Schizophrenia - psychological therapies

Question 1

Rector and Beck - CBT

Answer 1

• reviewed trials
• concluded that CBT and routine care led to substantial pretreatment/postreatment improvements in positive symptoms, negative symptoms and total symptoms
• effect size was 1.23

Question 2

Gould - CBT

Answer 2

• results from 7 controlled trials
• meta-analysis
• large effect size for reduction in psychotic symptoms
• effect size was 0.65
• only used 7 trials, 5 were significant

Question 3

Jones - CBT

Answer 3

• compared CBT with other psychological therapies
• all randomised controlled trials
• often small
• no difference in overall effectiveness between CBT and other talking therapies
• no better at improving mental state and no better at managing symptoms
• references inspected and authors contacted

Question 4

Pharaoh - family intervention

Answer 4

• review
• selected RCTs
• 53 trials
• found that family intervention decreases frequency of relapse and reduces hospital admissions and encourages compliance with medicatoin
• improve general social impairment and levels of EE within the family

Question 5

Wu - family intervention

Answer 5

• chinese database for reports of RCTs
• from intial sample of 37,313 only 3137 were actually RCTs
• only 207 had acceptable methodology
• randomisation may have stated to been used but was not; issue for Pharaoh study?

Question 6

McCreadie - family intervention

Answer 6

• 63 relatives of 52 schizophrenics were offered package of treatments: education seminars, relative groups and family meetings
• 32 refused, of 31 who agreed 14 didn’t show up
• participant attrition, time consuming, sceptical, don;t want to admit they have a role in the illness