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Cognitive–behavioural therapy for patients with schizophrenia: a multicentre randomized controlled trial in Beijing, China

Published online by Cambridge University Press:  23 December 2014

Z.-J. Li ,
Z.-H. Guo ,
N. Wang ,
Z.-Y. Xu ,
Y. Qu ,
X.-Q. Wang ,
J. Sun ,
L.-Q. Yan ,
R. M. K. Ng  and
D. Turkington
...Show all authors
Z.-J. Li*
Affiliation:
Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China
Z.-H. Guo
Affiliation:
Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China
N. Wang
Affiliation:
Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China
Z.-Y. Xu
Affiliation:
Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China
Y. Qu
Affiliation:
Beijing Huilongguan Hospital, Beijing, People's Republic of China
X.-Q. Wang
Affiliation:
Institute of Mental Health, Peking University (The Sixth Hospital, Peking University), Beijing, People's Republic of China
J. Sun
Affiliation:
Griffith Health Institute and School of Medicine, Griffith University, QLD 4222, Australia
L.-Q. Yan
Affiliation:
The Third Hospital of Chaoyang District, Beijing, People's Republic of China
R. M. K. Ng
Affiliation:
Department of Psychiatry, Kowloon Hospital, Hong Kong, People's Republic of China
D. Turkington
Affiliation:
University of Newcastle-on-Tyne, Newcastle, UK
D. Kingdon
Affiliation:
University of Southampton, Southampton, UK
*
* Address for correspondence: Z. J. Li, Ph.D., M.D., Department of Clinical Psychology, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Hutong, Deshengmen Wai, Xicheng District, Beijing 100088, People's Republic of China. (Email : [email protected])
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Abstract

Background

Meta-analyses support the efficacy of cognitive–behavioural therapy (CBT) for schizophrenia in western cultures. This study aimed to compare the efficacy of CBT and supportive therapy (ST) for patients with schizophrenia in China.

Method

A multicentre randomized controlled, single-blinded, parallel-group trial enrolled a sample of 192 patients with schizophrenia. All patients were offered 15 sessions of either CBT or ST over 24 weeks and followed up for an additional 60 weeks. All measures used were standardized instruments with good reliability and validity. The Positive and Negative Syndrome Scale (PANSS) was used to assess symptoms of schizophrenia. The Schedule for Assessing Insight (SAI) was used to assess patients’ insight and the Personal and Social Performance Scale (PSP) was used to assess their social functioning.

Results

Effect-size analysis showed that patients made rapid improvements in all symptoms, insight and social functioning as measured by the PANSS, SAI and PSP at 12 and 24 weeks and maintained these improvements over the course of the study to 84 weeks. Patients in the CBT group showed significantly greater and more durable improvement in PANSS total score (p = 0.045, between-group d = 0.48), positive symptoms (p = 0.018, between-group d = 0.42) and social functioning (p = 0.037, between-group d = 0.64), with significant differences emerging after completion of therapy.

Conclusions

Both CBT and ST combined with medication had benefits on psychopathology, insight and social functioning of patients with schizophrenia. CBT was significantly more effective than ST on overall, positive symptoms and social functioning of patients with schizophrenia in the long term.

Keywords

Cognitive–behavioural therapyrandomized controlled trialsschizophreniasupportive therapy
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 9 , July 2015 , pp. 1893 - 1905
Copyright
Copyright © Cambridge University Press 2014 

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