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CBT ineffective for schizophrenia

CBT is not an effective treatment for people with schizophrenia, and only has limited effect on depression, say University of Hertfordshire researchers.

The team from the university’s school of psychology looked at clinical trials which compared cognitive behavioural therapy (CBT) with a ‘psychological placebo’.

They also investigated the impact of ‘blinding’ – whether or not the people who assessed the patients knew if they were receiving active treatment or not.

Both of these factors are considered essential before a drug treatment is approved for use in psychiatric disorders. But according to the researchers, not a single trial they reviewed that employed blinding and psychological placebo found CBT to be effective in reducing symptoms or preventing relapses in people withschizophrenia.

The therapy is also ineffective in preventing relapses in bipolar disorder, and only has a weak effect in reducing symptoms of major depression, the researchers said.

However, CBT does have a greater effect in preventing relapses in people with depression, they acknowledged.

Lead study author, professor Keith Laws, said: ‘The results of this review are important because in March NICE re-approved CBT for use in all people with schizophrenia.

‘The government is also investing millions of pounds to provide CBT for depression and anxiety in 250 dedicated therapy centres in England. Yet the evidence here is that the effectiveness of this form of therapy may be less than previously thought, to the point of being non-existent in schizophrenia,’ he added.

The study findings are published online in the journal Psychological Medicine.

Readers' comments (2)

  • I had a course of CBT for psychosis in 2006 and it changed my life, since then I have been able to go to university because it gave me the resources to better manage my symptoms. So the findings have no correlation to my experience.

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  • The above findings seem strange when so much money has been spent on short term CBT to get people with depression back to work rapidly. It seems these treatments are more for the benefits of the NHS to reduce waiting lists for therapy for people suffering depression and to aleviate the work of the GPs and as a cost cutting measure. The problem is that there is no 'one case fits all' as far as MH is concerned and the needs of each patient have to be evaluated individually and a treatment plan implemented accordingly. It seems that suddenly everybody is being trained in a short course of CBT to deliver to patients without the proper theoretical background acquired by psychologists and psychiatrists, psychotherapists and possibly some MH nurses. This is a waste of resources, not necessarily beneficial to patients and can be harmful.
    Why don't the NHS and the government research their projects thoroughly and support their results with valid research results, which should be published for all to see, before pouring vast sums of money into them instead of basing their results on a few small studies which are not necessarily representative of the general population? This would be far better than spending money here on projects based on some piddling little studies.

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