Cognitive Behavioral Therapy for Patients With an Early Psychosis
Condition: Psychosis; Schizophrenia; Depressive Symptoms; Self-esteem
MeSH terms: Schizophrenia; Psychotic Disorders; Mental Disorders; Depression
Study type: Interventional
Phase: Phase 2

Summary: 
      The purpose of the present study is to examine whether cognitive behavior therapy will reduce
      depressive symptoms and increase self-esteem for patients with a first episode psychosis.
    

Detailed description: 
      A growing body of evidence supports the use of Cognitive Behavioural Therapy (CBT) for the
      treatment of schizophrenia. The strength of evidence is especially strong for patients with
      persistent hallucinations and delusions. As it comes to the effect of CBT for patients with a
      first episode psychosis the picture is more unclear. The main reason is probably that the CBT
      interventions to a less extent have been adjusted to fit first episode psychosis patients.
      The main problems for patients with a first episode psychosis (FEP) is rarely persistent
      hallucinations and delusions but they struggle with social anxiety, depression, alcohol and
      drug abuse and low self esteem. Forthcoming studies examining the effect of CBT for patients
      with a first episode psychosis should aim to have a focus on these symptoms.

      The main aim of the present study is to examine whether CBT has any effect on depressive
      symptoms and self-esteem in patients with a FEP.

      The study will include patients with a first episode psychosis with Axis-I DSM IV diagnosis
      of schizophrenia, schizoaffective disorder, delusional disorder, and psychosis not otherwise
      specified. To be included in the study the patients should meet the criteria of an affective
      episode the last year or have a score on Calgary Depression of Schizophrenia Scale above
      four. Patients are randomly selected to either a treatment group or a control (placebo)
      group. The aim is to include 30 patients in each group. Patients in the treatment group will
      receive a manual-based CBT intervention comprising up to 26 sessions during a six months
      period. The control group will receive treatment as usual (TAU).

      The patients are assessed before the entry of the study and after 6 months (end of
      treatment). Moreover they will be assessed after 9 months of ending therapy.

      Hypothesis:

      In this study we hypothesize that

        -  patients receiving CBT will have less depressive symptoms than TAU-patients at the and
           of treatment and at six months follow up

        -  CBT-patients will demonstrate a better improvement in their self-esteem than
           TAU-patients at the end of treatment and at six months follow up.

      To our knowledge, no previous studies have examined outcome after CBT treatment with regards
      to depressive symptoms and self-esteem. Furthermore, this is the first randomized controlled
      study in Norway of CBT among patients with a FEP.
    

Intervention name(s): cognitive behavioral therapy
Intervention type(s): Behavioral
Intervention description(s): Patients allocated to the treatment arm will receive up to 26 sessions of cognitive behavioral therapy
Other intervention name(s): CBT
Intervention model: Single Group Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Psychosis; Schizophrenia; Cognitive behavioral therapy; Self esteem; Depression