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疗效，以确定“综合”心理治疗是否会为首次接受治疗的人带来更好的结果。抗精神病药物是阳性症状的主要治疗方法（即，妄想、幻觉和思维障碍），这些都是精神病的典型症状，包括精神分裂症。然而，有理由认为应该研究其他方法。首先，并非所有患者都对药物有反应。第二，药物可能无法完全缓解阳性症状，第三，药物对病情的其他方面没有任何帮助。这些方面包括阴性症状（例如，缺乏动力和不合群）、抑郁、社交焦虑和在各种生活领域的功能，例如，学校、工作和社会化。在过去的15年里，出现了一种可行的心理治疗方法，称为认知行为疗法（CBT）。这似乎是有效的治疗幻觉和妄想，并有一个效果和以上所产生的药物。然而，这种治疗尚未应用于治疗首次出现的精神病患者在其疾病的急性期时的那些症状。重要的是要确定CBT是否在这组中产生积极的影响，以及是否与药物结合使用，它可以产生更大，更快地减少阳性症状的水平和严重程度。虽然CBT预计会对妄想和幻觉产生积极的改变，但申请人认为，这需要与CBT干预相结合，重点关注患者表现的其他方面，例如阴性和抑郁症状，以及改善各个方面的功能。生活领域。

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.