Treatment-Resistant to Antipsychotics: A Resistance to Everything? Psychotherapy in Treatment-Resistant Schizophrenia and Nonaffective Psychosis: A 25-Year Systematic Review and Exploratory Meta-Analysis

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 antipsychotics (1–7), demonstrating persistent positive symptoms (i.e., hallucinations, delusions). The experience of persistent delusions and hallucinations may result in further disability, poor prognosis, and risk of suicide (8, 9). Finally, treatment-resistant psychosis (TRP) is responsible for increasing health assistance expenditure. For instance, in the United States, treatment-resistant schizophrenia (TRS) adds more than 34 billion dollars in the annual direct medical costs (10).In the presence of pharmacological treatment resistance, can nonpharmacological, psychotherapy-based interventions significantly overcome the therapeutic response deadlock? Which psychotherapy in combination with antipsychotics does work better? Finally, what are the limitations and the pitfalls of the research on psychotherapy in TRS and TRP?This review aims to provi...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research