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Cognitive behavioural therapy andmotivational intervention for schizophrenia an
mental healthCognitive behavioural therapy andmotivational intervention for schizophrenia andsubstancemisuse 18-month outcomes of a randomised controlled trial

GILLIAN HADDOCK, CHRISTINE BARROWCLOUGH, NICHOLAS TARRIER, JAN MORING, ROBERT OBRIEN, NICHOLA SCHOFIELD, JOANNE QUINN, STEVEN PALMER, LINDA DAVIES, IAN LOWENS, JOHN McGOVERN and SHON LEWIS



Background Comorbid substance misuseinpeoplewith schizophrenia is associatedwith poor clinical and social outcomes.There are fewstudies of psychological treatments for this population andlittlelong-termfollow-up of their benefits. Aims Toinvestigate symptom, substance use, functioningandhealth economyoutcomes for patientswith schizophrenia and their carers18months after a cognitive^behavioural treatment (CBT) programme. Method Patientswith dualdiagnosis froma randomised controlledtrial of motivationalintervention, individual CBT and familyinterventionwere assessed on multiple outcomes at18-monthfollow-up. Carerswere assessed on symptom, functioningandneeds over12months. Health economydatawere collected over 18months. Results Therewere significant improvementsinpatient functioning comparedwithroutine care over18 months.No significantdifferences betweentreatmentgroupswere foundin careror costoutcomes. Conclusions The treatment programmewas superior to routine care on outcomes relating toillness and service use, andthe costwas comparable to the control treatment. Declaration of interest None. Fundingdetailedin Acknowledgements. Studies have indicated that cognitivebehavioural therapy (CBT) plus treatment as usual for patients with schizophrenia have significant benefits on relapse and patient functioning (Pilling et al, 2002; Cormac et al, 2003). However, the application of CBT to psychotic disorders involving substance use has been evaluated very little, or where evaluations have been reported the findings have been limited by poor methodology (Ley et al, 2001). The current study evaluated the effectiveness of an individual and family-oriented CBT programme for chronic treatment-resistant psychosis combined with motivational intervention for substance use problems over an 18-month follow-up period. Preliminary findings on patient outcome from the treatment phase of the study have been reported already (Barrowclough et al, 2001). The aim of the current study was to investigate whether the integrated programme of interventions had a beneficial effect on illness, substance use, carer and health economy outcomes over 18 months

 

ԴС Thursday 25 Sep 14@ 13:25:26 ICT admin
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