Michail Maria, Birchwood Max, Tait Lynda
School of Health Sciences, University of Nottingham, Jubilee Campus, Nottingham NG7 2TU, UK.
Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
Brain Sci. 2017 Apr 25;7(5):45. doi: 10.3390/brainsci7050045.
Social anxiety is highly prevalent among people with psychosis and linked with significant social disability and poorer prognosis. Although cognitive-behavioural therapy (CBT) has shown to be effective for the treatment of social anxiety in non-psychotic populations, there is a lack of evidence on the clinical effectiveness of CBT for the treatment of social anxiety when this is co-morbid in psychosis.
A systematic review to summarise and critically appraise the literature on the effectiveness of CBT interventions for the treatment of social anxiety in psychosis.
Two studies were included in the review assessing the effectiveness of group CBT for social anxiety in schizophrenia, both of poor methodological quality. Preliminary findings suggest that group-based CBT is effective in treating symptoms of social anxiety, depression and associated distress in people with schizophrenia.
The evidence-base is not robust enough to provide clear implications for practice about the effectiveness of CBT for the treatment of social anxiety in psychosis. Future research should focus on methodologically rigorous randomised controlled trials with embedded process evaluation to assess the effectiveness of CBT interventions in targeting symptoms of social anxiety in psychosis and identify mechanisms of change.
社交焦虑在精神病患者中极为普遍，与严重的社交功能障碍及较差的预后相关。尽管认知行为疗法（CBT）已被证明对非精神病患者的社交焦虑治疗有效，但对于精神病合并社交焦虑时CBT治疗的临床有效性，仍缺乏证据。
进行一项系统综述，以总结并批判性评价关于CBT干预对精神病患者社交焦虑治疗效果的文献。
该综述纳入了两项评估团体CBT对精神分裂症社交焦虑治疗效果的研究，两项研究的方法学质量均较差。初步研究结果表明，团体CBT对治疗精神分裂症患者的社交焦虑症状、抑郁及相关痛苦有效。
现有证据不够充分，无法为CBT治疗精神病患者社交焦虑的有效性提供明确的实践指导。未来的研究应聚焦于方法学严谨的随机对照试验，并进行嵌入式过程评估，以评估CBT干预针对精神病患者社交焦虑症状的有效性，并确定其改变机制。
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