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Randomised controlled trial of cognitive—behavioural therapy in early schizophrenia: acute-phase outcomes^*

School of Psychiatry and Behavioural Sciences, University of Manchester, UK

NICHOLAS TARRIER, PhD, GILLIAN HADDOCK, PhD and RICHARD BENTALL, PhD

School of Psychology, University of Manchester

PETER KINDERMAN, PhD

University Department of Clinical Psychology, University of Liverpool

DAVID KINGDON, FRCPsych

University Department of Mental Health, University of Southampton

RONALD SIDDLE, PhD and RICHARD DRAKE, MRCPsych

School of Psychiatry and Behavioural Sciences, University of Manchester

JULIE EVERITT, MSc

School of Nursing, University of Manchester

KAREN LEADLEY, MSc

York Mental Health Trust, York

ANDY BENN, MSc

Rampton Special Hospital Authority, Nottinghamshire

KATY GRAZEBROOK, MSc, CLIFF HALEY, MRCPsych, SHAHID AKHTAR, MB and LINDA DAVIES, MSc

School of Psychiatry and Behavioural Sciences, University of Manchester

STEVE PALMER, MSc

Centre for Health Economics, University of York

BRIAN FARAGHER, PhD

Department of Occupational Psychology, University of Manchester Institute of Science and Technology

GRAHAM DUNN, PhD

School of Epidemiology and Health Sciences, University of Manchester, UK

Correspondence: Professor Shôn Lewis, School of Psychiatry and Behavioural Sciences, University of Manchester, Wythenshawe Hospital, Manchester M23 9LT, UK

Declaration of interest None.

Funding detailed in Acknowledgements.

^* Presented in part at the European First Episode Schizophrenia Network Meeting, Whistler BC, Canada, 28 April 2001.

Background Cognitive—behavioural therapy (CBT) improves persistent psychotic symptoms.

Aims To test the effectiveness of added CBT in accelerating remission from acute psychotic symptoms in early schizophrenia.

Method A 5-week CBT programme plus routine care was compared with supportive counselling plus routine care and routine care alone in a multi-centre trial randomising 315 people with DSM—IV schizophrenia and related disorders in their first (83%) or second acute admission. Outcome assessments were blinded.

Results Linear regression over 70 days showed predicted trends towards faster improvement in the CBT group.

Uncorrected univariate comparisons showed significant benefits at 4 but not 6 weeks for CBTv. routine care alone on Positive and Negative Syndrome Scale total and positive sub-scale scores and delusion score and benefits v. supportive counselling for auditory hallucinations score.

Conclusions CBT shows transient advantages over routine care alone or supportive counselling in speeding remission from acute symptoms in early schizophrenia.

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