Outcomes of an effectiveness trial of cognitive–behavioural intervention by mental health nurses in schizophrenia

Background Little is known about the medium-term durability of cognitive–behavioural therapy (CBT) in a community sample of people with schizophrenia. Aims To investigate whether brief CBT produces clinically important outcomes in relation to recovery, symptom burden and readmission to hospital in people with schizophrenia at 1-year follow-up. Method Participants (336 of 422 randomised at baseline) were followed up at a mean of 388 days (s.d. =53) by raters masked to treatment allocation (CBT or usual care). Results At 1-year follow-up, participants who received CBT had significantly more insight (P=0.021) and significantly fewer negative symptoms (P=0.002). Brief therapy protected against depression with improving insight and against relapse; significantly reduced time spent in hospital for those who did relapse and delayed time to admission. It did not improve psychotic symptoms or occupational recovery, nor have a lasting effect on overall symptoms or depression at follow-up. Conclusions Mental health nurses should be trained in brief CBT for schizophrenia to supplement case management, family interventions and expert therapy for treatment resistance.