A randomized controlled trial of cognitive-behavior therapy for persistent symptoms in schizophrenia: A five-year follow-up

Turkington, Douglas; Sensky, Tom; Scott, Jan; Barnes, Thomas RE; Nur, Ula; Siddle, Ronald; Hammond, Katherine; Samarasekara, Neshika; Kingdon, David

doi:10.1016/j.schres.2007.09.026

« Previous Next »Schizophrenia Research
Volume 98, Issue 1 , Pages 1-7, January 2008

A randomized controlled trial of cognitive-behavior therapy for persistent symptoms in schizophrenia: A five-year follow-up

Douglas Turkington
- School of Neurology, Neurobiology and Psychiatry, Royal Victoria Infirmary, Leazes Wing, Richardson Road, University of Newcastle, Newcastle upon Tyne, Tyne and Wear, NE1 4LP, UK
- Corresponding author. Tel.: +44 1912824842; fax: +44 1912824839.
Tom Sensky
- Division of Neuroscience and Mental Health, Imperial College, London, UK
Jan Scott
- Department of Psychological Medicine, PO Box 96, Institute of Psychiatry, London, UK
Thomas RE Barnes
- Division of Neuroscience and Mental Health, Imperial College, London, UK
Ula Nur
- Division of Neuroscience and Mental Health, Imperial College, London, UK
Ronald Siddle
- Department of Psychiatry, University of Manchester, Withington Hospital, Manchester, UK
Katherine Hammond
- School of Neurology, Neurobiology and Psychiatry, Royal Victoria Infirmary, Leazes Wing, Richardson Road, University of Newcastle, Newcastle upon Tyne, Tyne and Wear, NE1 4LP, UK
Neshika Samarasekara
- School of Neurology, Neurobiology and Psychiatry, Royal Victoria Infirmary, Leazes Wing, Richardson Road, University of Newcastle, Newcastle upon Tyne, Tyne and Wear, NE1 4LP, UK
David Kingdon
- Mental Health Group, University of Southampton, Southampton, UK

Received 3 July 2007; received in revised form 11 September 2007; accepted 18 September 2007. published online 16 October 2007.

Abstract

Meta-analyses of randomized controlled trials support the efficacy of cognitive behavioral therapy (CBT) in the treatment of symptoms of schizophrenia refractory to antipsychotic medication. This article addresses the issue of medium term durability. A five-year follow-up was undertaken of a sample of 90 subjects who participated in a randomized controlled trial of CBT and befriending (BF). Patients received routine care throughout the trial and the follow-up period. Intention to treat multivariate analysis was performed by an independent statistician following multiple imputation of missing data. Fifty-nine out of ninety patients were followed up at 5 years (CBT=31, BF=28). In comparison to BF and usual treatment, CBT showed evidence of a significantly greater and more durable effect on overall symptom severity (NNT=10.36, CI −10.21, 10.51) and level of negative symptoms (NNT=5.22, CI −5.06 −5.37). No difference was found between CBT and BF on either overall symptoms of schizophrenia or depression. The initial cost of an adjunctive course of CBT for individuals with medication refractory schizophrenia may be justified in light of symptomatic benefits that persist over the medium term.