Efficacy of individualized cognitive-behavioral therapy for schizophrenic patients with negative symptoms and social disabilities: a controlled trial

Background: Antipsychotic medication is often effective in treating positive symptoms in schizophrenia, but many patients, even those who benefit from newer antipsychotic drugs, continue to have negative symptoms and social disabilities. Therefore, adequate clinical treatment should include evidence-based psychosocial interventions to improve outcomes. Objective: To examine the beneficial effects of combining individualized cognitive-behavioral therapy (CBT) and pharmacological treatment on negative symptoms and social disabilities. Methods: A cross-over design was used to compare the efficacy of additional CBT with that of 'routine treatment' (RT, standard medication alone). During the first 3 months, group 1 (N = 20) received 24 sessions CBT plus RT, followed by 3 months RT. Group 2 (N = 19) received at first 3 months RT, followed by 3 months CBT+RT. Results: Patients in the CBT+PR condition (group 1) overall had significantly higher levels of improvement compared with those in the RT condition (group 2), and the gains obtained in the CBT+RT-phase could be maintained until the 3-months follow-up. The beneficial effects of additional CBT on negative symptoms and social disabilities could be replicated in group 2. Conclusions: Additional CBT may improve outcomes for schizophrenic outpatients with negative symptoms and social disabilities.