Cognitive behavioural therapy in clozapine-resistant schizophrenia (FOCUS): an assessor-blinded, randomised controlled trial

The Lancet. Psychiatry
Anthony P MorrisonFOCUS trial group

Abstract

Although clozapine is the treatment of choice for treatment-refractory schizophrenia, 30-40% of patients have an insufficient response, and others are unable to tolerate it. Evidence for any augmentation strategies is scarce. We aimed to determine whether cognitive behavioural therapy (CBT) is an effective treatment for clozapine-resistant schizophrenia. We did a pragmatic, parallel group, assessor-blinded, randomised controlled trial in community-based and inpatient mental health services in five sites in the UK. Patients with schizophrenia who were unable to tolerate clozapine, or whose symptoms did not respond to the drug, were randomly assigned 1:1 by use of randomised-permuted blocks of size four or six, stratified by centre, to either CBT plus treatment as usual or treatment as usual alone. Research assistants were masked to allocation to protect against rater bias and allegiance bias. The primary outcome was the Positive and Negative Syndrome Scale (PANSS) total score at 21 months, which provides a continuous measure of symptoms of schizophrenia; PANSS total was also assessed at the end of treatment (9 months). The primary analysis was by randomised treatment based on intention to treat, for all patients for whom data we...Continue Reading

Citations

Aug 17, 2018·The British Journal of Psychiatry : the Journal of Mental Science·Derek K TracySukhwinder S Shergill
Feb 27, 2019·Health Technology Assessment : HTA·Anthony P MorrisonDavid Kingdon
Feb 14, 2019·Psychological Medicine·S JauharP J McKenna
Feb 23, 2020·The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry·Elias WagnerAlkomiet Hasan
Feb 15, 2020·Indian Journal of Psychiatry·Ajit AvasthiSandeep Grover
Nov 28, 2018·Irish Journal of Psychological Medicine·J Lally, F Gaughran
Apr 15, 2020·European Journal of Psychotraumatology·Rosie AdamsEmily Wood
May 6, 2021·International Journal of Environmental Research and Public Health·Wei YuBinggen Zhu
Nov 21, 2021·BMC Psychiatry·Robert O CotesTristan Gorrindo

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Methods Mentioned

BETA
cognitive behavioural therapy

Clinical Trials Mentioned

ISRCTN99672552

Software Mentioned

FOCUS
PSYRATS

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