JMIR Publications

ABSTRACT

Background:

Cognitive behavioral therapy for psychosis (CBTp) is not widespread enough in clinical practice, although evidence has been presented.

Objective:

The purpose of this study was to determine whether cognitive behavioral therapy for psychosis using video-conferencing (vCBTp) was more effective than usual care (UC) treatment alone in improving psychiatric symptoms in patients with schizophrenia attending outpatient clinics.

Methods:

In this exploratory randomized controlled trial, patients with schizophrenia and schizoaffective disorders who were still taking medication in an outpatient clinic were randomly assigned to either the UC plus vCBTp group (n=12) or the UC group (n=12). The vCBTp was conducted once a week, with each section lasting for 50 min, for a total of seven sessions in real-time. The primary outcome was the Positive and Negative Syndrome Scale (PANSS) total score, which measures the difference in the mean change from baseline at week 0 to post-test at week 8.

Results:

Concerning the significant difference in the primary endpoint between the two groups, the mean change from baseline in the PANSS total score at week 8 in the vCBTp plus UC group (-9.5) was significantly greater (P<.001) than the mean change in the UC alone group (6.9). In addition, significant improvements were observed in positive symptoms, negative symptoms, and overall psychopathology subscales. No participants dropped out of the study, and no serious adverse events occurred.

Conclusions:

Summarily, all seven vCBTp sessions were effective in improving psychiatric symptoms. This approach is expected to improve the acceptance and accessibility of CBTp among outpatients with schizophrenia, potentially contributing to relapse prevention support and stepped care. Clinical Trial: University Hospital Medical Information Network Clinical Trials Registry: UMIN000043396; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000049544