What works in schizophrenia: Cognitive behaviour therapy is not effective

doi:10.1136/bmj.333.7563.353-a

BMJ 2006;333:353 (12 August), doi:10.1136/bmj.333.7563.353-a

Letter

What works in schizophrenia

Cognitive behaviour therapy is not effective

The first 150 words of the full text of this article appear below.

EDITOR—Kingdon's statement that more than 20 randomisedcontrolled trials and five meta-analyses have shown cognitivebehaviour therapy to be beneficial in schizophrenia gives anoversimplified picture of both the randomised controlled trialsand the meta-analyses.¹ Reviewing the randomised controlledtrials, Tarrier and Wykes, two supporters of cognitive behaviourtherapy in schizophrenia, noted that five included groups whoreceived befriending, supportive counselling, or problem solvingto control for the non-specific effects of intervention, inother words as a psychological placebo.² They said that notone study has shown clear and significant overall differencesbetween cognitive behaviour therapy and the non-specific controlgroups.³

The conclusion of the Cochrane Collaboration's meta-analysisof cognitive behaviour therapy for schizophrenia was currentlythat trial based data supporting the wide use of such treatmentfor people with schizophrenia or other psychotic illnesses arefar from conclusive.³ Compared with standard care, cognitivebehaviour therapy was found . . . [Full text of this article]

Peter J McKenna, professor of psychiatry

University of Glasgow, Glasgow G12 0XH peter.mckenna@virgin.net