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The British Journal of Psychiatry (2000) 177: 8-14
© 2000 The Royal College of Psychiatrists

Cognitive therapy and recovery from acute psychosis : a controlled trial

3. Five-year follow-up

VAL DRURY, ClinPsyD, Clinical Psychologist

Nottingham Healthcare NHS Trust

MAX BIRCHWOOD, FBPsS, Consultant Clinical Psychologist and Director

Early Intervention Service, Birmingham

RAY COCHRANE, FBPsS, Professor of Psychology

University of Birmingham

Correspondence: Dr Val Drury, Division of Psychiatry, University of Nottingham, Duncan MacMillan House, Porchester Road, Nottingham NG3 6AA UK

Declaration of interest None.

Background This paper describes the 5-year outcome of a cohort of patients who had received a cognitive therapy intervention during an acute episode of non-affective psychosis.

Method Thirty-four out of the original 40 patients who had taken part in a randomised controlled trial of a cognitive intervention were assessed, using standardised instruments completed at entry into the study. In the original trial, half the patients received a cognitive therapy programme (CT group) and the other half received recreational activities and support (ATY group).

Results At follow-up no significant differences in relapse rate, positive symptoms or insight between the groups were found, although the CT group did show significantly greater perceived ‘Control over illness’ than the ATY group. For individuals who had experienced a maximum of one relapse in the follow-up period, self-reported residual delusional beliefs and observer-rated hallucinations and delusions were significantly less in the CT than in the ATY group.

Conclusion Cognitive therapy applied in the acute phase of a psychotic disorder can produce enduring and significant clinical benefits if experience of relapse can be minimised.




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