St. Olavs University Hospital, Trondheim, Norway.
Behav Cogn Psychother. 2013 Oct;41(5):511-24. doi: 10.1017/S1352465813000258. Epub 2013 May 1.
Cognitive behavioural therapy for psychosis (CBTp) is currently a recommended form of psychosocial treatment for persons suffering from persistent psychotic symptoms. It has been argued that effect sizes from efficacy studies cannot be generalized to real clinical settings.
Our aim was to evaluate whether the positive results from randomized controlled trials conducted by experts could be replicated in clinical setting with a heterogeneous sample of patients with psychotic disorder.
Patients referred to the study were either randomized to CBTp+TAU (the treatment group) or to a waiting-list group, only receiving TAU. The patients were assessed on different outcome measures such as the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS), and the Psychotic Symptom Rating Scales (PSYRATS), at pretreatment, at posttreatment (6 months), and at 12 months follow-up. In total, 45 patients participated in the study.
The results showed that 20 sessions of CBTp performed significantly better than the waiting list controls with respect to the global score on the BPRS, the delusional scale on the PSYRATS, and the GAF symptom score at posttreatment. At 12 months follow-up only the GAF symptom score remained significantly changed for the total sample.
The study revealed that CBTp delivered by non-experts in routine clinical settings can produce improvements in positive psychotic symptoms, and also that some of these improvements can be maintained at one year follow-up.
认知行为疗法（CBTp）是目前针对持续性精神病症状患者推荐的心理社会治疗形式。有人认为，从疗效研究中得出的效果大小不能推广到实际的临床环境中。
我们的目的是评估专家进行的随机对照试验的积极结果是否可以在具有精神障碍异质患者的临床环境中复制。
被转介到研究中的患者要么被随机分配到 CBTp+TAU（治疗组）或仅接受 TAU 的等待名单组。患者在不同的结果测量中进行评估，如简明精神病评定量表（BPRS）、阴性症状评定量表（SANS）和精神病症状评定量表（PSYRATS），在治疗前、治疗后（6 个月）和 12 个月随访时进行评估。共有 45 名患者参加了研究。
结果表明，与等待名单对照组相比，20 次 CBTp 在 BPRS 的总体评分、PSYRATS 的妄想量表和 GAF 症状评分方面表现出显著改善，在治疗后。在 12 个月的随访中，只有总样本的 GAF 症状评分仍然显著改变。
该研究表明，常规临床环境中的非专家提供的 CBTp 可以改善阳性精神病症状，而且其中一些改善可以在一年的随访中维持。
