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Joop Meijers December 5th, 2004 10:26 AM

CBT and psychoses
Maybe there are some previous references in this forum but I wonder who could help me with a good reference or source on the empirical status of CBT with psychotic conditions. I ask this specifically in relation to a consultation about a 30 yr old woman who three months ago had given birth to a healthy baby and who- suddenly- three months after the birth became psychotic: she hears voices, is delusional and paranoid, has fears of hurting her baby and has ideas or voices telling her to commit suicide. She has never been psychotic or depressed before although over the years she became somewhat more isolated from a social point of view. But untill 3 months after birth she functioned quite well in her academic life ( working on a Ph.D). She is now hospitalised and on anti-psychotic medication. She is not allowed to see or feed her baby.
Has CBT anything to offer in terms of treating her? What does the litterature or anyone's experience say?
Thanks for any useful information
Joop Meijers Ph.D

David Kingdon December 6th, 2004 04:29 PM

Re: CBT and psychoses
The most up-to-date review of evidence for CBT in psychosis is that by Pilling P, Bebbington P, Kuipers E, Garety P, Geddes J, Orbach G, Morgan C: Psychological treatments in schizophrenia: I. Meta-analysis of family interventions and cognitive-behaviour therapy. Psychological Medicine 2002; 32:763-782. However there have been a number of publications of RCTs since (e.g. Rector et al, 2003) in early (Tarrier et al, 2004) and prodromal (Morrision et al, 2004) schizophrenia and for relapse prevention (Gumley et al, 2003). Basically the evidence is now sufficiently strong for both Am Psychiatric Assoc. & UK government to recommend it for patients with schizophrenia especially those with medication resistant symptoms. Mark van der Gaag (?Leiden Univ or the Hague) has training materials in Dutch if you are interested.

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