Cbt for Psychosis and Affect on Psychosis Symptoms
Condition: Psychosis
MeSH terms: Psychotic Disorders; Mental Disorders
Study type: Interventional
Phase: Phase 2

Summary: 
      This study aims to examine the effectiveness of cognitive behavior therapy for psychosis in
      first episode patients and see the outcome of CBT on psychotic symptoms. Because cognitive
      behavior therapy mostly use in depressive patient to treat the negative thinking pattern
      Cognitive behavioral approaches in the treatment of psychosis have become more prevalent in
      recent years for a number of reasons. Evidence has been available for the past two or three
      decades regarding the success of these techniques with other forms of psychopathology such as
      depression, anxiety disorders, and medical problems. Anxiety, depression and low self-esteem
      have been cited as the most common consequences of psychotic disorders. The observation has
      also emerged that many patients develop their own coping strategies for reducing the
      frequency, severity, and disruptiveness of their symptoms. There has also been increasing
      evidence regarding the influence of social environmental factors on the course of psychosis
      and the development of stress-vulnerability models to explain these relationships. Research
      suggests that 20 to 50 percent of persons with psychosis who receive neuroleptics continue to
      experience difficulties related to their psychotic symptoms.
    

Detailed description: 
      This research aims to examine the effect of cognitive and behavior therapy for psychosis in
      first episode patients and see the outcome of CBT on psychotic symptoms.

      Cognitive and Behavior Therapy for Psychosis

      Cognitive behavioral therapy (CBT) is talking therapy that can help to manage problems by
      changing the way you think and behave.

      There are notable clinical successes in treating common emotional disorders using
      cognitive-behavioral approaches based on precise theoretical models. In anxiety disorders,
      the underlying fear beliefs are tested in behavioral experiments to substantially reduce
      symptoms; in depression, mood is lifted by reevaluating negative views of the self and
      limiting excessive rumination.

      With psychosis, similar psychological processes are active in the experience of delusions and
      hallucinations. For example, persecutory delusions are conceptualized as threat beliefs that
      are the patient's attempts to make sense of his or her personal experiences, while
      hallucinations are problematic when they are interpreted by the patient as representing
      powerful and destructive forces. Hence, in cognitive therapy for psychosis, fearful thoughts
      are carefully reevaluated; withdrawal from social contact and activity is gradually reversed;
      and feelings of hope, control, and self-worth are fostered. Patients with psychosis are given
      time to talk about their experiences and, importantly, strategies are developed from this
      collaborative discussion.

      In this one-on-one therapy, distressing experiences take center stage. The first generation
      of cognitive-behavioral therapy (CBT) for psychosis, when added to standard care, has
      demonstrated efficacy in treating patients with delusions and hallucinations.

      Psychosis Psychosis is a serious mental disorder characterized by thinking and emotions that
      are so impaired, that they indicate that the person experiencing them has lost contact with
      reality.

      People with psychosis are described as psychotic. People experiencing psychosis may exhibit
      some personality changes and thought disorder. Depending on its severity, this may be
      accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and
      impairment in carrying out daily life activities.

      The term "psychosis" is very broad and can mean anything from relatively normal aberrant
      experiences through to the complex and catatonic expressions of schizophrenia and bipolar
      type 1 disorder. In properly diagnosed psychiatric disorders (where other causes have been
      excluded by extensive medical and biological laboratory tests), psychosis is a descriptive
      term for the hallucinations, delusions, sometimes violence, and impaired insight that may
      occur. Psychosis is generally the term given to noticeable deficits in normal behavior
      (negative signs) and more commonly to diverse types of hallucinations or delusional beliefs,
      especially as regards the relation between self and others as in grandiosity and paranoia.

      Objectives

        1. To explore the effect of cognitive behavior therapy for psychosis in first episode
           patients.

        2. To develop a guide to conduct cognitive behavior therapy in early psychosis patients.

        3. To evaluate the major clinical outcomes in the treatment of psychotic symptoms.

        4. To examine the feasibility of cognitive behavior therapy in psychotic patients.
           Rationale of the study This study aims to examine the effectiveness of cognitive
           behavior therapy for psychosis in first episode patients and see the outcome of CBT on
           psychotic symptoms. Because cognitive behavior therapy mostly use in depressive patient
           to treat the negative thinking pattern

      Cognitive behavioral approaches in the treatment of psychosis have become more prevalent in
      recent years for a number of reasons. Evidence has been available for the past two or three
      decades regarding the success of these techniques with other forms of psychopathology such as
      depression, anxiety disorders, and medical problems. Anxiety, depression and low self-esteem
      have been cited as the most common consequences of psychotic disorders. The observation has
      also emerged that many patients develop their own coping strategies for reducing the
      frequency, severity, and disruptiveness of their symptoms. There has also been increasing
      evidence regarding the influence of social environmental factors on the course of psychosis
      and the development of stress-vulnerability models to explain these relationships. Research
      suggests that 20 to 50 percent of persons with psychosis who receive neuroleptics continue to
      experience difficulties related to their psychotic symptoms.

      The therapeutic process consists of helping the patient become aware of his or her internal
      stream of thoughts when distressed, and to identify and modify the dysfunctional thoughts.
      Behavioral techniques are used to bring about functional changes in behavior, regulate
      emotion, and help the cognitive restructuring process. Modifying the patient's underlying
      dysfunctional beliefs leads to lasting improvements. In this structured therapy, the
      therapist and patient work collaboratively to use an approach that features reality testing
      and experimentation.

      Method

      Research Design The present study will be a feasibility rater blind randomized controlled
      trial study to test the efficacy of brief CBT for patients with suffering from first episode
      psychosis.

      Sample Total 50 patients meeting the inclusion criteria of the study will be recruited from
      psychiatry unit of a public hospital of Raheem yar khan, Pakistan. conducted by using 50
      patient met the eligibility criteria.

      Instruments/Assessment Measures

      The following assessment measures will be used in the research:

        1. The Psychotic Symptom Rating Scales.

        2. Positive and Negative Symptom Scale.

        3. Schedule for Assessment of Insight.

      Procedure

        1. Authors of scales will be informed about usage of the scale in current research.

        2. Get permission to Dr.Farooq Naeem usage of the CBT manual of psychosis.

        3. SPSSv.20 for data analysis
    

Intervention name(s): cognitive behaviour therapy; Espidone; Olepra; Donu
Intervention type(s): Behavioral; Drug; Drug; Drug
Other intervention name(s): talk therapy; conversation therapy; risp; olan; zanzia
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: cognitive behaviour therapy; first episode