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CBT does not improve relapse rates in people with recently relapsed psychosis

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QUESTION

Question:

What is the effect of cognitive behavioural therapy (CBT) and family intervention on relapse rates and symptoms in people with recently relapsed non-affective psychosis?

Patients:

301 people aged 18–65 years (218 without carers, 83 with carers) with non-affective psychosis (ICD-10 category F2 and DSM-IV) and a second or subsequent psychotic episode not more than 3 months before the trial began, plus a rating of at least 4 for one or more positive symptoms on the Positive and Negative Syndrome Scale (PANSS). Exclusion criteria: primary diagnosis of alcohol or substance dependency; intellectual disability or organic syndrome; unreliable residential arrangements; or limited spoken English.

Setting:

Five local mental health services, UK; recruitment 2002–2004.

Intervention:

People with carers randomly allocated to: CBT for psychosis (12–20 sessions over 9 months, targeting key aspects of relapse prevention) plus treatment as usual (TAU), family intervention plus TAU or TAU only. People without carers randomly allocated to: the same CBT regimen plus TAU or TAU only. Quality of and adherence to the CBT protocol was …

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