[Differential indication for psychotherapy in psychosis : Are there evidence-based criteria?]

Abstract

The major objective of this paper is to discuss the available evidence on the question as to which patients benefit most from psychotherapy in psychotic disorders and the question of which kind of psychotherapy. From a methodological perspective, this task can be seen as the question of moderators of treatment success. To answer this question, the status of efficacy research on psychotherapeutic interventions in schizophrenia is summarized in a first step. Secondly, studies comparing different active psychotherapeutic approaches are discussed. There are no studies available on routine psychotherapeutic care. However, there appears to be a rationale for recommending a combination of cognitive behavioural therapy (CBT) and family therapy. If patients prefer other approaches or if the treatment model does not suit the patient, other approaches should be offered. There is evidence for CBT that insight into psychosis, female gender, a higher level of education, and age >21 are indicators of a better course in CBT. Overall, the options for differential indications are highly limited and considerably more research is required.

Keywords: Antipsychotics; Cognitive behavioral therapy; Family intervention; Psychoeducation; Schizophrenia.