Gumley A, O'Grady M, McNay L, Reilly J, Power K, Norrie J
Department of Psychological Medicine, University of Glasgow, Gartnavel Royal Hospital, Robertson Centre for Biostatistics.
Psychol Med. 2003 Apr;33(3):419-31. doi: 10.1017/s0033291703007323.
The paper describes a randomized controlled trial of targeting cognitive behavioural therapy (CBT) during prodromal or early signs of relapse in schizophrenia. We hypothesized that CBT would result in reduced admission and relapse, reduced positive and negative symptoms, and improved social functioning.
A total of 144 participants with schizophrenia or a related disorder were randomized to receive either treatment as usual (TAU) (N = 72) or CBT+TAU (N = 72). Participants were prospectively followed up between entry and 12 months.
At 12 months, 11 (15.3%) participants in the CBT group were admitted to hospital compared to 19 (26.4%) of the TAU group (hazard ratio = 0.53, P = 0.10, 95% CI 0.25, 1.10). A total of 13 (18.1%) participants in CBT relapsed compared to 25 (34.7%) in TAU (hazard ratio = 0.47, P < 0O05, 95% CI 0.24, 0.92). In addition, the CBT group showed significantly greater improvement in positive symptoms, negative symptoms, global psychopathology, performance of independent functions and prosocial activities.
The study provides evidence for the feasibility and effectiveness for targeting CBT on the appearance of early signs of relapse in schizophrenia. The results are discussed in context of the study's methodological limitations.
本文描述了一项针对精神分裂症前驱期或复发早期症状进行认知行为疗法（CBT）的随机对照试验。我们假设CBT会减少住院和复发情况，减轻阳性和阴性症状，并改善社会功能。
总共144名患有精神分裂症或相关疾病的参与者被随机分为两组，一组接受常规治疗（TAU）（N = 72），另一组接受CBT + TAU（N = 72）。对参与者在入组至12个月期间进行前瞻性随访。
在12个月时，CBT组有11名（15.3%）参与者住院，而TAU组有19名（26.4%）（风险比 = 0.53，P = 0.10，95%置信区间0.25，1.10）。CBT组共有13名（18.1%）参与者复发，而TAU组有25名（34.7%）（风险比 = 0.47，P < 0.005，95%置信区间0.24，0.92）。此外，CBT组在阳性症状、阴性症状、整体精神病理学、独立功能表现和亲社会活动方面有显著更大的改善。
该研究为针对精神分裂症复发早期迹象进行CBT的可行性和有效性提供了证据。研究结果在研究方法局限性的背景下进行了讨论。
