A recent study suggests that cognitive behavioral therapies are more effective than medication alone in combating the symptoms of schizophrenia.
Medication or cognitive behavioral therapy to treat schizophrenia? A study, published on February 6 in The Lancet, tried to define an alternative to antipsychotics in the treatment of this disease. Their argument: “many patients refuse to take, or do not systematically take their drug treatment. “
1 in 2 patients do not take their antipsychotics
Currently, schizophrenic patients have only one solution to fight their disease: antipsychotic drugs. “But half of all schizophrenic patients choose not to take them because of the side effects,” says Prof. Anthony Morrison, researcher at the Greater Manchester West Mental Health Foundation Trust. Substantial weight gain, metabolic disorders or even risk of heart attack … many arguments invoke by patients to explain their refusal to take antipsychotics. They also explain not to feel the effectiveness of drugs, and some believe that they do not need it, according to the researcher. But no alternative exists for these patients who refuse their drug treatment.
41% of patients are getting better
74 patients participated in this pilot study. Half received antipsychotics alone, the other half participated in 26 sessions of cognitive behavioral therapy (CBT) in addition to medication over a period of nine months. A CBT is carried out in two stages: identification with the patient of his problems (paranoia, isolation…) and development of techniques to control and / or modify the behaviors and thoughts which are at the source of these problems. It improves psychotic symptoms and improves the social functioning of patients. In 41% of cases, patients who received CBT experienced improvement in symptoms. The drug solution was only as effective in 18% of patients.
One step forward “
“We have shown that CBT is an acceptable intervention for a population that is often said to be difficult to integrate into mental health services. Antipsychotic drugs, although beneficial for many patients, can have severe side effects. Strong alternatives should be available for those who choose not to take them, ”according to Prof. Morrison. Another study is underway to compare the benefit of CBT alone versus the simple drug solution and the combination of the two. The researchers believe that the combination of the two approaches would be the most effective solution. Because if psychotherapy seems to work well on hallucinations and social functioning, it does not improve the deficient symptoms, such as disorders of concentration, memory or even abstraction capacities.
In a related commentary, Oliver Howes of the London Institute of Psychiatry writes that these findings “provide evidence that the concept of cognitive therapy is an alternative to antipsychotic treatments. “Developing CBTs in the treatment of schizophrenia would be a” step forward “in the management of the disease, according to him.
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