TY - JOUR
T1 - Cognitive Behavioral Therapy for Subjects at Ultrahigh Risk for Developing Psychosis: A Randomized Controlled Clinical Trial
AU - van der Gaag, M.
AU - Nieman, D.H.
AU - Rietdijk, J.
AU - Dragt, S.
AU - Ising, H.K.
AU - Klaassen, R.M.C.
AU - Koeter, M.W.J.
AU - Cuijpers, P.
AU - Wunderink, L.
AU - Linszen, D.H.
PY - 2012
Y1 - 2012
N2 - Background: Evidence for the effectiveness of treatments for subjects at ultrahigh risk (UHR) for developing psychosis remains inconclusive. Objective: A new cognitive behavioral intervention specifically targeted at cognitive biases (ie, Cognitive Behavioral Therapy [CBT] for UHR patients plus treatment as usual [TAU] called CBTuhr) is compared with TAU in a group of young help-seeking UHR subjects. Methods: A total of 201 patients were recruited at 4 sites and randomized. In most cases, CBTuhr was an add-on therapy because most people were seeking help for a comorbid disorder. The CBT was provided for 6 months, and the follow-up period was 18 months. Results: In the CBTuhr condition, 10 patients transitioned to psychosis compared with 22 in the TAU condition (χ (1) 5.575, P . 03). The number needed to treat (NNT) was 9 (95% confidence interval [CI]: 4.7-89.9). At 18-month follow-up the CBTuhr group was significantly more often remitted from an at-risk mental state, with a NNT of 7 (95% CI: 3.7-71.2). Intention-to-treat analysis, including 5 violations against exclusion criteria, showed a statistical tendency (χ (1) 3.338, P . 06). Conclusions: Compared with TAU, this new CBT (focusing on normalization and awareness of cognitive biases) showed a favorable effect on the transition to psychosis and reduction of subclinical psychotic symptoms in subjects at UHR to develop psychosis. © The Author 2012.
AB - Background: Evidence for the effectiveness of treatments for subjects at ultrahigh risk (UHR) for developing psychosis remains inconclusive. Objective: A new cognitive behavioral intervention specifically targeted at cognitive biases (ie, Cognitive Behavioral Therapy [CBT] for UHR patients plus treatment as usual [TAU] called CBTuhr) is compared with TAU in a group of young help-seeking UHR subjects. Methods: A total of 201 patients were recruited at 4 sites and randomized. In most cases, CBTuhr was an add-on therapy because most people were seeking help for a comorbid disorder. The CBT was provided for 6 months, and the follow-up period was 18 months. Results: In the CBTuhr condition, 10 patients transitioned to psychosis compared with 22 in the TAU condition (χ (1) 5.575, P . 03). The number needed to treat (NNT) was 9 (95% confidence interval [CI]: 4.7-89.9). At 18-month follow-up the CBTuhr group was significantly more often remitted from an at-risk mental state, with a NNT of 7 (95% CI: 3.7-71.2). Intention-to-treat analysis, including 5 violations against exclusion criteria, showed a statistical tendency (χ (1) 3.338, P . 06). Conclusions: Compared with TAU, this new CBT (focusing on normalization and awareness of cognitive biases) showed a favorable effect on the transition to psychosis and reduction of subclinical psychotic symptoms in subjects at UHR to develop psychosis. © The Author 2012.
U2 - 10.1093/schbul/sbs105
DO - 10.1093/schbul/sbs105
M3 - Article
SN - 0586-7614
VL - 38
SP - 1180
EP - 1188
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - 6
ER -
