Cognitive–behaviour therapy for schizophrenia: a review

Abstract

Most studies demonstrating the benefits of cognitive-behaviour therapy for schizophrenia were carried out in the 1990s. The majority targeted treatment resistant positive symptoms. Recent research is now focussing on the impact of cognitive-behaviour therapy on prodromal states, acute schizophrenia, negative symptoms, loss of insight and relapse prevention. There is mounting evidence to suggest that cognitive-behaviour therapy is an effective adjunct to antipsychotic medication in the management of positive symptoms of acute schizophrenia as well as negative and residual symptoms of chronic schizophrenia. The effect size at the end of therapy is strong, with durability at short-term follow up. There is also evidence that cognitive-behaviour therapy can be combined with family therapy and assertive community treatment programs targeted to reduce relapse. Cognitive-behaviour therapy improves the prognosis of patients with schizophrenia through improved adherence and symptom management leading to reduced relapse. It may prevent transition to psychosis in high-risk prodromal states. In conclusion, recent literature provides fairly strong evidence that cognitive-behaviour therapy in addition to antipsychotic medication is effective in the management of acute as well as chronic schizophrenia, However, despite its proven efficacy, it remains a rare commodity, especially outside the United Kingdom.