Rights statement: This is the author’s version of a work that was accepted for publication in Psychiatry Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Psychiatry Research, 285, 2020 DOI: 10.1016/j.psychres.2020.112806
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Final published version
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - Is cognitive behavioural therapy effective for individuals experiencing thought disorder?
AU - Shryane, Nick
AU - Drake, Richard
AU - Morrison, Anthony P.
AU - Palmier-Claus, Jasper
N1 - This is the author’s version of a work that was accepted for publication in Psychiatry Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Psychiatry Research, 285, 2020 DOI: 10.1016/j.psychres.2020.112806
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Various clinical guidelines recommend cognitive behavioural therapy (CBT) to treat psychosis without reference to patients’ thought disorder. However, there is a risk that disorganized thinking hampers CBT. We tested the prediction that thought disorder would interfere with the effectiveness of CBT for hallucinations and delusions, compared to treatment as usual and supportive counselling, in secondary data from two large, single blind randomised controlled trials. We fitted latent growth curve models separately for the development of frequency and distress of symptoms. CBT was significantly more successful than counselling in reducing delusional frequency in the short term and hallucinatory distress at any point, even in those with relatively high thought disorder. We found little evidence that clinicians should restrict CBT in this subgroup of patients. Nevertheless, the findings highlight the importance of effective initial treatment of thought disorder in maximising the benefit of CBT for psychosis, particularly for reducing distress from hallucinations.
AB - Various clinical guidelines recommend cognitive behavioural therapy (CBT) to treat psychosis without reference to patients’ thought disorder. However, there is a risk that disorganized thinking hampers CBT. We tested the prediction that thought disorder would interfere with the effectiveness of CBT for hallucinations and delusions, compared to treatment as usual and supportive counselling, in secondary data from two large, single blind randomised controlled trials. We fitted latent growth curve models separately for the development of frequency and distress of symptoms. CBT was significantly more successful than counselling in reducing delusional frequency in the short term and hallucinatory distress at any point, even in those with relatively high thought disorder. We found little evidence that clinicians should restrict CBT in this subgroup of patients. Nevertheless, the findings highlight the importance of effective initial treatment of thought disorder in maximising the benefit of CBT for psychosis, particularly for reducing distress from hallucinations.
KW - Psychosis
KW - Cognitive Behavioural Therapy
KW - Thought Disorder
KW - Randomized Controlled Trial
U2 - 10.1016/j.psychres.2020.112806
DO - 10.1016/j.psychres.2020.112806
M3 - Journal article
VL - 285
JO - Psychiatry Research
JF - Psychiatry Research
SN - 0165-1781
M1 - 112806
ER -