Search tips
Search criteria 


Logo of ijpsychHomeCurrent issueInstructionsSubmit article
Indian J Psychiatry. 2003 Oct-Dec; 45(4): 221–228.
PMCID: PMC2952368

Effect of cognitive behaviour therapy on adjustment, intensity of symptoms and automatic thoughts in schizophrenia


Aim :

This study was undertaken with the objective of assessing the effect of Cognitive Behaviour therapy (CBT) on subjects suffering from schizophrenia or schizo affective disorder and to observe the sustainability of its effects over a longest period of time. A brief study was also undertaken about changes in career attitudes after psycho education about their wards′ illness.

Method :

Fifty-one subjects participated in the study and completed the required numbers of sessions of CBT. Evaluation was carried out before and immediately after CBT. Twenty-four subjects were followed -up again after nine months to perceive sustainability of CBT effects. One family member for each subject was administered an attitude questionnaire before and after psycho education about schizophrenia.

Results :

CBT sessions resulted in marked improvement in overall adjustment. Intensity of symptoms decreased from high to moderate or high to low intensity immediately after CBT. At follow-up nine months later, intensity of symptoms increased from low to moderate in most of the subjects in comparison to immediate post CBT evaluation but was still less than baseline There was marked decrease in negative thoughts and feelings immediately after CBT. During follow-up after nine months 60% subjects showed more improvement marked in negative thoughts than immediate post CBT while 40% showed less improvement than immediately after CBT. Neptive feelings increased after nine months in most of the subjects, but not to pre treatment levels. Family membets also expetienced more positive feelings about their sick wards after psycho education.

Conclusion :

Positive effects of CBT may not be sustained over a longer period of time and may need repeated sessions

Keywords: CBT, Schizoprenia, Psychosis

Full Text

The Full Text of this article is available as a PDF (565K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Beck AT, Rector NA. Cognitive therapy of schizophrenia: a new therapy for the new millennium. Am J Psychother. 2000 Summer;54(3):291–300. [PubMed]
  • Bellack AS, Morrison RL, Mueser KT. Social problem solving in schizophrenia. Schizophr Bull. 1989;15(1):101–116. [PubMed]
  • Chadwick P, Birchwood M. The omnipotence of voices. A cognitive approach to auditory hallucinations. Br J Psychiatry. 1994 Feb;164(2):190–201. [PubMed]
  • Chadwick PD, Lowe CF. Measurement and modification of delusional beliefs. J Consult Clin Psychol. 1990 Apr;58(2):225–232. [PubMed]
  • Deshpande SN, Mathur MN, Das SK, Bhatia T, Sharma S, Nimgaonkar VL. A Hindi version of the Diagnostic Interview for Genetic Studies. Schizophr Bull. 1998;24(3):489–493. [PubMed]
  • Dickerson FB. Cognitive behavioral psychotherapy for schizophrenia: a review of recent empirical studies. Schizophr Res. 2000 Jun 16;43(2-3):71–90. [PubMed]
  • Dixon L, Adams C, Lucksted A. Update on family psychoeducation for schizophrenia. Schizophr Bull. 2000;26(1):5–20. [PubMed]
  • Fujita Hirokazu, Shimodera Shinji, Izumoto Yuji, Tanaka Shuichi, Kii Masaru, Mino Yoshio, Inoue Shimpei. Family attitude scale: measurement of criticism in the relatives of patients with schizophrenia in Japan. Psychiatry Res. 2002 Jul 31;110(3):273–280. [PubMed]
  • Gould RA, Mueser KT, Bolton E, Mays V, Goff D. Cognitive therapy for psychosis in schizophrenia: an effect size analysis. Schizophr Res. 2001 Mar 30;48(2-3):335–342. [PubMed]
  • Jenner JA, van de Willige G. HIT, hallucination focused integrative treatment as early intervention in psychotic adolescents with auditory hallucinations: a pilot study. Acta Psychiatr Scand. 2001 Feb;103(2):148–152. [PubMed]
  • Jenner JA, van de Willige G, Wiersma D. Effectiveness of cognitive therapy with coping training for persistent auditory hallucinations: a retrospective study of attenders of a psychiatric out-patient department. Acta Psychiatr Scand. 1998 Nov;98(5):384–389. [PubMed]
  • Kingdon DG, Turkington D. The use of cognitive behavior therapy with a normalizing rationale in schizophrenia. Preliminary report. J Nerv Ment Dis. 1991 Apr;179(4):207–211. [PubMed]
  • Leff J, Berkowitz R, Shavit N, Strachan A, Glass I, Vaughn C. A trial of family therapy versus a relatives' group for schizophrenia. Two-year follow-up. Br J Psychiatry. 1990 Oct;157:571–577. [PubMed]
  • Mbanga NI, Niehaus DJH, Mzamo NC, Wessels CJ, Allen A, Emsley RA, Stein DJ. Attitudes towards and beliefs about schizophrenia in Xhosa families with affected probands. Curationis. 2002 Feb;25(1):69–73. [PubMed]
  • McFarlane WR, Lukens E, Link B, Dushay R, Deakins SA, Newmark M, Dunne EJ, Horen B, Toran J. Multiple-family groups and psychoeducation in the treatment of schizophrenia. Arch Gen Psychiatry. 1995 Aug;52(8):679–687. [PubMed]
  • McGorry PD, Edwards J, Mihalopoulos C, Harrigan SM, Jackson HJ. EPPIC: an evolving system of early detection and optimal management. Schizophr Bull. 1996;22(2):305–326. [PubMed]
  • Norman Ross M G, Malla Ashok K, McLean Terry S, McIntosh Elizabeth M, Neufeld RWJ, Voruganti L Panth, Cortese L. An evaluation of a stress management program for individuals with schizophrenia. Schizophr Res. 2002 Dec 1;58(2-3):293–303. [PubMed]
  • Perris C. A cognitive-behavioral treatment program for patients with a schizophrenic disorder. New Dir Ment Health Serv. 1992 Spring;(53):21–32. [PubMed]
  • Pilsecker C. Hospital classes educate schizophrenics about their illness. Hosp Community Psychiatry. 1981 Jan;32(1):60–61. [PubMed]
  • Rector NA, Beck AT. Cognitive behavioral therapy for schizophrenia: an empirical review. J Nerv Ment Dis. 2001 May;189(5):278–287. [PubMed]
  • Schooler NR, Keith SJ, Severe JB, Matthews SM, Bellack AS, Glick ID, Hargreaves WA, Kane JM, Ninan PT, Frances A, et al. Relapse and rehospitalization during maintenance treatment of schizophrenia. The effects of dose reduction and family treatment. Arch Gen Psychiatry. 1997 May;54(5):453–463. [PubMed]
  • Sensky T, Turkington D, Kingdon D, Scott JL, Scott J, Siddle R, O'Carroll M, Barnes TR. A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication. Arch Gen Psychiatry. 2000 Feb;57(2):165–172. [PubMed]
  • Starkey D, Deleone H, Flannery RB., Jr Stress management for psychiatric patients in a state hospital setting. Am J Orthopsychiatry. 1995 Jul;65(3):446–450. [PubMed]
  • Tarrier N, Beckett R, Harwood S, Baker A, Yusupoff L, Ugarteburu I. A trial of two cognitive-behavioural methods of treating drug-resistant residual psychotic symptoms in schizophrenic patients: I. Outcome. Br J Psychiatry. 1993 Apr;162:524–532. [PubMed]
  • Tarrier N, Yusupoff L, Kinney C, McCarthy E, Gledhill A, Haddock G, Morris J. Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia. BMJ. 1998 Aug 1;317(7154):303–307. [PMC free article] [PubMed]
  • Wiersma D, Jenner JA, van de Willige G, Spakman M, Nienhuis FJ. Cognitive behaviour therapy with coping training for persistent auditory hallucinations in schizophrenia: a naturalistic follow-up study of the durability of effects. Acta Psychiatr Scand. 2001 May;103(5):393–399. [PubMed]

Articles from Indian Journal of Psychiatry are provided here courtesy of Medknow Publications