Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T19:48:08.698Z Has data issue: false hasContentIssue false

Authors' reply

Published online by Cambridge University Press:  02 January 2018

P. J. McKenna
Affiliation:
Germanes Hospitalàries Research Foundation and CIBERSAM, Spain. Email: [email protected]
K. R. Laws
Affiliation:
School of Life and Medical Sciences, University of Hertfordshire, UK
S. Jauhar
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, UK
Rights & Permissions [Opens in a new window]

Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2015 

Gold's findings using the end-of-treatment effect sizes from our meta-analysis of CBT for schizophrenia Reference Jauhar, McKenna, Radua, Fung, Salvador and Laws1 (available at www.cbtinschizophrenia.com) are of interest and may have implications for clinical practice. In particular, the National Institute for Health and Care Excellence's 2 (NICE) current recommendations that at least 16 sessions of therapy should be provided now seem open to question. As noted by Taylor & Perera Reference Taylor and Perera3 in their recent editorial in the BJPsych, this view is not evidence-based; instead it appears to derive from an impression gained by the Guideline Development Group that ‘the evidence for CBT is primarily driven by studies that included at least 16 planned sessions' (NICE, 2 p. 240).

Our database might additionally be used to examine two important claims about CBT for schizophrenia that have surfaced in the past year, one that it has more pronounced effects in treatment-resistant patients, Reference Burns, Erickson and Brenner4 and the other that it is most effective when delivered in an individually tailored, formulation-based form. Reference van der Gaag, Valmaggia and Smit5 Both these claims are based on meta-analyses that included only quite limited numbers of studies (12 and 13 respectively) and so could benefit from being examined in the full data-set of available studies.

References

1 Jauhar, S, McKenna, PJ, Radua, J, Fung, E, Salvador, R, Laws, KR. Cognitive–behavioural therapy for the symptoms of schizophrenia: systematic review and meta-analysis with examination of potential bias. Br J Psychiatry 2014; 204: 20–9.Google Scholar
2 National Institute for Health and Care Excellence. Psychosis and Schizophrenia in Adults: Treatment and Management (NICE Clinical Guideline CG178). NICE, 2014.Google Scholar
3 Taylor, M, Perera, U. NICE CG178 Psychosis and Schizophrenia in Adults: Treatment and Management – an evidence-based guideline? Br J Psychiatry 2015; 206: 357–9.CrossRefGoogle ScholarPubMed
4 Burns, AM, Erickson, DH, Brenner, CA. Cognitive-behavioral therapy for medication-resistant psychosis: a meta-analytic review. Psychiatr Serv 2014; 65: 874–80.CrossRefGoogle ScholarPubMed
5 van der Gaag, M, Valmaggia, LR, Smit, F. The effects of individually tailored formulation-based cognitive behavioural therapy in auditory hallucinations and delusions: a meta-analysis. Schizophr Res 2014; 156: 30–7.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.