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Integrating non-drug treatments in early schizophrenia

Division of Psychiatry, University of Manchester

NICOLAS TARRIER, PhD

School of Psychological Sciences, University of Manchester

RICHARD JAMES DRAKE, PhD, MRCPsych

Division of Psychiatry, University of Manchester, UK

Correspondence: Professor Shôn W. Lewis, Division of Psychiatry, University of Manchester, Second Floor, Education and Research Centre, Wythenshaw Hospital, Manchester M23 9LT. E-mail: shon.lewis{at}man.ac.uk

Declaration of interest S.L. has received fees for talks and consultancies from AstraZeneca, BMS, Pfizer, Wyeth, Lilly, Janssen and Novartis. He is an associate director of the UK Mental Health Research Network and a member of the MRC Neuroscience Board.

*Paper presented at the Third International Early Psychosis Conference, Copenhagen, Denmark, September 2002.

There is a range of psychological interventions for established schizophrenia. These include family interventions, motivational interventions for substance misuse and for non-adherence to medication, cognitive remediation for neurocognitive deficits and cognitive–behavioural therapy for symptoms. Psychological interventions may explicitly target risk factors for poor outcome, such as substance use, or protective factors, such as adherence to medication, or be directed at specific symptoms or deficits. There is emerging evidence for efficacy of psychological treatments during, following and even prior to the first episode. Important areas for further study are how different treatment modalities can interact productively, and patient and carer preferences for treatment. Many trials of psychological treatments have design flaws and this tends to overestimate the treatment effect.