Should people with psychosis be supported in choosing cognitive therapy as an alternative to antipsychotic medication: A commentary on current evidence

Evidence from randomised controlled trials suggest that both antipsychotic medication and cognitive behaviour therapy (CBT) can be helpful to people with a diagnosis of a schizophrenia spectrum disorder. On this basis, many clinical guidelines recommend that people with psychosis should be offered both antipsychotic medication and CBT and that they should be collaboratively involved in the decisions about which treatment options they choose. The reality of service provision is often very different, with data regarding the availability of such treatment options and the extent of user involvement in decision making suggesting that medication is much more widely available and that service users are often not involved in these decisions, despite retaining decision making capacity.
Source: Schizophrenia Research - Category: Psychiatry Authors: Source Type: research

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Authors: Guo ZH, Li ZJ, Ma Y, Sun J, Guo JH, Li WX, Wang ZQ, Xu HL, Ng RMK, Turkington D, Kingdon D PMID: 31111798 [PubMed - as supplied by publisher]
Source: The British Journal of Psychiatry for Mental Science - Category: Psychiatry Tags: Br J Psychiatry Source Type: research
PMID: 31059624 [PubMed]
Source: World Psychiatry - Category: Psychiatry Authors: Tags: World Psychiatry Source Type: research
Conclusion: This is the first implementation of SocialMind, which is the first mindfulness-based social cognition training. It is well tolerated by participants with schizophrenia spectrum disorders, and a further randomized controlled trial is proposed for people who have suffered their first episode of psychosis within the past 5 years.Clinical Trial Registration:, identifier NCT03434405.IntroductionPeople suffering from psychosis frequently find it difficult to establish or maintain relationships with others or to engage in community activities (1, 2). These deficits are present even in high-risk ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusions: CBT, psychosocial intervention, supportive counseling, psychodynamic psychotherapy, and other psychological interventions can be recommended for clinical practice. More studies are needed, especially for non-CBT interventions and for all psychotherapies on negative symptoms.IntroductionSchizophrenia affects approximately 1% of the population, usually starting in adolescence or young adulthood, frequently leading to persistent disability, with a high risk of suicide (8%). Despite the advance in antipsychotics treatment, approximately 30% of patients with schizophrenia show a poor response or no response to anti...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
In conclusion, treatment outcomes in different domains seem to be linked to the client’s motivation to attend treatment and the feeling of being coerced into therapy, regardless of mandate (2). It has been argued that there is, potentially, an element of coercion in every clinical encounter (80) and the perception of coercion has a variety of determinants, many of which are dependent on the quality of relationship with the service provider (45). Therefore, reducing feelings of coercion might improve treatment outcomes, prevent disengagement from services, and ameliorate therapeutic relationships (5). Facilitating the...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusions: The findings from this exploratory study are consistent with the possibility that dialogue therapy may lead to improvements in symptoms and functioning compared to standard treatment in psychosis. Introduction Standard treatment (ST) for psychosis consists primarily of antipsychotics, hospitalization, social rehabilitation, and different types of supportive therapy (1–3). Antipsychotic drugs have only moderate effects on positive symptoms and no demonstrable effects on negative symptoms (4–6). Side effects are often prominent and might include a reduction in emotional expression, menstrual ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
This study examined all admissions for adults diagnosed with schizophrenia over a 6-month period in 2017 to an inpatient psychiatric unit situated in a nonprofit general hospital in Kingston, Ontario, Canada. The Health Quality Ontario standards for the inpatient care of adults with schizophrenia were used to assess the quality of care provided in hospital. Standards were determined to have been met by doing a thorough chart review for each patient, reviewing all documentation in progress notes, admission notes, discharge notes and emergency room notes for quality standard completion. RESULTS: The average length of st...
Source: Clinical and Investigative Medicine - Category: Biomedical Science Authors: Tags: Clin Invest Med Source Type: research
This study is a quantitative service evaluation project which uses a questionnaire design to explore the factors that influence a clinician ’s decision to refer a patient for CBTp. Three qualitative questions are included for thematic analysis to allow the respondents to elaborate on their views on potential barriers. All appropriate Community Mental Health Team (CMHT) staff in adult mental health in NHS Lothian were invited to partic ipate in the study. Findings CMHT staff in NHS Lothian hold favourable views of CBTp and would support an increase in access for patients with psychosis. Key barriers to access for CBTp...
Source: Mental Health Review Journal - Category: Psychiatry Source Type: research
CONCLUSION: Group CBTp can be an effective adjunctive psychological intervention in improving positive psychotic experiences among people with persistent psychotic symptoms, and can be applied in routine clinical practice. PMID: 30639991 [PubMed - as supplied by publisher]
Source: Asian Journal of Psychiatry - Category: Psychiatry Tags: Asian J Psychiatr Source Type: research
CONCLUSIONS: Relative to standard care alone, adding CBT to standard care appears to have no effect on long-term risk of relapse. A very small proportion of the available evidence indicated CBT plus standard care may improve long term global state and may reduce the risk of adverse events. Whether adding CBT to standard care leads to clinically important improvement in patients' long-term mental state, quality of life, and social function remains unclear. Satisfaction with care (measured as number of people leaving the study early) was no higher for participants receiving CBT compared to participants receiving standard car...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
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