Friday, November 30, 2012

Therapy Aimed at 'Cognitive Biases' May Avert Psychosis in At-Risk Individuals

A new cognitive-behavioral intervention specifically targeted at cognitive biases—the misleading or erroneous thoughts and ideas that accompany psychosis—appears to have a favorable effect on reducing the likelihood of an acute psychotic episode in individuals deemed to be at “ultra-high risk” for psychosis. That was the finding from a study, “Cognitive-Behavioral Therapy for Subjects at Ultrahigh Risk for Developing Psychosis: A Randomized, Controlled Clinical Trial,” appearing online in Schizophrenia Bulletin.

A total of 201 patients were recruited at four sites in the Netherlands and randomized to receive either cognitive-behavior therapy plus treatment as usual, or treatment as usual alone. (The cognitive-behavioral therapy was used as an add-on therapy because people were seeking help for a comorbid disorder.) The CBT was provided for 6 months, and the follow-up period was 18 months.

The CBT intervention is designed to address thoughts and ideas that are common to psychosis such as jumping to conclusions, selective attention to threatening stimuli, negative expectation bias and underrating of one’s capacities, and overrating the causal relationship between independent events.

Among patients receiving the CBT intervention, 10 transitioned to psychosis, compared with 22 who received only treatment as usual. At 18-month follow-up, the CBT group was significantly more often remitted from an at-risk mental state.

“In this group of UHR patients, a CBT intervention specifically targeting the appraisal of subclinical symptoms and teaching awareness of cognitive biases reduced the number of transitions to psychosis and increased the number of patients who no longer experience subclinical psychotic symptoms,” the authors state.

The study is posted here. For more information on this subject, see Psychiatric News here.

(Image: Andrea Michele Piacquadio/


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