Cognitive Behavioral Psychotherapy as an Add-on in Comprehensive Outpatient Care of Non-affective Psychoses: A Multicenter Randomized-Controlled Effectiveness Trial in a Naturalistic Setting.
Schizophr Bull
; 2024 Jul 14.
Article
em En
| MEDLINE
| ID: mdl-39004927
ABSTRACT
BACKGROUND AND HYPOTHESIS:
Non-affective psychoses (NAP) are associated with severe consequences with regard to social functioning, physical health, employment, and suicidality. Treatment guidelines recommend cognitive behavioral therapy for psychosis (CBTp) as an effective additional treatment strategy to psychopharmacology. We hypothesized that outpatient CBTp has an add-on effect in individuals with NAP who already receive comprehensive outpatient care (COC) in Germany. STUDYDESIGN:
In a randomized-controlled effectiveness trial, 6 months of COCâ +â CBTp were compared to COC. The primary outcomes were change of symptom severity as assessed by the Positive and Negative Symptom Scale (pre-/post-treatment and 6-month follow-up). Mixed linear models and effect sizes were used to compare changes across treatment groups. Additionally, the number of readmissions was compared. STUDYRESULTS:
Nâ =â 130 individuals with chronic NAP were recruited (COCâ +â CBTp nâ =â 64, COC nâ =â 66). COCâ +â CBTp participants significantly improved more regarding positive symptom severity (estimated mean difference at follow-up -2.33, 95% CI -4.04 to -0.61, Pâ =â .0083, dâ =â 0.32) and general psychopathology (estimated mean difference at follow-up -4.55, 95% CI -7.30 to -1.81, Pâ =â .0013, dâ =â 0.44) than the COC group. In both groups, negative symptom severity did not change significantly over time nor did groups differ regarding readmissions.CONCLUSION:
The results underline an add-on benefit of CBTp in chronically ill individuals with NAP. Superiority of CBTp was demonstrated in comparison with high-quality comprehensive care and may also be true in different comprehensive care settings. CLINICAL TRIALS REGISTRATION DRKS00015627.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article