Cognitive-Behavioral Therapy as an Adjunct to Second-Generation Antipsychotics in the Treatment of Schizophrenia

Objective: This study determined whether adding cognitive-behavioral therapy to treatment for outpatients with schizophrenia would be more effective than the use of second-generation antipsychotics alone. Thirty-three patients were randomly assigned to receive either second-generation antipsychotics alone (N=18) or second-generation antipsychotics plus cognitive-behavioral therapy (N=15). Methods: All patients received pharmacotherapy from a single provider and in a predetermined standard manner. Psychopathology ratings were done at baseline, at the end of treatment (12 weeks) and three months after completion of treatment (24 weeks). Results: Twenty-five (76%) patients completed baseline and 12-week evaluations, and 17 (68%) patients who finished treatment also completed evaluations at 24 weeks. At the end of treatment persons in the second-generation antipsychotics plus cognitive- behavioral therapy group were rated as having less severe delusions than patients in the group receiving second-generation antipsychotics only, and this difference was maintained three months after treatment ended. Conclusions: Adding cognitive-behavioral therapy may help with reducing the severity of delusions among patients with schizophrenia. (Psychiatric Services 61: 940943, 2010)