The long-term benefits of CBT for schizophrenia

Not only can cognitive behavioural therapy (CBT) provide sufferers of schizophrenia with additional benefits above and beyond those gained from taking anti-psychotic medication, but some of these benefits continue to persist two years later. Furthermore, the extra expense of providing cognitive behavioural therapy to these patients is offset by money saved from the patients spending less time in hospital.

Mike Startup (University of Newcastle, Australia) and colleagues at the University of Wales, UK, recruited 90 patients with schizophrenia spectrum disorder who had been admitted to hospital suffering from an acute episode of psychosis. Forty-three of them were given treatment-as-usual, which included anti-psychotic medication and nursing care. Forty-seven of them were additionally given up to 25 90-minute sessions of CBT provided by one of three clinical psychologists.

A previous study found that a year after their hospital admission, those patients given CBT on top of treatment-as-usual had fewer positive symptoms (hallucinations and delusions), fewer negative symptoms (for example apathy and lack of emotion) and better social functioning. Now Startup’s team have managed to test 73 per cent of the original sample two years after their hospital admission, and they’ve found that the CBT group still enjoy fewer negative symptoms and better social functioning than the treatment-as-usual group. Moreover, they estimated that the extra cost of providing CBT (average of £769 per patient over the two years) was compensated by savings gained by the CBT patients tending to spend less time in hospital (estimated £2704 average saving per patient).

“CBT for patients with schizophrenia who have been admitted to hospital as a result of an acute psychotic episode is likely to be no more expensive than routine care, but should secure for those patients advantages in terms of negative symptoms and social functioning which persist for at least two years”, the researchers concluded.
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Startup, M., Jackson, M.C., Evans, K.E. & Bendix, S. (2005). North Wales randomised controlled trial of cognitive behaviour therapy for acute schizophrenia spectrum disorders: two-year follow-up and economic evaluation.Psychological Medicine, 35, 1307-1316.

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