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Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan

BACKGROUND: Evidence for efficacy of cognitive-behavioural therapy (CBT) in treatment of schizophrenia is growing. CBT is effective and cost efficient in treating positive and negative symptoms. To effectively meet the needs of diverse cultural groups, CBT needs to be adapted to the linguistic, cult...

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Autores principales: Husain, Muhammed Omair, Chaudhry, Imran B., Mehmood, Nasir, Rehman, Raza ur, Kazmi, Ajmal, Hamirani, Munir, Kiran, Tayyeba, Bukhsh, Ameer, Bassett, Paul, Husain, Muhammad Ishrat, Naeem, Farooq, Husain, Nusrat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718081/
https://www.ncbi.nlm.nih.gov/pubmed/29207980
http://dx.doi.org/10.1186/s12913-017-2740-z
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author Husain, Muhammed Omair
Chaudhry, Imran B.
Mehmood, Nasir
Rehman, Raza ur
Kazmi, Ajmal
Hamirani, Munir
Kiran, Tayyeba
Bukhsh, Ameer
Bassett, Paul
Husain, Muhammad Ishrat
Naeem, Farooq
Husain, Nusrat
author_facet Husain, Muhammed Omair
Chaudhry, Imran B.
Mehmood, Nasir
Rehman, Raza ur
Kazmi, Ajmal
Hamirani, Munir
Kiran, Tayyeba
Bukhsh, Ameer
Bassett, Paul
Husain, Muhammad Ishrat
Naeem, Farooq
Husain, Nusrat
author_sort Husain, Muhammed Omair
collection PubMed
description BACKGROUND: Evidence for efficacy of cognitive-behavioural therapy (CBT) in treatment of schizophrenia is growing. CBT is effective and cost efficient in treating positive and negative symptoms. To effectively meet the needs of diverse cultural groups, CBT needs to be adapted to the linguistic, cultural and socioeconomic context. We aimed to assess the feasibility, efficacy and acceptability of a culturally adapted CBT for treatment of psychosis (CaCBTp) in a low-income country. METHODS: Rater-blind, randomised, controlled trial of the use of standard duration CBT in patients with psychosis from a low-income country. Participants with a ICD-10 diagnosis of psychosis were assessed using Positive and Negative Syndrome Scale for Schizophrenia (PANSS), Psychotic Symptom Rating Scales (PSYRATS), and the Schedule for Assessment of Insight (SAI) (baseline, 3 months and 6 months). They were randomized into the intervention group (n = 18) and Treatment As Usual (TAU) group (n = 18). The intervention group received 12 weekly sessions of CaCBTp. RESULTS: The CaCBTp group had significantly lower scores on PANSS Positive (p = 0.02), PANSS Negative (p = 0.045), PANSS General Psychopathology (p = 0.008) and Total PANSS (p = 0.05) when compared to TAU at three months. They also had low scores on Delusion Severity Total (p = 0.02) and Hallucination Severity Total (p = 0.04) of PSYRATS, as well as higher scores on SAI (p = 0.01) at the same time point. At six months only the improvement in PANSS positive scores (p = 0.045) met statistical significance.. CONCLUSIONS: It is feasible to offer CaCBTp as an adjunct to TAU in patients with psychosis, presenting to services in a lower middle-income country. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT02202694 (Retrospectively registered).
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spelling pubmed-57180812017-12-08 Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan Husain, Muhammed Omair Chaudhry, Imran B. Mehmood, Nasir Rehman, Raza ur Kazmi, Ajmal Hamirani, Munir Kiran, Tayyeba Bukhsh, Ameer Bassett, Paul Husain, Muhammad Ishrat Naeem, Farooq Husain, Nusrat BMC Health Serv Res Research Article BACKGROUND: Evidence for efficacy of cognitive-behavioural therapy (CBT) in treatment of schizophrenia is growing. CBT is effective and cost efficient in treating positive and negative symptoms. To effectively meet the needs of diverse cultural groups, CBT needs to be adapted to the linguistic, cultural and socioeconomic context. We aimed to assess the feasibility, efficacy and acceptability of a culturally adapted CBT for treatment of psychosis (CaCBTp) in a low-income country. METHODS: Rater-blind, randomised, controlled trial of the use of standard duration CBT in patients with psychosis from a low-income country. Participants with a ICD-10 diagnosis of psychosis were assessed using Positive and Negative Syndrome Scale for Schizophrenia (PANSS), Psychotic Symptom Rating Scales (PSYRATS), and the Schedule for Assessment of Insight (SAI) (baseline, 3 months and 6 months). They were randomized into the intervention group (n = 18) and Treatment As Usual (TAU) group (n = 18). The intervention group received 12 weekly sessions of CaCBTp. RESULTS: The CaCBTp group had significantly lower scores on PANSS Positive (p = 0.02), PANSS Negative (p = 0.045), PANSS General Psychopathology (p = 0.008) and Total PANSS (p = 0.05) when compared to TAU at three months. They also had low scores on Delusion Severity Total (p = 0.02) and Hallucination Severity Total (p = 0.04) of PSYRATS, as well as higher scores on SAI (p = 0.01) at the same time point. At six months only the improvement in PANSS positive scores (p = 0.045) met statistical significance.. CONCLUSIONS: It is feasible to offer CaCBTp as an adjunct to TAU in patients with psychosis, presenting to services in a lower middle-income country. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT02202694 (Retrospectively registered). BioMed Central 2017-12-06 /pmc/articles/PMC5718081/ /pubmed/29207980 http://dx.doi.org/10.1186/s12913-017-2740-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Husain, Muhammed Omair
Chaudhry, Imran B.
Mehmood, Nasir
Rehman, Raza ur
Kazmi, Ajmal
Hamirani, Munir
Kiran, Tayyeba
Bukhsh, Ameer
Bassett, Paul
Husain, Muhammad Ishrat
Naeem, Farooq
Husain, Nusrat
Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan
title Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan
title_full Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan
title_fullStr Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan
title_full_unstemmed Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan
title_short Pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (CaCBTp) in Pakistan
title_sort pilot randomised controlled trial of culturally adapted cognitive behavior therapy for psychosis (cacbtp) in pakistan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718081/
https://www.ncbi.nlm.nih.gov/pubmed/29207980
http://dx.doi.org/10.1186/s12913-017-2740-z
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