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Cognitive-behavioural therapy role in the prevention of psychosis

Published online by Cambridge University Press:  13 August 2021

M. Pinho ,
D. Martins  and
S. Carvalho
M. Pinho*
Affiliation:
Department Of Psychiatry, Hospital de Magalhães Lemos, Porto, Portugal
D. Martins
Affiliation:
Department Of Psychiatry, Hospital de Magalhães Lemos, Porto, Portugal
S. Carvalho
Affiliation:
Department Of Psychiatry, Hospital de Magalhães Lemos, Porto, Portugal
*
*Corresponding author.

Abstract

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Introduction

About 30% of individuals in ultra-high risk (UHR) of psychosis develop overt psychosis within 3 years, and about 40% of those who don’t will keep experiencing ongoing attenuated psychotic symptoms and persistent functional disability. During this prodromal period, it’s possible to prevent the transition to a first-episode psychosis.

Objectives

To conduct a short review of literature on the role of cognitive-behavioural therapy (CBT) in preventing psychosis in ultra-high risk patients.

Methods

We performed a literature search on PUBMED, using the query: “Cognitive Behavioral Therapy” [Mesh] AND “psychosis” AND “prevention”. We focused on data from systematic reviews, clinical trials and meta-analysis published on last 5 years, either in English or Portuguese.

Results

Some authors claim cognitive-behavioural therapy (CBT) as first-choice treatment in clients with ultra-high risk (UHR) for psychosis. CBT aims to normalize extraordinary experiences with education and to prevent delusional explanations. On a Japanese study, the total score of Positive and Negative Syndrome Scale (PANSS) significantly improved on post-intervention and follow-up assessments, with large effect sizes observed. Teaching families to apply CBT with their offspring may bolster therapeutic gains made in time-limited treatment. CBT showed an 83% probability of being more effective and less costly than routine care.

Conclusions

Patients with UHR for psychosis can be treated successfully with CBT to postpone and prevent the transition to a first-episode psychosis. CBT for UHR has been included in the European guidelines and awaits dissemination and implementation in mental health services.

Keywords

cognitive-behavioural therapyUltra-High Riskpsychosisprevention
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S498
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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