Cognitive-behavioural therapy of positive symptoms in psychotic disorders - background and treatment rational of the POSITIVE-study

For a long time, psychotherapeutic interventions had not been considered as indicated for the treatment of psychotic disorders. However, in the middle of the nineties of the lost century British researchers systematically adopted cognitive behaviourally interventions for treatment of these severe mental diseases. In the meantime, there is a multitude of findings from randomised clinical trials which call the psychotherapeutic abstinence in this field into question. Meta-analyses showed moderate effect sizes about 0.4 for cognitive behavioural therapy (CBT) in addition to antipsychotic medication. On this background the current treatment guidelines recommend the implementation of CBT in routine treatment. Nevertheless, there remain many unanswered questions. In the framework of the BMBF-funded research networks on psychotherapy a multicenter clinical study addresses the question whether CBT is specifically efficacious or whether the described treatment effects might be ascribed to unspecific factors. The present paper presents the treatment rational of CBT on the basis of case vignettes.