Evid Based Nurs 3:116 doi:10.1136/ebn.3.4.116
  • Treatment

Cognitive behavioural therapy improved psychiatric symptoms in drug refractory schizophrenia

 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 …

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