Haddock G, Tarrier N, Morrison A P, Hopkins R, Drake R, Lewis S
Department of Clinical Psychology, University of Manchester, UK.
Soc Psychiatry Psychiatr Epidemiol. 1999 May;34(5):254-8. doi: 10.1007/s001270050141.
Recent research indicates that cognitive-behaviour therapy (CBT) can be effective in ameliorating persistent positive symptoms in chronic psychotic patients. The effectiveness of CBT in acute and recent-onset psychosis has been little explored, although a recent pilot study indicated that CBT could significantly improve recovery in acutely psychotic inpatients.
Short-term individual CBT was compared to supportive counselling/psychoeducation (SC) as an adjunct to standard inpatient hospital care and medication in 21 inpatients experiencing a recent-onset acute schizophrenic episode.
Both groups showed significant reductions in Brief Psychiatric Rating Scale (BPRS) scores following treatment, although there were no group differences. Time to discharge did not differ significantly between the groups, although there was a greater variance for the SC patients. Two-year follow-up showed no significant differences between the groups, although the number of patients who relapsed, the number of relapses and the time to recurrence of psychotic symptoms was lower in the CBT group than the SC group. Interestingly, the time to readmission was shorter in the CBT group.
CBT and SC are acceptable treatments for recent-onset acutely psychotic inpatients. A larger randomised controlled trial over multiple hospital sites is warranted.
近期研究表明，认知行为疗法（CBT）可有效改善慢性精神病患者持续存在的阳性症状。尽管最近一项初步研究表明，CBT可显著改善急性精神病住院患者的康复情况，但CBT在急性和近期发病精神病中的有效性鲜少得到探讨。
将短期个体CBT与支持性咨询/心理教育（SC）进行比较，作为21例近期发生急性精神分裂症发作的住院患者标准住院治疗和药物治疗的辅助手段。
两组治疗后简明精神病评定量表（BPRS）评分均显著降低，但两组之间无差异。两组出院时间无显著差异，尽管SC组患者的差异更大。两年随访显示两组之间无显著差异，尽管CBT组复发患者数量、复发次数及精神病症状复发时间均低于SC组。有趣的是，CBT组再次入院时间更短。
CBT和SC是近期发病的急性精神病住院患者可接受的治疗方法。有必要在多个医院开展更大规模的随机对照试验。
