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Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis
Cognitive Behavior Therapy for psychosis (CBTp) is an effective treatment resulting in small to medium effect sizes with regard to changes in positive symptoms and psychopathology. As a consequence, CBTp is recommended by national guidelines for all patients with schizophrenia. However, although CBT...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593948/ https://www.ncbi.nlm.nih.gov/pubmed/26500570 http://dx.doi.org/10.3389/fpsyg.2015.01450 |
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author | Mehl, Stephanie Werner, Dirk Lincoln, Tania M. |
author_facet | Mehl, Stephanie Werner, Dirk Lincoln, Tania M. |
author_sort | Mehl, Stephanie |
collection | PubMed |
description | Cognitive Behavior Therapy for psychosis (CBTp) is an effective treatment resulting in small to medium effect sizes with regard to changes in positive symptoms and psychopathology. As a consequence, CBTp is recommended by national guidelines for all patients with schizophrenia. However, although CBTp was originally developed as a means to improve delusions, meta-analyses have generally integrated effects for positive symptoms rather than for delusions. Thus, it is still an open question whether CBTp is more effective with regard to change in delusions compared to treatment as usual (TAU) and to other interventions, and whether this effect remains stable over a follow-up period. Moreover, it would be interesting to explore whether newer studies that focus on specific factors involved in the formation and maintenance of delusions (causal-interventionist approach) are more effective than the first generation of CBTp studies. A systematic search of the trial literature identified 19 RCTs that compared CBTp with TAU and/or other interventions and reported delusions as an outcome measure. Meta-analytic integration resulted in a significant small to medium effect size for CBTp in comparison to TAU at end-of-therapy (k = 13; [Formula: see text] = 0.27). However, the comparison between CBTp and TAU after an average follow-up period of 47 weeks was not statistically significant (k = 12, [Formula: see text] = 0.16). When compared with other interventions, there was no significant effect of CBTp at end-of-therapy (k = 8; [Formula: see text] = 0.16) and after a follow-up period (k = 5; [Formula: see text] = −0.04). Comparison between newer studies taking a causal-interventionist approach (k = 4) and first-generation studies showed a difference of 0.33 in mean effect sizes in favor of newer studies at end-of-therapy. The findings suggest that CBTp is superior to TAU post-therapy in bringing about a change in delusions, but that this change may not be maintained over the follow-up period. Moreover, interventions that focus on causal factors of delusions seem to be a promising approach to improving interventions for delusions. |
format | Online Article Text |
id | pubmed-4593948 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-45939482015-10-23 Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis Mehl, Stephanie Werner, Dirk Lincoln, Tania M. Front Psychol Psychology Cognitive Behavior Therapy for psychosis (CBTp) is an effective treatment resulting in small to medium effect sizes with regard to changes in positive symptoms and psychopathology. As a consequence, CBTp is recommended by national guidelines for all patients with schizophrenia. However, although CBTp was originally developed as a means to improve delusions, meta-analyses have generally integrated effects for positive symptoms rather than for delusions. Thus, it is still an open question whether CBTp is more effective with regard to change in delusions compared to treatment as usual (TAU) and to other interventions, and whether this effect remains stable over a follow-up period. Moreover, it would be interesting to explore whether newer studies that focus on specific factors involved in the formation and maintenance of delusions (causal-interventionist approach) are more effective than the first generation of CBTp studies. A systematic search of the trial literature identified 19 RCTs that compared CBTp with TAU and/or other interventions and reported delusions as an outcome measure. Meta-analytic integration resulted in a significant small to medium effect size for CBTp in comparison to TAU at end-of-therapy (k = 13; [Formula: see text] = 0.27). However, the comparison between CBTp and TAU after an average follow-up period of 47 weeks was not statistically significant (k = 12, [Formula: see text] = 0.16). When compared with other interventions, there was no significant effect of CBTp at end-of-therapy (k = 8; [Formula: see text] = 0.16) and after a follow-up period (k = 5; [Formula: see text] = −0.04). Comparison between newer studies taking a causal-interventionist approach (k = 4) and first-generation studies showed a difference of 0.33 in mean effect sizes in favor of newer studies at end-of-therapy. The findings suggest that CBTp is superior to TAU post-therapy in bringing about a change in delusions, but that this change may not be maintained over the follow-up period. Moreover, interventions that focus on causal factors of delusions seem to be a promising approach to improving interventions for delusions. Frontiers Media S.A. 2015-10-06 /pmc/articles/PMC4593948/ /pubmed/26500570 http://dx.doi.org/10.3389/fpsyg.2015.01450 Text en Copyright © 2015 Mehl, Werner and Lincoln. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychology Mehl, Stephanie Werner, Dirk Lincoln, Tania M. Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis |
title | Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis |
title_full | Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis |
title_fullStr | Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis |
title_full_unstemmed | Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis |
title_short | Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis |
title_sort | does cognitive behavior therapy for psychosis (cbtp) show a sustainable effect on delusions? a meta-analysis |
topic | Psychology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593948/ https://www.ncbi.nlm.nih.gov/pubmed/26500570 http://dx.doi.org/10.3389/fpsyg.2015.01450 |
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