© 2000 Evidence-Based Nursing
Cognitive behavioural therapy improved psychiatric symptoms in drug refractory schizophrenia
Sensky T, Turkington D, Kingdon D, et al.A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication.Arch Gen Psychiatry 2000 Feb;57:165–72
QUESTION: Is cognitive behavioural therapy (CBT) more effective than a befriending intervention for reducing psychiatric symptoms in drug refractory schizophrenia?
Randomised (allocation concealed), blinded (outcome assessors), controlled trial with 9 months of follow up after treatment.
5 clinical services in the UK (Newcastle, Cleveland, Durham, and 2 in west London).
90 patients who were 16–60 years of age (mean age 39 y, 59% men, 89% white), met ICD-10 research and DSM-IV criteria for schizophrenia, and had symptoms causing distress or dysfunction for 
6 months despite adequate doses of antipsychotic drugs. Follow up was 100% for all outcomes except for scores on the Scale for Assessment of Negative Symptoms (SANS), which had 98% follow up.
Patients were allocated to CBT (n=46) or befriending (n=44). Both interventions were done by the same experienced nurses. CBT involved attaining a collaborative understanding of the development of symptoms and working towards reducing distress and disability. The provision of CBT was guided by a manual and regular supervision. Befriending involved sessions focused on neutral topics (ie,
Clinical Nurse Specialist, Psychiatry Assistant Professor, School of Nursing McMaster University Hamilton, Ontario, Canada
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