The Efficacy Of Two-stage Cognitive Behavioral Therapy Augmentation In Inpatients With Schizophrenia

Background Schizophrenia is a mental disorder with multiple impairment in perception,thinking,emotion and behavior.At present,antipsychotics are effective in positive symptoms,with limited effect on negative symptoms,social function and compliance.In recent years,cognitive behavioral therapy(CBT)combined with drug therapy have been found that can promote the improvement of schizophrenia patients' mental symptoms and social function.Objective Our study proposed the two-stage cognitive behavioral therapy combined with drugs to evaluate the augmented efficacy of the two-stage cognitive behavioral therapy model in inpatients with schizophrenia.Method A total of 158 inpatients with schizophrenia were recruited and randomly assigned,84 to antipsychotics,and 74 to antipsychotics plus CBT.Positive and Negative Syndrome Scale(PANSS),Clinical Global Impression Scale(CGI),Personal and Social Performance Scale(PSP)and Self-Awareness Inventor(SAI)were used to assess the symptom,severity of illness,social function and self-awareness at baseline and followed up 3th months,6th months and 12 th months.And the mixed effects model for repeated-measures analyses(MMRM)was used to compare the difference in efficacy between the two groups.Results: The majority of the patients included were young adults between 19 to 58 years old,educated in middle school.Their first episode happened in adulthood most,with the age of 11 to 45 years old.Most of them had schizophrenia for over 2 years and had been hospitalized in the last year with 3 months hospital stays in average.It was found that the score of PANSS,CGI-S,and PSP subscale all decreased gradually over time in two groups,and that SAI score and PSP total score increased gradually as well.In addition,significant changes were shown in all of the scales after treatment in both groups(P < 0.0001).Moreover,there was an interaction effect between grouping and time in PANSS score and CGI-S score(P < 0.05)by using MMRM.And total score of PANSS(Cohen's d= 0.51[0.12-0.89]),the score of negative symptom scale(Cohen's d= 0.63[0.24-1.03])and the general psychopathological scale(Cohen's d= 0.48[0.09-0.87])were statistically significant(P < 0.05)in the 12 th month between two groups with Bonferroni adjusted multiple comparisons.Conclusion: The two-stage CBT augmentation helped chronic schizophrenia(the duration of schizophrenia was over 2 years)inpatients alleviate the general pathological symptoms,and reduce the negative symptoms and the severity of illness slowly.