Cognitive Behavioural Therapy for schizophrenia - outcomes for functioning, distress and quality of life : A meta-analysis

Background: The effect of cognitive behavioural therapy for psychosis (CBTp) on the core symptoms of schizophrenia has proven contentious, with current meta-analyses finding at most only small effects. However, it has been suggested that the effects of CBTp in areas other than psychotic symptoms are at least as important and potentially benefit from the intervention. Method: We meta-analysed RCTs investigating the effectiveness of CBTp for functioning, distress and quality of life in individuals diagnosed with schizophrenia and related disorders. Data from 36 randomised controlled trials (RCTs) met our inclusion criteria- 27 assessing functioning (1579 participants); 8 for distress (465 participants); and 10 for quality of life (592 participants). Results: The pooled effect size for functioning was small but significant for the end-of-trial (0.25: 95% CI: 0.14 to 0.33); however, this became non-significant at follow-up (0.10 [95%CI -0.07 to 0.26]). Although a small benefit of CBT was evident for reducing distress (0.37: 95%CI 0.05 to 0.69), this became nonsignificant when adjusted for possible publication bias (0.18: 95%CI -0.12 to 0.48). Finally, CBTp showed no benefit for improving quality of life (0.04: 95% CI: -0.12 to 0.19). Conclusions: CBTp has a small therapeutic effect on functioning at end-of-trial, although this benefit is not evident at follow-up. Although CBTp produced a small benefit on distress, this was subject to possible publication bias and became nonsignificant when adjusted. We found no evidence that CBTp increases quality of life post-intervention.Peer reviewedFinal Published versio

Formal thought disorder: self-report in non-clinical populations

This study present data from 300 unselected individuals who had completed the Formal Thought Disorder-Self Scale (FTD-S) (Study 1) and from a separate sample of over 150 unselected individuals who had completed the FTD-S and also had a relative or friend complete the Formal Thought Disorder-Other Scale (FTD-O) (Study 2). The questionnaire, originally devised to measure self-ratings of thought disorder in clinical samples, was adapted from a yes-no questionnaire to a 4 point Likert format, to more sensitively determine the extent to which such characteristics may be reported amongst the healthy population. Principal Components Analysis of the FTD-S scale suggested a three-component solution for which we proposed the nomenclature of: odd speech, conversational ability and working memory deficit. Study 2 found that the FTD-S (self-report) and the FTD-O (other rated) reached a significant but low correlation (r = .29; p <0.01); these findings are discussed in terms of its significance for self-report of Formal Thought Disorder and proneness to psychosis

Semantic memory and symptomatology in schizophrenia : A review

This chapter reviews the past twenty years of research on semantic memory function in schizophrenia. This now substantial body of work has consistently documented abnormal semantic memory in most schizophrenia patients across a range of tasks (including priming, semantic fluency, picture naming) and which, varies from being quite mild through to some cases being indistinguishable from the impairment seen in Alzheimer's disease. Furthermore, although some patients have problems accessing intact semantics, others-possibly with longer illness duration-show an apparent loss of knowledge from the semantic store itself. While the abnormalities of semantic memory i.e. knowledge, offer a potential candidate of explanation for some symptoms, little work has examined the relationship between semantic memory and symptomatology