This is not the most recent version of the article. View current version (21 OCT 2015)

Intervention Review

You have free access to this content

Cognitive behavioural therapy (brief versus standard duration) for schizophrenia

  1. Farooq Naeem1,*,
  2. Saeed Farooq2,
  3. David Kingdon3

Editorial Group: Cochrane Schizophrenia Group

Published Online: 11 APR 2014

Assessed as up-to-date: 7 DEC 2013

DOI: 10.1002/14651858.CD010646.pub2


How to Cite

Naeem F, Farooq S, Kingdon D. Cognitive behavioural therapy (brief versus standard duration) for schizophrenia. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD010646. DOI: 10.1002/14651858.CD010646.pub2.

Author Information

  1. 1

    Queen's University, Department of Psychiatry, Kingston, Ontario, Canada

  2. 2

    Staffordshire University & Black Country Social Partnership NHS Foundation Trust, Centre for Ageing and Mental Health, Wolverhampton, UK

  3. 3

    University of Southampton, Mental Health Group, Southampton, UK

*Farooq Naeem, Department of Psychiatry, Queen's University, Kingston, Ontario, Canada. farooqnaeem@yahoo.com.

Publication History

  1. Publication Status: New
  2. Published Online: 11 APR 2014

SEARCH

This is not the most recent version of the article. View current version (21 OCT 2015)

 
Characteristics of excluded studies [ordered by study ID]

StudyReason for exclusion

Kemp 1998Allocation: randomised.

Participants: people who were inpatients (schizophrenia, schizoaffective disorder, delusional disorder).

Interventions: compliance therapy (4 to 6 sessions) compared with treatment as usual. Not brief CBTp versus standard CBTp.

Levine 1998Allocation: randomised.

Participants: people with paranoid schizophrenia.

Interventions: group CBT (6 weekly sessions) compared with supportive therapy. Not brief CBTp versus standard CBTp.

Lewis 2002Allocation: randomised.

Participants: schizophrenia or other psychotic disorders.

Interventions: inpatient CBT (15 to 20 hours in 5 weeks) compared with supportive counselling. Not brief CBTp versus standard CBTp.

O’Donnell 2003Allocation: randomised.

Participants: people with schizophrenia.
Interventions: compliance therapy (5 sessions) compared with non-specific counselling. Not brief CBTp versus standard CBTp.

Turkington 2000Allocation: randomised.

Participants: people with schizophrenia.

Interventions: CBT (6 sessions plus 1 to 2 for family) compared with befriending. Not brief CBTp versus standard CBTp.

Turkington 2002Allocation: randomised.

Participants: people with schizophrenia.

Interventions: CBT delivered by nurses trained in CBT (6 sessions, plus 3 for carers), compared with standard care. Not brief CBTp versus standard CBTp.

Wykes 2005Allocation: randomised.

Participants: people with schizophrenia.

Interventions: group CBT for voices (7 sessions) compared with standard care. Not brief CBTp versus standard CBTp.

 
Summary of findings for the main comparison. BRIEF CBT compared to STANDARD DURATION CBT for schizophrenia

BRIEF CBT compared to STANDARD DURATION CBT for schizophrenia

Patient or population: Patients with schizophrenia
Settings:
Intervention: Brief CBT
Comparison: Standard duration CBT

OutcomesIllustrative comparative risks* (95% CI)Relative effect
(95% CI)
No of participants
(studies)
Quality of the evidence
(GRADE)
Comments

Assumed riskCorresponding risk

STANDARD DURATION CBTBRIEF CBT

Global state: Improved to any extentSee commentNot estimable0
(0)
See commentWe identified no trials comparing brief versus standard duration CBT.

Leaving the study early

Mental state: Improved to any extent

Service use: Admitted

Quality of life: Improved to any extent

Satisfaction with treatment: Improved to any extent

Economic outcomes

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

 
Table 1. Other directly relevant Cochrane reviews

Review/Protocol titleReference

Cognitive behavioural therapy (group) for schizophreniaGuaiana 2012

Cognitive behavioural therapy versus specific pharmacological treatments for schizophreniaJones 2009b

Cognitive behavioural therapy versus standard care for schizophreniaJones 2009a

Cognitive behavioural therapy versus other psychosocial treatments for schizophreniaJones 2012

Supportive therapy for schizophreniaBuckley 2007*

 * Major update imminent
 
Table 2. Reviews suggested by excluded studies

ComparisonExcluded trialRelevant Cochrane review

Befriending for schizophreniaTurkington 2000-

Brief CBT versus standard care for schizophreniaTurkington 2002Jones 2009a*

Brief CBT versus therapies other than standard duration CBT for schizophreniaLevine 1998 Lewis 2002 , Turkington 2000Jones 2012*

Compliance therapy for schizophreniaKemp 1998, O’Donnell 2003McIntosh 2006

Group CBT for schizophreniaLevine 1998, Wykes 2005Guaiana 2012

Supportive therapy versus CBT for schizophreniaLevine 1998 Lewis 2002Buckley 2007**

 * It is possible that these studies be included in this review but it may be justified to have a full new review on brief CBT.
** Update imminent
 
Table 3. Suggested design of study

MethodsAllocation: randomised, fully explicit description of methods of randomisation and allocation concealment.
Blinding: open.
Setting: anywhere.
Duration: 1 year.

ParticipantsDiagnosis: schizophrenia (clinical diagnoses, operational for random sample).
N = 300.*
Age: adults.
Sex: both.

Interventions1. Brief CBT: 4 to 6 sessions. N = 150.

2. Standard CBT: 15 to 20 sessions. N = 150.

OutcomesGlobal state: CGI.**

Leaving the study early.

Mental state: CGI.

Service use.

Quality of life: CGI.

Satisfaction with treatment: CGI.

Economic outcomes.

Notes* Powered to be able to identify a difference of ˜ 20% between groups for primary outcome with adequate degree of certainty.

** This simple measure can be used to target specific aspects of functioning, symptoms or attitudes.