Cognitive therapy can help reduce the severity psychotic symptoms in patients who are at high risk of developing schizophrenia and other serious mental disorders, claims a study published by BMJ.
Authors from several UK universities (Birmingham, Glasgow, Cambridge, Manchester and UEA), led by the University of Manchester, set out to determine whether cognitive therapy, combined with monitoring, is effective in preventing the development and worsening of psychotic symptoms which can lead to schizophrenia, in young adults who were actively seeking help and were considered at high risk of developing schizophrenia and similar serious mental disorders. Risk factors included having intermittent or very mild symptoms suggesting psychosis, or schizophrenia-like personality problems, or having at least one close relative with psychosis. Monitoring was defined as aiming to provide warm, emphatic and supportive face-to-face contact.
The 288 young people in the trial were between the ages of 14 and 35 and came from across the UK: Manchester, Birmingham, Worcestershire, Glasgow, Cambridge and Norfolk. 114 were assigned at random to cognitive therapy and 144 to monitoring of mental state alone and were followed up for two years. Those in the cognitive therapy group had up to 26 weekly sessions over six months and all patients had access to a GP throughout the trial if they required.
The study found that the effect of monitoring sessions were greater than originally expected, mainly because they provided regular contact for the patients. This is consistent with earlier findings that brief, simple psychological interventions that target worry have significant effect on psychotic experiences.
The authors suggest that depression and anxiety among this age group, in conjunction with psychotic experiences, are common, and should be considered as suitable treatment targets. They conclude the importance of "future research [which] examines the developmental process in the transition to psychosis" and that anti-psychotic medication should not be offered as the first option to people at risk of developing schizophrenia, since more benign options appear equally effective.