Cognitive behavior therapy in early psychosis with a focus on depression and low self-esteem: A randomized controlled trial

Nasrettin Sönmez; Kristin Lie Romm; Tiril Østefjells; Marit Grande; Lene Hunnicke Jensen; Benjamin Hummelen; Martin Tesli; Ingrid Melle; Jan Ivar Røssberg

doi:10.1016/j.comppsych.2019.152157

Cognitive behavior therapy in early psychosis with a focus on depression and low self-esteem: A randomized controlled trial

Compr Psychiatry. 2020 Feb:97:152157. doi: 10.1016/j.comppsych.2019.152157. Epub 2019 Dec 26.

Authors

Nasrettin Sönmez¹, Kristin Lie Romm², Tiril Østefjells³, Marit Grande⁴, Lene Hunnicke Jensen⁵, Benjamin Hummelen⁶, Martin Tesli⁷, Ingrid Melle², Jan Ivar Røssberg⁸

Affiliations

¹ Diakonhjemmet Hospital, Forskningsveien 7, 0373 Oslo, Norway; Department of Research and Education, Clinic of Mental Health and Addiction, Oslo University Hospital, Norway.
² Department of Research and Education, Clinic of Mental Health and Addiction, Oslo University Hospital, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.
³ NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Department for Specialised Inpatient Treatment, Akershus University Hospital, Sykehusveien 25, 1478 Lørenskog, Norway.
⁴ Grande, Sandviksveien 157, 1337 Sandvika, Norway.
⁵ Early Intervention in Psychosis Unit, Vestre Viken Hospital Trust, Drammen, Norway.
⁶ Department of Research and Education, Clinic of Mental Health and Addiction, Oslo University Hospital, Norway.
⁷ NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403 Oslo, Norway.
⁸ Department of Research and Education, Clinic of Mental Health and Addiction, Oslo University Hospital, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway. Electronic address: j.i.rossberg@medisin.uio.no.

PMID: 31935529
DOI: 10.1016/j.comppsych.2019.152157

Abstract

Background: Patients in early phases of psychosis often struggle with depressive symptoms and low self-esteem. The main aims of the present study were to examine whether cognitive behavior therapy (CBT) compared to treatment as usual (TAU) would reduce depressive symptoms (primary outcome) and increase self-esteem (secondary outcome). Furthermore, we wanted to examine whether CBT reduces symptoms measured with the PANSS (positive, negative, cognitive, or excited symptoms) or increases general functioning compared to TAU.

Methods: A total of 63 early psychosis patients were included and randomly assigned to receive either CBT (maximum 26 sessions) or TAU for a period of up to six months. A linear mixed model was used for longitudinal analysis, with a focus on whether patients in the CBT group or the TAU group changed differently to one another between the baseline and 15-month follow-up.

Results: There were no differences between the CBT group and TAU group regarding improvements in depressive symptoms measured with the Calgary Depression Scale for Schizophrenia (P = 0.188) or self-esteem measured with the Rosenberg Self-Esteem Scale (P = 0.580). However, patients in the CBT group improved significantly more on negative symptoms (P = 0.002) and social functioning (P = 0.001).

Conclusions: We did not find CBT to be more effective than TAU in reducing depressive symptoms or increasing self-esteem in patients with early psychosis. However, CBT seems to improve negative symptoms and functioning. These results still need to be replicated in further studies as the present one was merely an exploratory analysis. ClinicalTrials.gov Identifier: NCT01511406.

Keywords: Cognitive behavior therapy; First-episode psychosis; Randomized controlled trials.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Cognitive Behavioral Therapy / methods*
Depression / therapy*
Female
Humans
Male
Middle Aged
Psychotherapy, Group
Psychotic Disorders / psychology
Psychotic Disorders / therapy*
Schizophrenia / therapy*
Self Concept
Treatment Outcome

Associated data

ClinicalTrials.gov/NCT01511406