Haddock Gillian, Barrowclough Christine, Shaw Jennifer J, Dunn Graham, Novaco Raymond W, Tarrier Nicholas
School of Psychological Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
Br J Psychiatry. 2009 Feb;194(2):152-7. doi: 10.1192/bjp.bp.107.039859.
Aggression and violence are serious problems in schizophrenia. Cognitive-behavioural therapy (CBT) has been shown to be an effective treatment for psychosis although there have been no studies to date evaluating the impact of CBT for people with psychosis and a history of violence.
To investigate the effectiveness of CBT on violence, anger, psychosis and risk outcomes with people who had a diagnosis of schizophrenia and a history of violence.
This was a single-blind randomised controlled trial of CBT v. social activity therapy (SAT) with a primary outcome of violence and secondary outcomes of anger, symptoms, functioning and risk. Outcomes were evaluated by masked assessors at 6 and 12 months (trial registration: NRR NO50087441).
Significant benefits were shown for CBT compared with control over the intervention and follow-up period on violence, delusions and risk management.
Cognitive-behavioural therapy targeted at psychosis and anger may be an effective treatment for reducing the occurrence of violence and further investigation of its benefits is warranted.
攻击和暴力行为是精神分裂症中的严重问题。认知行为疗法（CBT）已被证明是治疗精神病的有效方法，尽管迄今为止尚无研究评估CBT对有暴力史的精神病患者的影响。
调查认知行为疗法对诊断为精神分裂症且有暴力史的患者在暴力、愤怒、精神病及风险方面的疗效。
这是一项认知行为疗法与社交活动疗法（SAT）的单盲随机对照试验，主要结局为暴力行为，次要结局为愤怒、症状、功能及风险。由经过盲法培训的评估人员在6个月和12个月时对结局进行评估（试验注册号：NRR NO50087441）。
与对照组相比，在干预期和随访期，认知行为疗法在暴力行为、妄想及风险管理方面显示出显著益处。
针对精神病和愤怒情绪的认知行为疗法可能是减少暴力行为发生的有效治疗方法，有必要对其益处进行进一步研究。
