Tayside-Fife clinical trial of cognitive-behavioural therapy for medication-resistant psychotic symptoms - Results to 3-month follow-up

Background Evidence for the efficacy of cognitive - behavioural therapy for schizophrenia is promising but evidence for clinical effectiveness is limited. Aims To test the effectiveness of cognitive- behavioural therapy delivered by clinical nurse specialists in routine practice. Method Of 274 referrals, 66 were allocated randomly to 9 months of treatment as usual (TAU), cognitive-behavioural therapy plusTAU (CBT) or supportive psychotherapy plusTAU (SPT) and followed up for 3 months. Results Treatment effects were modest but the CBT condition gave significantly greater improvement in overall symptom severity than the SPT or TAU conditions combined (F (1,53) = 4.14; P = 0.05). Both the CBT and SPT conditions combined gave significantly greater improvement in severity of delusions than did the TAU condition (F (1,53)= 4.83; P = 0.03). Clinically significant improvements were achieved by 7/21 in the CBT condition (33%),3/19 in the SPT condition (16%) and 2/17 in the TAU condition (12%). Conclusions Cognitive-behavioural therapy delivered by clinical nurse specialists is a helpful adjunct to routine care for some people with chronic psychosis. Declaration of interest None.