Cognitive Therapy Reduces Schizophrenia Symptoms in Patients Who Refuse Medication — Physician’s First Watch
Cognitive Therapy Reduces Schizophrenia Symptoms in Patients Who Refuse Medication
By Amy Orciari Herman
Cognitive therapy helps reduce schizophrenia symptoms in patients who refuse drug therapy, according to a pilot study in the Lancet.
Seventy-four patients who'd chosen not to take medication for psychosis were randomized to cognitive therapy plus usual care or usual care alone. Cognitive therapy included some 30 sessions over 18 months.
The cognitive therapy group had lower schizophrenia symptom scores throughout the study, versus usual care alone. The benefits were seen largely for positive symptoms (e.g., hallucinations) rather than negative ones (e.g., apathetic social avoidance).
Peter Roy-Byrne, a psychiatrist with NEJM Journal Watch, commented: "This is a promising finding, but the sample size is small and may have included selected patients more able to tolerate psychotic symptoms without severe functional impact. Because studies of psychotherapy alone (without medication) as treatment for other severe disorders (e.g., bipolar disorder, ADHD) have not shown positive effects, this promising lead must be followed up in larger, more real-world samples to demonstrate generalizability."