from cognitive therapy, to a number of contemporary developments. Recent developments include the application of acceptance- and mindfulness-based approaches, and consolidation of methods for working with connections between voices and views of self, others, relationships and personal history. In this article, we discuss the development of therapies for voices and review the empirical findings. This review shows that psychological therapies are broadly effective for people with positive symptoms, but that more research is required to understand the specific application of therapies to voices. Six key research directions are identified: (1) moving beyond the focus on overall efficacy to understand specific therapeutic processes targeting voices, (2) better targeting psychological processes associated with voices such as trauma, cognitive mechanisms, and personal recovery, (3) more focused measurement of the intended outcomes of therapy, (4) understanding individual differences among voice hearers, (5) extending beyond a focus on voices and schizophrenia into other populations and sensory modalities, and (6) shaping interventions for service implementation.

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A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service

Abstract: The only robust improvement was in depression. Nevertheless, there were further encouraging but modest improvements in both emotional and cognitive variables, in addition to psychotic symptoms.

Cited by 76 publications

References 57 publications

Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST)

Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST)

Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.

Psychological Therapies for Auditory Hallucinations (Voices): Current Status and Key Directions for Future Research

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