The effect of cognitive behavioral therapy in reducing psychotic symptoms and enhancing functions in schizophrenic patients

Abstract

Objectives: This study tried to develop a treatment group based on the cognitive behavioral approach, to help schizophrenic patients to cope with their psychiatric symptoms. The effectiveness of the treatment group in reducing psychotic symptoms and the functional improvement resulted among schizophrenic patients were assessed.

Methods: A total of 50 psychiatric in-patients who were diagnosed to be suffering from schizophrenia with active positive psychotic symptoms for more than one year (i.e., treatment resistant) were recruited from Kwai Chung Hospital. The experimental group received cognitive behavioral therapy group, whereas the control group received a series of educational groups. A pretest and two posttests (immediately after the treatment and at one-month follow-up) were conducted to assess patients’ schizophrenic symptoms and functional abilities. Two trained occupational therapists who were blinded to the hypothesis rated the participants in both conditions.

Results: Both measurement of symptom areas and functional abilities had a moderate to high internal consistency and inter-rater reliability. Patients who stayed longer in the hospital tend to have poorer self-care, more disturbing behavior, and lower social and general function. Social, affect, and thought process symptom categories were strongly negatively correlated with patients’ self-care, social contact, and communication skills. No significant difference was found between the experimental and control group in their functional abilities after the treatments. Significant difference was found between the two groups in the symptom hallucinations when tested immediately after the treatments, but not on the one-month follow-up test.

Discussion: The fading of the improvement in the present study may be due to the lack of practice and environmental constraint. After the treatment phase, participants will have to resume to their previous daily routines in the hospital, which are not favorable to the practice of the cognitive behavioral coping method.