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Meta-Analysis
. 2018 Dec 20;12(12):CD007964.
doi: 10.1002/14651858.CD007964.pub2.

Cognitive behavioural therapy plus standard care versus standard care for people with schizophrenia

Christopher Jones  1 , David Hacker, Jun Xia, Alan Meaden, Claire B Irving, Sai Zhao, Jue Chen, Chunhu Shi
Affiliations
Meta-Analysis

Cognitive behavioural therapy plus standard care versus standard care for people with schizophrenia

Christopher Jones et al. Cochrane Database Syst Rev. .

Abstract

Background: Cognitive behavioural therapy (CBT) is a psychosocial treatment that aims to re-mediate distressing emotional experiences or dysfunctional behaviour by changing the way in which a person interprets and evaluates the experience or cognates on its consequence and meaning. This approach helps to link the person's feelings and patterns of thinking which underpin distress. CBT is now recommended by the National Institute for Health and Care Excellence (NICE) as an add-on treatment for people with a diagnosis of schizophrenia. This review is also part of a family of Cochrane CBT reviews for people with schizophrenia.

Objectives: To assess the effects of cognitive behavioural therapy added to standard care compared with standard care alone for people with schizophrenia.

Search methods: We searched the Cochrane Schizophrenia Group's Trials Register (up to March 6, 2017). This register is compiled by systematic searches of major resources (including AMED, BIOSIS CINAHL, Embase, MEDLINE, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings, with no language, date, document type, or publication status limitations for inclusion of records into the register.

Selection criteria: We selected all randomised controlled clinical trials (RCTs) involving people diagnosed with schizophrenia or related disorders, which compared adding CBT to standard care with standard care given alone. Outcomes of interest included relapse, rehospitalisation, mental state, adverse events, social functioning, quality of life, and satisfaction with treatment.We included studies fulfilling the predefined inclusion criteria and reporting useable data.

Data collection and analysis: We complied with the Cochrane recommended standard of conduct for data screening and collection. Where possible, we calculated relative risk (RR) and its 95% confidence interval (CI) for binary data and mean difference (MD) and its 95% confidence interval for continuous data. We assessed risk of bias for included studies and created a 'Summary of findings' table using GRADE.

Main results: This review now includes 60 trials with 5,992 participants, all comparing CBT added to standard care with standard care alone. Results for the main outcomes of interest (all long term) showed no clear difference between CBT and standard care for relapse (RR 0.78, 95% CI 0.61 to 1.00; participants = 1538; studies = 13, low-quality evidence). Two trials reported global state improvement. More participants in the CBT groups showed clinically important improvement in global state (RR 0.57, 95% CI 0.39 to 0.84; participants = 82; studies = 2 , very low-quality evidence). Five trials reported mental state improvement. No differences in mental state improvement were observed (RR 0.81, 95% CI 0.65 to 1.02; participants = 501; studies = 5, very low-quality evidence). In terms of safety, adding CBT to standard care may reduce the risk of having an adverse event (RR 0.44, 95% CI 0.27 to 0.72; participants = 146; studies = 2, very low-quality evidence) but appears to have no effect on long-term social functioning (MD 0.56, 95% CI -2.64 to 3.76; participants = 295; studies = 2, very low-quality evidence, nor on long-term quality of life (MD -3.60, 95% CI -11.32 to 4.12; participants = 71; study = 1, very low-quality evidence). It also has no effect on long-term satisfaction with treatment (measured as 'leaving the study early') (RR 0.93, 95% CI 0.77 to 1.12; participants = 1945; studies = 19, moderate-quality evidence).

Authors' conclusions: Relative to standard care alone, adding CBT to standard care appears to have no effect on long-term risk of relapse. A very small proportion of the available evidence indicated CBT plus standard care may improve long term global state and may reduce the risk of adverse events. Whether adding CBT to standard care leads to clinically important improvement in patients' long-term mental state, quality of life, and social function remains unclear. Satisfaction with care (measured as number of people leaving the study early) was no higher for participants receiving CBT compared to participants receiving standard care. It should be noted that although much research has been carried out in this area, the quality of evidence available is poor - mostly low or very low quality and we still cannot make firm conclusions until more high quality data are available.

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Conflict of interest statement

Chris Jones: clinical psychologist who uses cognitive behavioural therapy for those with serious mental illnesses, employed by Birmingham and Solihull Mental Health Foundation Trust and the University of Birmingham.

David Hacker: clinical psychologist who uses cognitive behavioural therapy for those with serious mental illnesses, employed by Birmingham and Solihull Mental Health Foundation Trust.

Jun Xia: Owner of SRS ‐ Systematic Review Solutions ‐ professional review writing company.

Alan Meaden: none known.

Claire Irving: Managing Editor of Cochrane Schizophrenia.

Sai Zhao: Employed by SRS as an author to complete systematic reviews.

Chunhu Shi: Employed by SRS as an author to complete systematic reviews.

Jue Chen: Employed by SRS as an author to complete systematic reviews.

Figures

1
1
Study flow diagram for 2017 search
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD007964

References

References to studies included in this review

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    1. Wang L, Du X, Li X, Guo Y. Control study of cognitive behavioral nursing therapy for chronic schizophrenic [认知行为护理疗法对慢性精神分裂症作用的对照研究]. Medical Journal of Chinese People's Health [中国民康医学] 2005;17(9):548‐9.
Wang 2008 {published data only}
    1. Wang D, Li X, Xu J, Yin G, Chen S. A comparison of clinical study of schizophrenia with and without cognitive behavior therapy [认知行为治疗精神分裂症患者临床对照研究]. China Medical Herald [中国医药导报] 2008;5(28):39‐40.
Wang 2012 {published data only}
    1. Wang C, An Q. The effect of cognitive behavioural therapy for the compliance behaviour in patients with schizophrenia [认知行为治疗对精神分裂症患者遵医行为的影响]. Seek Medical and Ask the Medicine [求医问药] 2012;7:651.
Wang 2015 {published data only}
    1. Wang Z, Guo Z, Han G, Wang J, Li Z. Efficacy of cognitive‐behavioral therapy in community schizophrenia patients [认知行为治疗对社区精神分裂症患者的疗效]. China Journal of Health Psychology [中国健康心理学杂志] 2015;23(1):16‐9.
    1. Wang Z, Guo Z, Wang J, Yan G, Han G, Li Z. Effects of normalized cognitive‐behavioral therapy on quality of life and social function in community residual schizophrenia patients [规范化认知行为治疗对社区残留型精神分裂症患者生活质量和社会功能的影响]. Journal of Neuroscience and Mental Health [神经疾病与精神卫生] 2014;14(5):494‐6.
Yao 2015 {published data only}
    1. Yao L. Nursing interventions on anxiety and depression in schizophrenics during recovery stage [康复期精神分裂症患者焦虑抑郁情绪的护理措施]. World Latest Medicine Information [世界最新医学信息文摘] 2015;15(41):251‐2.
Zhang 2014 {published data only}
    1. Zhang Y. Effects of cognitive behavioral therapy on medication adherence in homeless psychotic patients during recovery stage [认知行为干预对恢复期住院流浪精神病患者服药依从性的影响]. Medical Journal of Chinese People's Health [中国民康医学] 2014;26(22):117‐8.
Zhang 2015 {published data only}
    1. Zhang H. The effect of cognitive psychology therapy for patients with psychosis [康复期精神病患者认知心理治疗的护理观察]. World Latest Medicine Information [世界最新医学信息文摘] 2015;15(41):191, 19.
Zhao 2013 {published data only}
    1. Zhao D, Zhao X, Guo J, Wu L, Xu N, Huo X, et al. Effects of cognitive behavioral therapy on social support system in schizophrenia patients [认知行为疗法改善精神分裂症患者社会支持系统的临床研究]. 中外健康文摘 2014;5(22):66‐7.
    1. Zhao X, Zhao D, Guo J, Wu L. Clinical study of cognitive behavioral therapy combined with risperidone for social support system in patients with schizophrenia [认知行为疗法联合利培酮对精神分裂症患者社会支持系统进行干预的临床研究]. Gansu Science and Technology [甘肃科技] 2013, (12):117‐20.
Zhao 2014 {published data only}
    1. Zhao S, Wang J. Rehabilitation efficacy of cognitive behavioral therapy on chronic schizophrenia patients [认知行为治疗对慢性精神分裂症患者康复疗效的对照研究]. Chinese Journal of Trauma and Disability Medicine [中国伤残医学] 2014;22(8):209‐10.
Zou 2013 {published data only}
    1. Zou H, Wang F, Li Z, Yao X, Zhang L, Feng Y, et al. Cognitive behavioral therapy and exercise intervention for patients taking antipsychotic [认知行为治疗和运动干预对服用抗精神病药物患者影响的效果评价]. Chinese Nursing Management [中国护理管理] 2013, (4):33‐6.

References to studies excluded from this review

ACTRN12606000 {unpublished data only}
    1. ACTRN12606000101583. Randomised controlled trial of cognitive behaviour therapy to prevent psychosis among people with at‐risk mental states. anzctr.org.au/Trial/Registration/TrialReview.aspx?id=1167 (first received.
Agius 2007 {published data only}
    1. Agius M, Shah S, Ramkisson R, Murphy S, Zaman R. Three year outcomes of an early intervention for psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team. Final results. Psychiatria Danubina 2007;19(3):130‐8. - PubMed
Bach 2002 {published data only}
    1. Bach P, Hayes SC. The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: a randomized controlled trial. Journal of Consulting and Clinical Psychology 2002;70(5):1129‐39. - PubMed
Barrowclough 2006 {published data only}
    1. Barrowclough C, Haddock G, Lobban F, Jones S, Siddle R, Roberts C, et al. Group cognitive‐behavioural therapy for schizophrenia. Randomised controlled trial. British Journal of Psychiatry 2006;189:527‐32. - PubMed
Bechdolf 2004 {published data only}
    1. Bechdolf A, Knost B, Kuntermann C, Schiller S, Klosterkötter J, Hambrecht M, et al. A randomized comparison of group cognitive‐behavioural therapy and group psychoeducation in patients with schizophrenia. Acta Psychiatrica Scandinavica 2004;110:21‐8. - PubMed
    1. Bechdolf A, Kçhn D, Knost B, Pukrop R, Klosterkçtter J. A randomized comparison of group cognitive‐behavioural therapy and group psychoeducation in acute patients with schizophrenia: outcome at 24 months. Acta Psychiatrica Scandinavica 2005;112:173‐9. - PubMed
Bechdolf 2005b {published data only}
    1. Bechdolf A, Veitha V, Schwarzer D, Schormann M, Stamm E, Janssen B, et al. Cognitive‐behavioral therapy in the pre‐psychotic phase: an exploratory study. Psychiatry Research 2005;136:251–5. - PubMed
Bradshaw 1996 {published data only}
    1. Bradshaw W. Structured group work for individuals with schizophrenia: a coping skills approach. Research on Social Work Practice 1996;6(2):139‐54.
Bradshaw 2000 {published data only}
    1. Bradshaw W. Integrating cognitive behavioural psychotherapy for persons with schizophrenia into a psychiatric rehabilitation programme: results of a three‐year trial. Community Mental Health Journal 2000;36(5):491‐500. - PubMed
Byerly 2005 {published data only}
    1. Byerly MJ, Fisher R, Cramody T, Rush AJ. A trial of compliance therapy in outpatients with schizophrenia or schizoaffective disorder. Journal of Clinical Psychiatry 2005;66(8):997‐1001. - PubMed
Cai 2014c {published data only}
    1. Cai S. Effects of cognitive psychotherapy in schizophrenia patients during recovery stage [康复期精神病患者认知心理治疗的效果观察]. World Latest Medicine Information [世界最新医学信息文摘] 2014;14:161‐4.
Cather 2005 {published data only}
    1. Cathera C, Penn D, Ottoa MW, Yovela I, Mueserc KT, Goff DC. A pilot study of functional Cognitive Behavioral Therapy (fCBT) for schizophrenia. Schizophrenia Research 2005;75:201–9. - PubMed
Cella 2014 {published data only}
    1. Cella M, Reeder C, Wykes T. It is all in the factors: effects of cognitive remediation on symptom dimensions. Schizophrenia Research 2014;156(1):60‐2. - PubMed
Chen 2012 {published data only}
    1. Chen R. The analysis of cognitive‐behavioral psychological intervention on the rehabilitation of chronic schizophrenia [认知行为心理干预对慢性精神分裂症康复作用分析]. Guide of China Medicine [中国医药指南] 2012, (11):57‐8.
ChiCTR‐TRC‐14004187 2014 {published data only}
    1. ChiCTR‐TRC‐14004187. Group cognitive behavioral therapy for psychosis. chictr.org.cn/com/25/showprojen.aspx?proj=5381. China, (accessed: 21 January 2014).
    1. HKUCTR‐1829. Randomized controlled trial of group cognitive‐behavioral therapy for psychosis. hkuctr.com (accessed: 22 April 2014).
Deng 2014 {published data only}
    1. Deng M, Ding N. Effects of group CBT on schizophrenia patients during recovery stage [对精神分裂症康复期患者实施团体CBT的效果观察]. Today Nurse [当代护士] 2014;10:116‐8.
Dong 2015 {published data only}
    1. Dong X. Cognitive behavioural therapy in combination with antipsychotic medication for schizophrenia. Medical Information 2015;28(19):324.
Drury 1996 {published data only}
    1. Drury V, Birchwood M, Cochrane R. Cognitive therapy and recovery from acute psychosis: a controlled trial. III. Five‐year follow‐up. British Journal of Psychiatry 2000;177:8‐14. - PubMed
    1. Drury V, Birchwood M, Cochrane R, Macmillan F. Cognitive therapy and recovery from acute psychosis: a controlled trial. I. Impact on psychotic symptoms. British Journal of Psychiatry 1996;169:593‐601. - PubMed
    1. Drury V, Birchwood M, Cochrane R, Macmillan F. Cognitive therapy and recovery from acute psychosis: a controlled trial. II. Impact on recovery time. British Journal of Psychiatry 1996;169:602‐7. - PubMed
Du 2016 {published data only}
    1. Du LN, Pei JZ, Liu QQ. Cognitive behavioural therapy for the rehabilitation of schizophrenia [认知行为疗法治疗精神分裂症的康复效果观察]. 临床合理用药杂志 2015;8(16):140.
Eack 2014 {published data only}
    1. Eack SM, Hogarty SS, Greenwald DP, Litschge MY, McKnight SA, Bangalore SS, et al. Cognitive enhancement therapy in substance misusing schizophrenia: results of an 18‐month feasibility trial. Schizophrenia Research 2016;161(2‐3):478‐83. - PMC - PubMed
Farreny 2012 {published data only}
    1. Farreny A, Aguado J, Ochoa S, Huerta‐Ramos E, Marsà F, López‐Carrilero R, et al. REPYFLEC cognitive remediation group training in schizophrenia: looking for an integrative approach. Schizophrenia Research 2012;142(1‐3):137‐44. - PubMed
Favrod 2014 {published data only}
    1. Favrod J, Rexhaj S, Bardy S, Ferrari P, Hayoz C, Moritz S, et al. Sustained antipsychotic effect of metacognitive training in psychosis: a randomized‐controlled study. European Psychiatry 2014;29(5):275‐81. - PubMed
Feng 2013 {published data only}
    1. Feng Y, Song H, Wang X. The effect of venlafaxine plus cognitive therapy for depression after the treatment of schizophrenia: a controlled study [文拉法辛合并认知疗法治疗精神分裂症后抑郁的对照研究]. Yi Xue Li Lun Yu Shi Jian [医学理论与实践] 2013, (15):2014‐5.
Gaudiano 2006 {published data only}
    1. Gaudiano BA, Herbert JD. Acute treatment of inpatients with psychotic symptoms using Acceptance and Commitment Therapy: pilot results. Behavioural Research and Therapy 2006;44(3):415‐37. - PubMed
Granholm 2007 {published data only}
    1. Granholm E, McQuaid JR, McClure FS, Auslander LA, Perivoliotis D, Pedrelli P, et al. A randomized, controlled trial of cognitive behavioral social skills training for middle‐aged and older outpatients with chronic schizophrenia. American Journal of Psychiatry 2005;162:520‐9. - PubMed
Haddock 1998 {published data only}
    1. Haddock G, Tarrier N, Morrison AP, Hopkins R, Drake R, Lewis S. A pilot study evaluating the effectiveness of individual inpatient cognitive‐behavioural therapy in early psychosis. Social Psychiatry and Psychiatric Epidemiology 1999;34:254‐8. - PubMed
Hang 2014 {published data only}
    1. Hang RH, Cheng WL, Wu MF, Feng LP. Cognitive training for geriatric chronic schizophrenia patients [认知训练对老年慢性精神分裂症患者认知功能的影响]. Chinese Journal of Gerontology [中国老年学杂志] 2014;34:2678‐80.
Hert 2000 {published data only}
    1. Herz MI, Lamberti JS, Mintz J, Scott R, O'Dell SP, McCartan L, et al. A program for relapse prevention in schizophrenia: a controlled study. Archives General Psychiatry 2000;57(3):277‐83. - PubMed
Hogarty 1997 {published data only}
    1. Hogarty GE, Greenwald D, Ulrich RF, Kornblith SJ, DiBarry AL, Cooley S. Three‐year trials of personal therapy among schizophrenic patients living with or independent of family, II: Effects on adjustment of patients. American Journal of Psychiatry 1997;154(11):1514–24. - PubMed
    1. Hogarty GE, Kornblith SJ, Greenwald D, DiBarry AL, Cooley S, Ulrich RF, et al. Three‐year trials of personal therapy among schizophrenic patients living with or independent of family, I: Description of study and effects on relapse rates. American Journal of Psychiatry 1997;154(11):1504–13. - PubMed
Hogarty 2004 {published data only}
    1. Hogarty GE, Flesher S, Ulrich R, Carter M, Greenwald D, Pogue‐Geile M. Cognitive enhancement therapy for schizophrenia: effects of a 2‐year randomized trial on cognition and behavior. Archives General Psychiatry 2004;61(9):866–76. - PubMed
Huang 2014 {published data only}
    1. Huang S, Wang J. The application of cognitive therapy in 120 cases of patients with schizophrenia [认知治疗在120例精神分裂症缓解期患者中的应用分析]. Guide of China Medicine [中国医药指南] 2014;12:115‐6.
Ibranhim 2012 {published data only}
    1. Ibrahim WE, El‐Bilsha MA, Abeldayem SM. Effect of cognitive behavior therapy (CBT) on depression among schizophrenic patients with low self esteem. Middle East Journal of Psychiatry and Alzheimers 2012;3(4):3‐10.
ISRCTN11889976 {unpublished data only}
    1. ISRCTN11889976. Comparison between extension of specialised early intervention for first episode psychosis and regular care: a randomised controlled trial. isrctn.com/ISRCTN11889976.
ISRCTN34966555 {published data only}
    1. ISRCTN34966555. Active assistance for psychological therapy (Actissist): using mobile technology to deliver cognitive behaviour therapy for psychosis ‐ RCT. isrctn.com/ISRCTN34966555.
ISRCTN47998710 {published data only}
    1. ISRCTN47998710. PRODIGY: Prevention of long term social disability amongst young people with emerging psychological difficulties ‐ a pilot randomised controlled trial of social recovery cognitive behavioural therapy. isrctn.com/ISRCTN47998710 [Date Accessed: 29 November 2012].
ISRCTN77762753 {published data only}
    1. Hazell CM, Hayward M, Cavanagh K, Jones AM, Strauss C. Guided self‐help cognitive behavioral intervention for VoicEs (GiVE): study protocol for a pilot randomized controlled trial. Trials 2016;17(1):351. - PMC - PubMed
    1. ISRCTN77762753. A pilot randomised controlled trial of guided self‐help cognitive behaviour therapy for distressing voices. isrctn.com/search?q=ISRCTN77762753 (first received 23 July 2015).
Jackson 1998 {published data only}
    1. Jackson H, McGorry P, Edwards J, Hulbert C, Henry L, Francey S, et al. Cognitively‐oriented psychotherapy for early psychosis (COPE). Preliminary results. British Journal Psychiatry 1998;172(33 suppl):93‐100. - PubMed
    1. Jackson H, McGorry P, Edwards J, Hulbert C, Henry L, Harrigan S, et al. A controlled trial of cognitively oriented psychotherapy for early psychosis (COPE) with four‐year follow‐up readmission data. Psychological Medicine 2005;35(9):1295‐306. - PubMed
    1. Jackson H, McGorry P, Henry L, Edwards J, Hulbert C, Harrigan S, et al. Cognitively oriented psychotherapy for early psychosis (COPE): a 1‐year follow‐up. British Journal Clinical Psychology 2001;40(Pt 1):57‐70. - PubMed
Jackson 2008 {published data only}
    1. Bendall S, Jackson HJ, Killackey E, Allott K, Johnson T, Harrigan S, et al. The credibility and acceptability of befriending as a control therapy in a randomized controlled trial of cognitive behaviour therapy for acute first episode psychosis. Behavioural and Cognitive Psychotherapy 2006;34:277‐91.
    1. Jackson HJ, McGorry PD, Killackey E, Bendall S, Allott K, Dudgeon P, et al. Acute‐phase and 1‐year follow‐up results of a randomized controlled trial of CBT versus befriending for first‐episode psychosis: the ACE project. Psychological Medicine 2008;38(5):725‐35. - PubMed
Jenner 2004 {published data only}
    1. Jenner JA, Nienhuis FJ, Wiersma D, Willige G. Hallucination focused integrative treatment: a randomized controlled trial. Schizophrenia Bulletin 2004;30(1):133–45. - PubMed
Jiang 2014 {published data only}
    1. Jiang M, Chen H, Sun X. Application of cognitive‐behavioral therapy on schizophrenia patients comorbid with diabetes mellitus [认知行为疗法在精神分裂症伴糖尿病患者中的应用]. Journal of Nursing Science [护理学杂志] 2014;29(17):69‐70.
Johnson 2008 {published data only}
    1. Johnson DP, Penn DL, Bauer DJ, Meyer P, Evans E. Predictors of the therapeutic alliance in group therapy for individuals with treatment‐resistant auditory hallucinations. British Journal of Clinical Psychology 2008;47(Pt. 2):171‐83. - PubMed
Kidd 2014 {published data only}
    1. Kidd SA, Kaur J, Virdee G, George TP, McKenzie K, Herman Y, et al. Cognitive remediation for individuals with psychosis in a supported education setting: a randomized controlled trial. Schizophrenia Research 2014;157(1‐3):90‐8. - PubMed
Klingberg 2009 {published data only}
    1. Klingberg S1, Wittorf A, Herrlich J, Wiedemann G, Meisner C, Buchkremer G, et al. Cognitive behavioural treatment of negative symptoms in schizophrenia patients: study design of the TONES study, feasibility and safety of treatment. European Archives of Psychiatry and Clinical Neuroscience 2009;259(2):149‐54. - PubMed
Kong 2015 {published data only}
    1. Kong LJ, Zuo XY, Zhou YB, Jiao F. The effect of cognitive behavioural therapy for quality of life in patients with schizophrenia. Journal of Yangtze University (Natural Science Edition) 2015;12(30):70‐2.
Kuipers 2004 {published data only}
    1. Kuipers E, Holloway F, Rabe‐Hesketh S, Tennakoon L, Croydon Outreach and Assertive Support Team (COAST). An RCT of early intervention in psychosis. Social Psychiatry and Psychiatric Epidemiology 2004;39(5):358–63. - PubMed
Lang 2014 {published data only}
    1. Lang Y, Li W, Wang F, Xu X. The effect of cognitive nursing intervention on the rehabilitation in young schizophrenia patients with impaired memory [认知护理干预在儿童精神分裂症记忆损害患儿恢复中的应用]. Nursing Practice and Research [护理实践与研究] 2014;11:104‐5.
Leclerc 2000 {published data only}
    1. Leclerc C, Lesage AD, Ricard N, Lecomte T, Cyr M. Assessment of a new rehabilitative coping skills module for persons with schizophrenia. American Journal of Orthopsychiatry 2000;70(3):380‐8. - PubMed
Lecomte 2008 {published data only}
    1. Lecomte T, Leclerc C, Corbiere M, Wykes T, Wallace CJ, Spidel A. Group cognitive behavior therapy or social skills training for individuals with a recent onset of psychosis? Results of a randomized controlled trial. Journal of Nervous Mental Disorders 2008;196:866‐75. - PubMed
Li 2013 {published data only}
    1. Li J, Deng X, Xie Y, Liang L. Effects of cognitive behavioral therapy on cognitive function in patients with chronic schizophrenia [认知行为治疗对慢性精神分裂症患者认知功能的影响]. Chinese and Foreign Medical Research [中外医学研究] 2013, (24):130‐2.
Li 2013b {published data only}
    1. Li X, Guo Y, Fu C, Chen L, Zhang Z. The effect of group cognitive behavioral therapy for refractory auditory hallucinations in schizophrenia [小组认知行为治疗对精神分裂症顽固性幻听的疗效观察 ]. Chinese Journal of Rehabilitation [中国康复] 2013, (4):313‐5.
Li 2014b {published data only}
    1. Li L, Hu L, Liang Z, Wen Z. Impact of cognitive intervention on quality of living and related factor of patients with chronic schizophrenia [认知干预对慢性精神分裂症患者生活质量及相关因素的影响]. Clinical Medical and Engineering [临床医学工程] 2014;21(8):1073‐4.
Li 2015c {published data only}
    1. Li Y, Yang Y, Wei Z, Yin Y. The influence of cognitive behavior intervention on olanzapine induced weight gain in schizophrenia [认知行为干预对奥氮平致精神分裂症患者体质量增加的影响]. Journal of Clinical Psychosomatic Diseases [临床心身疾病杂志] 2015;21:29‐31.
Lin 2014 {published data only}
    1. Lin J. Effects of cognitive‐behavioral therapy for post‐schizophrenic depression [认知行为疗法在精神分裂症后抑郁中的应用效果分析]. Guide of China Medicine [中国医药指南] 2014;12(33):174.
Lincoln 2012 {published data only}
    1. Lincoln TM, Ziegler M, Mehl S, Kesting ML, Lullmann E, Westermann S, et al. Moving from efficacy to effectiveness in cognitive behavioral therapy for psychosis: a randomized clinical practice trial. Journal of Consulting and Clinical Psychology 2012;80:674‐86. - PubMed
Liu 2013 {published data only}
    1. Liu D, Liu J, Li S, Feng A. Effects of token therapy and cognitive therapy on quality of life in schizophrenia patients [代币疗法与认知治疗对精神分裂症患者生活质量的影响]. China Health Industry [中国卫生产业] 2014, (2):107+109.
Liu 2015 {published data only}
    1. Liu J, Yong S, Xu X, Zhang J, Xie P, Xu C, et al. Influence of CBT on rehabilitation outcome of hospitalized schizophrenics [认知行为治疗对住院精神分裂症患者康复效果的影响]. Journal of Clinical Psychosomatic Diseases [临床心身疾病杂志] 2015;21:64‐6.
Lu 2012 {published data only}
    1. Lu H, Li Y, Li F, Jiao X, Shi W, Guo K, et al. Randomized controlled trial on adjunctive cognitive remediation therapy for chronically hospitalised patients with schizophrenia [慢性精神分裂症住院患者辅以认知矫正治疗的随机对照研究]. Shanghai Archives of Psychiatry [上海精神医学] 2012;24:149‐54. - PMC - PubMed
Lu 2014a {published data only}
    1. Lu HM, Wang XL, Tang Y, Fei P. The application of cognitive therapy in patients with schizophrenia. Medical Information 2014;27:463.
Lysaker 2009 {published data only}
    1. Davis LW, Lysaker PH, Lancaster RS, Bryson GJ, Bell MD. The Indianapolis Vocational Intervention Program: a cognitive behavioral approach to addressing rehabilitation issues in schizophrenia. Journal of Rehabilitation Research and Development 2005;42(1):35. - PubMed
    1. Lysaker PH, Davis LW, Bryson GJ, Bell MD. Effects of cognitive behavioral therapy on work outcomes in vocational rehabilitation for participants with schizophrenia spectrum disorders. Schizophrenia Research 2009;107:186‐91. - PubMed
McLeod 2007 {published data only}
    1. McLeod T, Morris M, Birchwood M, Dovey A. Cognitive behavioural therapy group work with voice hearers. Part 1. British Journal of Nursing 2007;16:248‐52. - PubMed
Mo 2015 {published data only}
    1. Mo Y, Li X, Fu C, He R, Cai Y, Mo T. Effects of cognitive‐behavioral intervention on mental status in homeless schizophrenia patients [认知行为干预对流浪精神疾病患者心理状态的影响]. China Modern Medicine [中国现代药物应用] 2015; Vol. 9, issue 1:201‐2.
Morrison 2014 {published data only}
    1. Morrison AP, Turkington D, Pyle M, Spencer H, Brabban A, Dunn G, et al. Cognitive therapy for people with schizophrenia spectrum disorders not taking antipsychotic medication: a randomised controlled trial. Lancet 2014; Vol. 153:1395‐403. - PubMed
NCT00810355 {unpublished data only}
    1. NCT00810355. Cognitive Behavior Therapy and Work Outcome. clinicaltrials.gov/ct2/show/NCT00810355 [Date Accessed: 18 December 2008].
NCT00960375 {unpublished data only}
    1. NCT00960375. Smoking Cessation for Veterans With Severe and Persistent Mental Illness. clinicaltrials.gov/ct2/show/NCT00960375 [Date Accessed: 17 August 2009].
NCT02105779 {published data only}
    1. NCT02105779. Optimizing Cognitive Remediation Outcomes in Schizophrenia. clinicaltrials.gov/ct2/show/NCT02105779 [Date Accessed: 7 April 2014].
NCT02420015 {published data only}
    1. NCT02420015. Mobile Health Technology to Enhance Abstinence in Smokers With Schizophrenia. clinicaltrials.gov/ct2/show/NCT02420015 [Date Accessed: 17 April 2015].
NCT02535923 {published data only}
    1. NCT02535923. CBT‐I for Psychosis: Guidelines, Preliminary Efficacy, and Functional Outcomes. clinicaltrials.gov/ct2/show/NCT02535923 [Date Accessed: 31 August 2015].
NCT02751632 {published data only}
    1. ACTRN12616000098437. Staged Treatment in Early Psychosis (STEP): a sequential multistage randomized clinical trial (SMART) of interventions for Ultra High Risk (UHR) of psychosis patients. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369499 [Date Accessed: 1 February 2016].
    1. NCT02751632. The Staged Treatment in Early Psychosis Study. clinicaltrials.gov/ct2/show/NCT02751632 [Date Accessed: 26 April 2016].
Nordentoff 2005 {published data only}
    1. Bertelsen M, Jeppesen P, Petersen L, Thorup A, Øhlenschlaeger J, Quach P, et al. Five‐year follow‐up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Archives of General Psychiatry 2008;65(7):762‐71. - PubMed
O'Connor 2007 {published data only}
    1. O'Connor K, Stip E, Pelissier MC, Aardema F, Guay S, Gaudette G, et al. Treating delusional disorder: a comparison of cognitive‐behavioural therapy and attention placebo control. Canadian Journal of Psychiatry 2007;52(3):182‐90. - PubMed
O'Donnell 2003 {published data only}
    1. O'Donnell C, Donohoe G, Sharkey L, Owens N, Migone M, Harries R, et al. Compliance therapy: a randomised controlled trial in schizophrenia. BMJ 2003;327(7419):834. - PMC - PubMed
O'Driscoll 2015 {published data only}
    1. O'Driscoll C, Mason O, Brady F, Smith B, Steel C. Process analysis of trauma‐focused cognitive behavioural therapy for individuals with schizophrenia. Psychology and Psychotherapy 2016;89(2):117‐32. - PubMed
Owen 2015 {published data only}
    1. Owen M, Sellwood W, Kan S, Murray J, Sarsam M. Group CBT for psychosis: a longitudinal, controlled trial with inpatients. Behaviour Research and Therapy 2015;65:76‐85. - PubMed
Penades 2006 {published data only}
    1. Penades R, Catalen R, Salamero M, Boget T, Puig O, Guarch J, et al. Cognitive remediation therapy for outpatients with chronic schizophrenia: a controlled and randomized study. Schizophrenia Research 2006;87:323–31. - PubMed
Penn 2009 {published data only}
    1. Penn DL, Meyer PS, Evans E, Wirth RJ, Cai K, Burchinal M. A randomized controlled trial of group cognitive‐behavioral therapy vs. enhanced supportive therapy for auditory hallucinations. Schizophrenia Research 2009;109:52–9. - PubMed
Phillips 2002 {published data only}
    1. Phillips LJ, Leicester SB, O’Dwyer LE, Francey SM, Koutsogiannis J, Abdel‐Baki A, et al. The PACE Clinic: identification and management of young people at "ultra" high risk of psychosis. Journal of Psychiatric Practice 2002;8(5):255‐9. - PubMed
    1. Phillips LJ, Yung AR, Yuen HP, Pantelis C, McGorry PD. Prediction and prevention of transition to psychosis in young people at incipient risk for schizophrenia. American Journal of Medical Genetics 2002;114(8):929–37. - PubMed
Pinto 1999 {published data only}
    1. Pinto A, Pia SL, Mennella R, Giorgio D, DeSimone L. Cognitive‐behavioral therapy and clozapine for clients with treatment‐refractory schizophrenia. Psychiatry Service 1999;50(7):901–4. - PubMed
Qi 2012 {published data only}
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Rector 2005 {published data only}
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Reeder 2014 {published data only}
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Richmond 2005 {unpublished data only}
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Sellwood 2000 {published data only}
    1. Sellwood W, Barrowclough C, Tarrier N, Quinn J, Mainwaring J, Lewis S. Needs‐based cognitive‐behavioural family intervention for carers of patients suffering from schizophrenia: 12‐month follow‐up. Acta Psychiatrica Scandinavica 2001;104(5):346‐55. - PubMed
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Sensky 2000 {published data only}
    1. Sensky T, Turkington D, Kingdon D, Scott JL, Scott J, Siddle R, et al. A randomized controlled trial of cognitive‐behavioral therapy for persistent symptoms in schizophrenia resistant to medication. Archives of General Psychiatry 2000;57(2):165‐72. - PubMed
Shao 2013 {published data only}
    1. Shao G. Cognitive behavioral therapy used in the treatment of mentally ill [认知行为疗法在精神病康复治疗中的应用]. Guide of China Medicine [中国医药指南] 2013, (11):567‐8.
Shi 2015 {published data only}
    1. Shi Y, Jiao Y, Jiang L, Sun Y, Bo Z, Wu Q, et al. Effects of cognitive‐behavioral therapy on executive function in chronic schizophrenia patients [认知行为治疗对慢性精神分裂症患者执行功能的影响]. Journal of Neuroscience and Mental Health [神经疾病与精神卫生] 2015;15(5):497‐9.
Song 2012 {published data only}
    1. Song X, Liu Y, Zhang Y, Zhou L. The effective of cognitive behavioral therapy on negative symptoms of schizophrenia [认知行为治疗对改善精神分裂症病人阴性症状的效果研究]. XinLi YiSheng [心理医生] 2012;7:30‐1.
Song 2014 {published data only}
    1. Song X, Li J, Zhang Y, Wang X, Wang E. Effects of group CBT on quality of life in schizophrenia patients with auditory hallucination [团体CBT对精神分裂症幻听患者生存质量的影响]. International Medicine and Health Guidance News [国际医药卫生导报] 2014;20(16):2572‐4.
Turkington 2008 {published data only}
    1. Turkington D, Sensky T, Scott J, Barnes TRE, Nur U, Siddle R, et al. A randomized controlled trial of cognitive‐behavior therapy for persistent symptoms in schizophrenia: a five‐year follow‐up. Schizophrenia Research 2008;98:1‐7. - PubMed
Valmaggia 2005 {published data only}
    1. Valmaggia LR, Gaag M, Tarrier N, Pijnenborg M, Slooff CJ. Cognitive‐behavioural therapy for refractory psychotic symptoms of schizophrenia resistant to atypical antipsychotic medication. Randomised controlled trial. British Journal of Psychiatry 2005;186:324‐30. - PubMed
Wang 2003 {published data only}
    1. Wang C, Li Y, Zhao Z, Pan M, Feng Y, Sun F, et al. Controlled study on long‐term effect of cognitive behavior intervention on first episode schizophrenia. Chinese Mental Health Journal 2003;7466:200‐2.
Wang 2013 {published data only}
    1. Wang H, Chen Y, Xie W, Xiao B, Qiu C, Xie S. The effect of cognitive treatment on the compliance for treatment of outpatient with schizophrenia [认知治疗对门诊精神分裂症患者治疗依从性的影响]. Medical Journal of Chinese People's Health [中国民康医学] 2013;25(7):16‐8.
Wang 2013a {published data only}
    1. Wang C, Cheng M, Sheng M. Cognitive ‐ the existence group therapy for patients with chronic schizophrenia in community [认知‐存在团体对社区慢性精神分裂症患者的干预效果]. China Journal of Health Psychology [中国健康心理学杂志] 2013;21:974‐7.
Wang 2014 {published data only}
    1. Wang E. Effects of cognitive rehabilitation care on cognitive function impairment in 40 schizophrenia patients [40例认知康复护理对精神分裂症患者认知功能障碍的影响]. Contemporary Medicine [当代医学] 2014;20(19):129‐30.
Wei 2012 {published data only}
    1. Wei Q, Li J, Wen C. Clinical efficacy of cognitive therapy for schizophrenia and its impact on the social function of patients [认知疗法治疗精神分裂症的临床疗效及对患者社会功能的影响]. Chinese Journal of Medicinal Guide [中国医药导刊] 2012;14(11):1910‐1.
Wu 2012 {published data only}
    1. Wu S. Cognitive psychotic therapy for depression in patients with schizophrenia [认知心理治疗改善精神分裂症后抑郁的疗效分析]. Journal of Modern Medicine and Health [现代医药卫生] 2012;14:2155‐6.
Wu 2013 {published data only}
    1. Wu L. Application of psychological intervention in nursing care of patients with chronic schizophrenia with negative symptoms [心理干预在慢性精神分裂症阴性症状患者护理中的应用]. Medical Journal of Chinese People's Health [中国民康医学] 2013;25(9):81‐2.
Wykes 2005 {published data only}
    1. Wykes T, Hayward P, Thomas N, Green N, Surguladze S, Fannon D, et al. What are the effects of group cognitive behaviour therapy for voices? A randomised control trial. Schizophrenia Research 2005;77(2):201‐10. - PubMed
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    1. Xie W, Xie Y, Xiao Y, Wang H, Xiao B. The application of multimedia in cognitive intervention to enhance its effect in patients with schizophrenia [精神分裂症患者应用多媒体加强认知干预的效果研究]. Journal of Nursing [护理学报] 2013;20(4B):57‐9.
Xu 2014 {published data only}
    1. Xu M. Effects of cognitive behavioral social work team on anxiety in schizophrenia inpatients [认知行为社工小组对住院精神分裂症患者焦虑情绪的影响]. Medical Journal of Chinese People's Health [中国民康医学] 2014;26(1):23‐4.
Yang 2012 {published data only}
    1. Yang X, Xiong Y. Cognitive psychotherapy efficacy for the prevention of relapse of schizophrenia research [认知心理治疗对预防精神分裂症复发的疗效研究]. China Foreign Medical Treatment [中外医疗] 2012, (5):18+20.
Zeng 2014 {published data only}
    1. Zeng Y, Lin S, Dai C. Effects of different nursing models on negative symptoms and social function in psychotic patients [不同护理模式干预对精神病患者阴性症状和社会功能的影响]. China Modern Medicine [中国当代医药] 2014;21(18):108‐9+112.
Zhang 2005 {published data only}
    1. Zhang J. Cognitive behavioral therapy for rehabilitation of schizophrenic patients with anxiety [认知行为疗法对康复期精神分裂患者焦虑情绪的影响]. Journal of Qiqihar Medical College [齐齐哈尔医学院学报] 2005;26(9):1010‐1.
Zhao 2012 {published data only}
    1. Zhao Y, Qin F. Risperidone combined with cognitive insight therapy efficacy study of first‐episode schizophrenia [利培酮合并认知领悟治疗对首发精神分裂症疗效研究]. Journal of Mathematical Medicine [数理医药学杂志] 2012;25(2):211‐3.
Zhou 2015b {published data only}
    1. Zhou J. Effects of cognitive behavioral therapy on social function and quality of life in schizophrenia patients [认知行为疗法对精神分裂症患者社会功能和生活质量的影响]. Health Research [健康研究] 2015;35(05):539‐41.

References to studies awaiting assessment

Chen 2015c {published data only}
    1. Chen G. Efficacy of cognitive‐behavioral therapy on schizophrenia patients during recovery stage [认知行为疗法治疗精神分裂症患者康复期的疗效观察]. 14th academic annual meeting of the Committee on Mental Illness of China Association of Traditional Chinese and Western Medicine [中国中西医结合学会精神疾病专业委员会第十四届学术年会暨首届国际中西医结合精神病学研究进展培训班]. 2015:4.
Fohlmann 2010 {published data only}
    1. Fohlmann AH, Hjorthoej C, Larsen A, Nordentoft M. Capopus. Randomized clinical trial: specialized addiction treatment (MI & CBT) versus treatment as usual for young patients with cannabis abuse and psychosis. Early Intervention in Psychiatry 2010;4(Suppl. 1):160.
    1. Hjorthaj CR. Validity of self‐reported cannabis use as measured by the timeline follow‐back instrument in a trial randomizing people with comorbid cannabis use disorder and schizophrenia spectrum disorder. Early Intervention in Psychiatry 2010;4(Suppl. 1):160.
Hardy 2015 {published data only}
    1. Hardy A, Steel C, Smith B, Wykes T, Rose S, Enright S, et al. Cognitive behavioural therapy for the treatment of posttraumatic stress disorder in schizophrenia. European Archives of Psychiatry and Clinical Neuroscience 2015;1:S31‐2.
Hassan 2014 {published data only}
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Moun 2015 {published data only}
    1. Moun V, Tripathi A, Dalal PK, Sinha PK. Home based cognitive training in patients of schizophrenia. Indian Journal of Psychiatry 2015;57:S78.
Nagui 2016 {published data only}
    1. Rizk DN, Salama H, Molokhiya T, Kassem L. Effectiveness of brief individual cognitive behavioral therapy for auditory hallucinations in a sample of Egyptian patients with schizophrenia. European Psychiatry 2016;33(Suppl.):S259‐60.
Tang 2015 {published data only}
    1. Tang W, Zhang J, Wen N, Pan J, Yang F, Jiang S. Effects on prognosis recurrence and efficacy in schizophrenia patients treated with palpiperone palmitate long‐acting injection and cognitive‐behavioral intervention [棕榈酸帕利哌酮长效针剂联合认知行为干预对精神分裂症患者疗效及预后复发的影响]. 30th anniversary of the establishment of China Mental Health Association and the eighth National Academic Conference on Mental Health [中国心理卫生协会成立30周年纪念活动暨第八次全国心理卫生学术大会]. 2015:192.
Tecic 2012 {published data only}
    1. Tecic T, Guttgemanns J, Lehmkuhl G, Mueller K, Stoesser D, Wiedemann G, et al. Modified cognitive behavioral therapy in adolescents with persistent psychotic symptoms ‐ results of a randomized controlled trial. Schizophrenia Research 2012;136:S302.

References to ongoing studies

Edwards 2008 {published data only}
    1. Edwards J, Harris M, Harrigan S, Merritt A, Amminger G, Lurdes Santos M, et al. A clinical audit of the first six months of care of first‐episode psychosis patients in seven European sites. Early Intervention in Psychiatry 2008;2:A25.
ISRCTN06022197 {published data only}
    1. ISRCTN06022197. A pilot study of a randomised controlled trial of antipsychotic medication in comparison to cognitive behaviour therapy and a combined treatment in adults with psychosis. www.isrctn.com/ISRCTN06022197. Uk, [Date Accessed: 20 March 2014].
ISRCTN12668007 {published data only}
    1. ISRCTN12668007. The nightmare intervention study. www.isrctn.com/ISRCTN12668007 [Date Accessed: 20 November 2015].
ISRCTN33695128 {published data only}
    1. ISRCTN33695128. Better Sleep Trial: a pilot randomised controlled trial for patients with delusions and/or hallucinations. www.isrctn.com/ISRCTN33695128 [Date Accessed: 26 September 2012].
ISRCTN61621571 {published data only}
    1. ISRCTN61621571. Sustaining positive engagement and recovery (supereden) ‐ the next step after early intervention for psychosis. Study 3: Improving social recovery in young people with emerging severe social disability: a proof of principle randomised controlled trial. www.isrctn.com/ISRCTN61621571 [Date Accessed: 26 June 2012].
NCT00484302 {published data only}
    1. NCT00484302. Cannabis and psychosis randomized clinical trial: specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis. clinicaltrials.gov/ct2/show/NCT00484302 [Date Accessed: 8 June 2007].
NCT00495911 {published data only}
    1. NCT00495911. A randomized controlled trial of individual therapy for first episode psychosis. clinicaltrials.gov/ct2/show/NCT00495911 [Date Accessed: 25 July 2008].
NCT02134418 {published data only}
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NCT02380885 {published data only}
    1. NCT02380885. RCT social cognition training and therapeutic alliance focused therapy for persons with severe mental illness. clinicaltrials.gov/ct2/show/NCT02380885 [Date Accessed: 5 March 2015].
NCT02408198 {published data only}
    1. NCT02408198. The Street Smart Group: a feasibility trial of a group intervention targeting anxiety processes in paranoia. clinicaltrials.gov/ct2/show/NCT02408198 [Date Accessed: 3 April 2015].
NCT02427542 {published data only}
    1. NCT02427542. Feasibility trial of CBT for depersonalisation in psychosis. clinicaltrials.gov/ct2/show/NCT02427542 [Date Accessed: 28 April 2015].
NCT02653729 {published data only}
    1. NCT02653729. CBT for psychosis and affect on psychosis symptoms. clinicaltrials.gov/ct2/show/NCT02653729 [Date Accessed: 12 January 2016].
NCT02787122 {published data only}
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NCT02787135 {published data only}
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Waller 2014 {published data only}
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