A comparison of an integrated psychological intervention with 'befriending' in first-presentation psychosis

该项目旨在测试两种治疗方法的有效性，以确定“综合”心理治疗是否能为那些首次接受治疗的人带来更好的结果。抗精神病药物是治疗包括精神分裂症在内的典型精神病的阳性症状(即妄想、幻觉和思维障碍)的主要药物。然而，还有其他方法需要调查的原因。首先，并不是所有的患者对药物都有反应。第二，药物治疗可能不能完全缓解阳性症状，第三，药物治疗对病情的其他方面没有任何帮助。这些方面包括消极症状(例如，缺乏动力和孤僻)、抑郁、社交焦虑和各种生活领域的功能，例如，学校、工作和社交。在过去的15年里，出现了一种可行的心理疗法，即认知行为疗法(CBT)。这在治疗幻觉和妄想方面似乎是有效的，并且比药物产生的效果更好。然而，此类治疗尚未应用于治疗首次出现的精神病患者在病情急性期时的这些症状。重要的是要确定CBT在这一组中是否产生积极影响，以及它是否与药物一起使用可以更大更快地降低阳性症状的水平和严重程度。虽然CBT有望在妄想和幻觉中产生积极的变化，但申请者认为，这需要与CBT Intervening结合起来，CBT Intervening专注于患者表现的其他方面，如阴性和抑郁症状，以及改善不同生活领域的功能。

The project aims to test the efficacy of two treatments to determine whether 'integrated' psychological treatment leads to better outcomes for those individuals presenting for treatment for the first time. Neuroleptic medication is the main treatment for the positive symptoms (i.e., delusions, hallucinations and thought disorder) which typify the psychoses, including schizophrenia. Yet, there are reasons why other approaches should be investigated. Firstly, not all patients respond to medications. Secondly, medication may not totally alleviate the positive symptoms, and thirdly, other aspects of the condition are not helped to any extent by medication. These aspects include negative symptoms (e.g., lack of motivation and asociality), depression, social anxiety and functioning in the various life domains, e.g., school, work and socialization. In the last 15 years a viable psychological treatment known as cognitive-behavioural therapy (CBT) has emerged. This appears to be effective in the treatment of hallucinations and delusions and has an effect over and above that produced by medication. However, such treatments have not yet been applied to treating those symptoms in first presentation psychotic patients when they are in the acute stage of their illness. It is important to determine whether CBT produces positive effects in this group and whether used in conjunction with medication it can produce greater and more rapid reductions in the level and severity of positive symptoms. Whilst CBT is expected to produce positive changes in delusions and hallucinations, the applicants believe this needs to be integrated with CBT interevention focussed on other aspects of a patient's presentation, such as negative and depressive symptoms, and also on improving functioning in various life domains.