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Effects of cognitive therapy on the longitudinal development of psychotic experiences in people at high risk of developing psychosis

Psychology Services, Bolton Salford & Trafford Mental Health Trust

N. SHRYANE, PhD and R. P. BENTALL, PhD

School of Psychological Sciences, The University of Manchester

S. W. LEWIS, MD

School of Psychiatry and Behavioural Sciences, The University of Manchester

A. P. MORRISON, ClinPsyD

Psychology Services, Bolton Salford & Trafford Mental Health Trust and School of Psychological Sciences, The University of Manchester, Manchester, UK

Correspondence: Paul French, Associate Director, Early Intervention Service, BSTMHT, Bury New Road, Prestwich, Manchester M25 3BL. Email: paul.french{at}bstmht.nhs.uk

Declaration of interest None. Funding detailed in Acknowledgements.

Background There have been recent advances in the identification of people at high risk of psychosis and psychological treatments have shown promise for prevention.

Aims To compare the longitudinal course of psychotic experiences and emotional dysfunction in high-risk participants receiving cognitive therapy with those receiving treatment as usual.

Method Data from a recent randomised controlled trial of cognitive therapy for people at risk of developing psychosis were utilised to examine three different statistical models that were based on 432 measurements of psychotic experiences and 421 of emotional dysfunction (anxiety–depression) contributed by 57 participants across the 13 measurement occasions (monthly monitoring for a year).

Results Psychotic experiences and emotional dysfunction were correlated and decreased significantly over the course of the study, with most improvement in the early months. The reduction in positive symptoms, but not emotional dysfunction, was enhanced by allocation to cognitive therapy.

Conclusions Psychotic experiences and emotional dysfunction appear to interact in people at risk of developing psychosis. There appears to be a specific benefit of cognitive therapy.