Cognitive behavior therapy in early psychosis with a focus on depression and low self-esteem: A randomized controlled trial
Nasrettin Sönmez, Kristin Lie Romm, Tiril Østefjells, Marit Grande, Lene Hunnicke Jensen, Benjamin Hummelen, Martin Tesli, Ingrid Melle, Jan Ivar Røssberg, Nasrettin Sönmez, Kristin Lie Romm, Tiril Østefjells, Marit Grande, Lene Hunnicke Jensen, Benjamin Hummelen, Martin Tesli, Ingrid Melle, Jan Ivar Røssberg
Abstract
Background: Patients in early phases of psychosis often struggle with depressive symptoms and low self-esteem. The main aims of the present study were to examine whether cognitive behavior therapy (CBT) compared to treatment as usual (TAU) would reduce depressive symptoms (primary outcome) and increase self-esteem (secondary outcome). Furthermore, we wanted to examine whether CBT reduces symptoms measured with the PANSS (positive, negative, cognitive, or excited symptoms) or increases general functioning compared to TAU.
Methods: A total of 63 early psychosis patients were included and randomly assigned to receive either CBT (maximum 26 sessions) or TAU for a period of up to six months. A linear mixed model was used for longitudinal analysis, with a focus on whether patients in the CBT group or the TAU group changed differently to one another between the baseline and 15-month follow-up.
Results: There were no differences between the CBT group and TAU group regarding improvements in depressive symptoms measured with the Calgary Depression Scale for Schizophrenia (P = 0.188) or self-esteem measured with the Rosenberg Self-Esteem Scale (P = 0.580). However, patients in the CBT group improved significantly more on negative symptoms (P = 0.002) and social functioning (P = 0.001).
Conclusions: We did not find CBT to be more effective than TAU in reducing depressive symptoms or increasing self-esteem in patients with early psychosis. However, CBT seems to improve negative symptoms and functioning. These results still need to be replicated in further studies as the present one was merely an exploratory analysis. ClinicalTrials.gov Identifier: NCT01511406.
Keywords: Cognitive behavior therapy; First-episode psychosis; Randomized controlled trials.
Conflict of interest statement
Declaration of competing interest The present study was funded by ExtraStiftelsen. The funding agency was not involved in the study design, data analysis, decision to publish, or writing of the current manuscript. The authors declare that they have no other conflicts of interest related to the current study.
Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.
Source: PubMed