Talk Therapy of Limited Use for Psychosis
While they failed to show a statistically significant effect of the intervention, the authors said that the beneficial effect of the cognitive therapy on transition rate could not be ruled out.
Morrison and colleagues also noted that the findings imply the at-risk mental state paradigm may need updating. It “has been of great benefit in developing thinking about prevention, but these data suggest it needs further research and refinement,” they wrote.
Talk Therapy Lifts Severe Schizophrenics
New findings suggest that such patients have far more capability to improve their lives than was previously assumed and, if replicated, could change the way that doctors treat the one million patients for whom the disorder is profoundly limiting.
The therapy - a variant of cognitive behavior therapy, which focuses on defusing self-defeating assumptions - increased motivation and reduced symptoms. In previous studies, researchers have used cognitive techniques to help people with schizophrenia manage their hallucinations and sharpen their attention and memory. The new study is the first to rigorously test using the therapy to combat so-called negative symptoms - the listlessness, exhaustion and emotional flatness that trap many people in solitary lives, playing out their days smoking in front of the TV or holed up in their homes.
Dr. Bob Buchanan, a psychiatrist at the University of Maryland School of Medicine who was not involved in the study, said the results looked impressive. “This is a group of patients who have tried just about everything - drug treatments as well as psychosocial ones - and many clinicians and systems of care have essentially given up on them. If there’s an intervention out there that can make a difference, I think that’s an incredibly important development.”
They also called for future research examining developmental processes involved in the transition to psychosis, as well as resilience in at-risk patients.
The study was supported by the Medical Research Council and Department of Health.
The researchers reported no conflicts of interest.
Primary source: BMJ
Source reference: Morrison AP, et al “Early detection and intervention evaluation for people at risk of psychosis: Multisite randomized controlled trial” BMJ 2012; DOI: 10.1136/bmj.e2233.