Group cognitive behavioural therapy as a treatment for negative symptoms in first-episode psychosis.

AIM: We aimed to test the idea that there is an early critical time period during a psychotic illness when patients may be more responsive to psychological treatment attention. METHODS: We tested this hypothesis by comparing the treatment responsiveness to group cognitive behavioural therapy (CBT) of 25 first-episode psychosis participants (FEP) and 15 patients with currently stable psychosis (n = 40). RESULTS: Following 12 sessions of outpatient-based group CBT, there were significant decreases in positive, depressive and anxiety symptoms, and an improvement in quality of life for both groups. However, negative symptoms only improved in the FEP group. CONCLUSION: Considering the pernicious nature of negative symptoms as well as the difficulties in treating them, this study provides some support for the concept of early intervention with CBT.

Is the duration of untreated psychosis temporally stable?

Although there is some evidence that duration of untreated psychosis (DUP) is geographically stable, few have examined whether the phenomenon is temporally stable. We examined DUP in two cohorts within two discrete time periods (1995-1999 and 2003-2005) spanning a decade in the same geographically defined community psychiatric service with no early intervention programme. Patients were diagnosed by Structured Clinical Interview for DSM (SCID) and we determined the DUP using the Beiser Scale. The DUP of the 240 participants did not differ significantly between study periods.

Toxic psychosis? Duration of untreated psychosis, symptomatology and cognitive deterioration in first episode psychosis.

OBJECTIVES: To examine the relationship between cognitive deficits, the duration of untreated psychosis (DUP) and positive and negative symptoms in a first episode psychosis sample. METHOD: We assessed a consecutive sample of first episode psychosis participants from a catchment area service with a comprehensive neuropsychology battery, a family and service-user based measure of DUP and measures of symptomatology. RESULTS: Using correlations and stepwise linear regressions, we found strong relationships between measures of DUP and positive symptomatology. We found that positive and negative symptoms were associated with different time periods within DUP. However, we did not find evidence of a relationship between DUP and cognitive factors. CONCLUSIONS: There was no evidence of a relationship between DUP and cognitive deterioration. However, there does appear to be evidence of a relationship between positive symptoms and aspects of DUP. These results highlight the importance of the heterogeneity of DUP and the potential to reduce positive symptoms through early intervention.