The British Journal of Psychiatry (2009) 194: 152-157. doi: 10.1192/bjp.bp.107.039859
© 2009 The Royal College of Psychiatrists
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Cognitive–behavioural therapy v. social activity therapy for people with psychosis and a history of violence: randomised controlled trial

Gillian Haddock and Christine Barrowclough

School of Psychological Sciences, University of Manchester, UK

Jennifer J. Shaw and Graham Dunn

School of Community Based Medicine, University of Manchester, UK

Raymond W. Novaco

Department of Psychology and Social Behavior, University of California at Irvine, California, USA

Nicholas Tarrier

School of Psychological Sciences, University of Manchester, UK

Correspondence: Gillian Haddock, School of Psychological Sciences, Zochonis Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. Email: gillian.haddock{at}manchester.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Aggression and violence are serious problems in schizophrenia. Cognitive–behavioural therapy (CBT) has been shown to be an effective treatment for psychosis although there have been no studies to date evaluating the impact of CBT for people with psychosis and a history of violence.

Aims

To investigate the effectiveness of CBT on violence, anger, psychosis and risk outcomes with people who had a diagnosis of schizophrenia and a history of violence.

Method

This was a single-blind randomised controlled trial of CBT v. social activity therapy (SAT) with a primary outcome of violence and secondary outcomes of anger, symptoms, functioning and risk. Outcomes were evaluated by masked assessors at 6 and 12 months (trial registration: NRR NO50087441).

Results

Significant benefits were shown for CBT compared with control over the intervention and follow-up period on violence, delusions and risk management.

Conclusions

Cognitive–behavioural therapy targeted at psychosis and anger may be an effective treatment for reducing the occurrence of violence and further investigation of its benefits is warranted.


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