Naeem Farooq, Farooq Saeed, Kingdon David
Department of Psychiatry, Queen's University, Kingston, ON, Canada.
Cochrane Database Syst Rev. 2015 Oct 21;2015(10):CD010646. doi: 10.1002/14651858.CD010646.pub3.
Cognitive behavioural therapy for people with schizophrenia is a psychotherapeutic approach that establishes links between thoughts, emotions and behaviours and challenges dysfunctional thoughts. There is some evidence to suggest that cognitive behavioural therapy for people with psychosis (CBTp) might be an effective treatment for people with schizophrenia. There are however, limitations in its provision due to available resource and training issues. One way to tackle this issue might be to offer a brief version of CBTp.
To review the effects of brief CBTp (6 to 10 regular sessions given in less than 4 months and using a manual) for people with schizophrenia compared with standard CBTp (12 to 20 regular sessions given in 4 to 6 months and using a manual).
We searched the Cochrane Schizophrenia Group's Trials Register (August 21, 2013 and August 26, 2015) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO and registries of Clinical Trials. There are no language, date, document type, or publication status limitations for inclusion of records in the register. We inspected all references of the selected articles for further relevant trials. We also contacted experts in the field regarding brief CBTp studies.
Randomised controlled trials involving adults with schizophrenia or related disorders, comparing brief cognitive behavioural therapy for people with psychosis versus standard CBTp.
Two review authors independently screened and assessed studies for inclusion using pre-specified inclusion criteria.
We found only seven studies which used a brief version of CBTp, but no study compared brief CBTp with CBTp of standard duration. No studies could be included.
AUTHORS' CONCLUSIONS: Currently there is no literature available to compare brief with standard CBTp for people with schizophrenia. We cannot, therefore, conclude whether brief CBTp is as effective, less effective or even more effective than standard courses of the same therapy. This lack of evidence for brief CBTp has serious implications for research and practice. Well planned, conducted and reported randomised trials are indicated.
针对精神分裂症患者的认知行为疗法是一种心理治疗方法，它在思想、情感和行为之间建立联系，并对功能失调的思想提出挑战。有证据表明，针对精神病患者的认知行为疗法（CBTp）可能是治疗精神分裂症患者的一种有效方法。然而，由于可用资源和培训问题，其应用存在局限性。解决这个问题的一种方法可能是提供简短版的CBTp。
比较简短版CBTp（在不到4个月的时间内进行6至10次常规治疗并使用手册）与标准CBTp（在4至6个月内进行12至20次常规治疗并使用手册）对精神分裂症患者的疗效。
我们检索了Cochrane精神分裂症研究组的试验注册库（2013年8月21日和2015年8月26日），该注册库基于对CINAHL、BIOSIS、AMED、EMBASE、PubMed、MEDLINE、PsycINFO的定期检索以及临床试验注册库。注册库中纳入记录没有语言、日期、文献类型或出版状态限制。我们检查了所选文章的所有参考文献以寻找进一步的相关试验。我们还就简短版CBTp研究联系了该领域的专家。
涉及成年精神分裂症患者或相关障碍患者的随机对照试验，比较针对精神病患者的简短认知行为疗法与标准CBTp。
两位综述作者独立使用预先指定的纳入标准筛选和评估研究以确定是否纳入。
我们仅发现七项使用简短版CBTp的研究，但没有研究将简短版CBTp与标准疗程的CBTp进行比较。无法纳入任何研究。
目前没有文献可用于比较简短版CBTp与标准CBTp对精神分裂症患者的疗效。因此，我们无法得出简短版CBTp与相同疗法的标准疗程相比是否同样有效、效果更差甚至效果更好的结论。缺乏关于简短版CBTp的证据对研究和实践具有严重影响。需要开展精心设计、实施和报告的随机试验。
