Summary of Evidence of Psychotic Disorders

Question 1

National Institute for Clinical Excellence (2009) - Schizophrenia

Answer 1

Interventions
- CBT, Family therapy and Psychoeducation

Findings
- CBT was effective in reducing rehospitalisation rates up to 18 months posttreatment and there was also evidence indicating that length of stay in hospital was reduced. CBT was effective in reducing symptom severity both at treatment end and at 12 months follow up.

• When compared with any control or other active treatment, CBT was more effective in reducing depression. Although the evidence for CBT in relation to positive symptoms was more limited, data demonstrated some effect for hallucinations, but not for delusions.
• Family intervention appears to be an efficacious treatment for schizophrenia. Compared with standard care or other control conditions, family intervention reduced the risk of relapse at treatment end and up to 12 months posttreatment.
• Family intervention may also be effective in improving additional critical outcomes such as social functioning and disorder knowledge. When indirect comparisons were made between single family intervention and multiple
  family intervention, the data suggest that only the former may be efficacious in reducing hospital admission.

Question 2

Geraty et al (2008) - Schizophrenia - CBT & FT

Answer 2

Interventions
- CBT and Family Therapy

Findings
- Neither intervention had an effect on rates of remission and relapse or on days in hospital at 12-24 months

• CBT showed a beneficial effect on depression at 24 months but there were no effects for family intervention

Question 3

Penn et al (2009) - CBT - Schizophrenia

Answer 3

Interventions
- CBT

Findings
- Patients who received CBT were more likely both to resist voices and to rate them as less malevolent through 12 month follow up

• CBT reduces severity of auditory hallucinations

Question 4

Wykes et al (2008) - CBT - Schizophrenia

Answer 4

Interventions
- CBT

Findings
- CBT has beneficial effects on the target symptom as well as significant effects for positive and negative symptoms, functioning, mood and social anxiety

• However, there was no effect on hopelessness