Cognitive therapy for the prevention of psychosis in people at ultra-high risk - Randomised controlled trial

被引:483
作者
Morrison, AP
French, P
Walford, L
Lewis, SW
Kilcommons, A
Green, J
Parker, S
Bentall, RP
机构
[1] Univ Manchester, Dept Psychol, Manchester M13 9PL, Lancs, England
[2] Univ Manchester, Psychiat Serv, Salford & Trafford Mental Hlth Trust, Manchester M13 9PL, Lancs, England
[3] Univ Manchester, Sch Psychiat & Behav Sci, Manchester M13 9PL, Lancs, England
关键词
D O I
10.1192/bjp.185.4.291
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background Advances in the ability to identify people at high risk of developing psychosis have generated interest in the possibility of preventing psychosis. Aims To evaluate the efficacy of cognitive therapy for the prevention of transition to psychosis. Method A randomised controlled trial compared cognitive therapy with treatment as usual in 58 patients at ultra-high risk of developing a first episode of psychosis. Therapy was provided over 6 months, and all patients were monitored on a monthly basis for 12 months. Results Logistic regression demonstrated that cognitive therapy significantly reduced the likelihood of making progression to psychosis as defined on the Positive and Negative Syndrome Scale over 12 months. In addition, it significantly reduced the likelihood of being prescribed antipsychotic medication and of meeting criteria for a DSM-IV diagnosis of a psychotic disorder. Analysis of covariance showed that the intervention also significantly improved positive symptoms of psychosis in this population over the 12-month period Conclusions Cognitive therapy appears to be an acceptable and efficacious intervention for people at high risk of developing psychosis. Declaration of interest None. Funding detailed in Acknowledgements.
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页码:291 / 297
页数:7
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