Tuesday, February 25, 2014

CBT More Efficacious Than Other Psychological Interventions for Positive Symptoms of Psychosis

Small but important differences in effectiveness of various psychological interventions for symptoms of psychosis emerged in a metanalysis, “Psychological Interventions for Psychosis: A Meta-Analysis of Comparative Outcome Studies,” in AJP in Advance (February 18, 2014).

Dutch researchers analyzed forty-eight outcome trials comparing psychological interventions for psychosis. The comparisons included 3,295 participants. Categorization of interventions resulted in six interventions being compared against other interventions pooled: Cognitive behavior therapy (CBT), supportive counselling, social skills training, psychoeducation, cognitive remediation and befriending. Separate sub-meta-analyses for positive, negative, or general symptoms were undertaken when there were sufficient studies assessing these outcomes.

CBT was significantly more efficacious than other interventions pooled in reducing positive symptoms, and significantly more efficacious when compared directly with befriending for overall symptoms and supportive counseling for positive symptoms. Social skills training was significantly more efficacious in reducing negative symptoms.

“Although the differences observed between interventions for psychosis were small in this meta-analysis, the relatively robust nature of the differences and the pattern by which differences occur have implications for the continued clinical implementation, design, and improvement of psychosocial therapies for psychosis," the researchers state.

For more on how CBT has been used in a city-wide system to treat symptoms of psychosis see the Psychiatric News article, “CBT Addresses Most Debilitating Symptoms in Chronic Schizophrenia.”



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