Talking therapy may provide effective alternative to medication for people with schizophrenia

By Sally Robertson, B.Sc.Feb 6 2014

Cognitive therapy may provide an effective alternative to antipsychotic medication for patients with schizophrenia, report researchers.

In a groundbreaking study published in The Lancet, cognitive therapy was shown to significantly reduce psychiatric symptoms in schizophrenic individuals who had chosen not to take antipsychotic drugs.

While antipsychotic medication may be beneficial to some patients, it can have severe side effects, explains lead author of the study Anthony Morrison from the University of Manchester in the UK. “We have shown that cognitive therapy is an acceptable intervention for a population who are usually considered to be very challenging to engage in mental health services.”

Cognitive therapy is a form of talking therapy that aims to help an individual identify dysfunctional thinking patterns that may negatively affect their behaviour and ability to cope. Although this therapy has previously proved helpful in schizophrenia when combined with antipsychotics, the effects of the therapy alone have not been demonstrated until now.

For the study, the team recruited 74 individuals with schizophrenia who had chosen not to take antipsychotic treatment for the condition. Thirty-seven of the participants received 26 sessions of cognitive therapy over a 9-month period and the remaining 37 served as a control group. A standard tool for measuring symptoms called the positive and negative syndrome scale (PANSS) was used to assess the patients at baseline and at regular intervals throughout the study.

Morrison et al. report that the patients who received cognitive therapy showed consistently greater improvements in symptoms throughout the study, compared with those who did not engage in the therapy.

After 18 months, the PANSS results showed a greater than 50% improvement in psychiatric symptoms among 41% of those who received cognitive therapy compared with only 18% of those who did not receive the therapy.

Recognizing that the study population was small in this study, Morrison acknowledges the need for a large, definitive clinical trial to confirm the implications of the team’s study.

“Evidence-based alternatives should be available to those who choose not to take these drugs,” he says. “For many, cognitive therapy might prove to be the preferred form of treatment.”