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What is already known on this topic?
Individuals with psychotic disorders might choose to forgo antipsychotic medication because of side effects.1 Over 40 randomised controlled trials (RCT) have demonstrated that cognitive behavioural therapy for psychosis (CBTp) is generally efficacious in improving symptoms, with small to medium effect sizes in individuals with psychotic disorders.2 It was unknown, until now, if individuals with psychotic disorders who were antipsychotic-free could tolerate CBTp and benefit from it.
What this paper adds?
This is the first RCT to demonstrate that individuals with schizophrenia-spectrum psychotic disorder receiving clinical services in first episode of psychosis programmes but refusing all antipsychotic medication could tolerate and benefit from CBTp both in terms of symptoms and social functioning.
Morrison and colleagues offer insight into how symptoms change over 18 months in individuals not taking antipsychotics—whether receiving CBTp or otherwise—with few participants worsening overtime.
Most participants in the CBTp condition improved in terms of overall and positive symptoms. It is noteworthy that these improvements were comparable to those found in other …
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