Cognitive therapy for schizophrenia: treatment and dissemination.

Although medication is the treatment of choice for schizophrenia, most patients continue to experience exhibit residual symptoms despite compliance. Recent studies suggest that cognitive behavioral therapy (CBT) is useful in the treatment of schizophrenia and other psychotic disorders [1]. Results of previous studies suggest that patients treated with CBT, in conjunction with medication, exhibit decreased frequency and severity of delusions, hallucinations and negative symptoms. Finally, CBT has been shown to increase medication compliance in patients with schizophrenia and bipolar disorder. Speaking of the outcome data on CBT, Weiden was recently quoted as saying, "if this were a patented drug trial, you would have heard about [these findings]" [2]. Despite the empirical evidence supporting the use of CBT in patients with schizophrenia, this treatment is relatively unknown to the psychiatric community. This article will review the mechanisms and findings associated with CBT and schizophrenia, and suggest future directions for dissemination in the psychiatric community.

Stability of the diagnosis of deficit syndrome in schizophrenia.

OBJECTIVE: Primary, enduring negative symptoms have been distinguished from negative symptoms more generally and are used to define the deficit syndrome of schizophrenia. Although the validity of the deficit syndrome has been demonstrated by using brain imaging, neuropsychological, illness outcome, and developmental history data, the stability of this diagnostic category has not been tested prospectively by using direct patient assessments. METHOD: Forty-three outpatients with schizophrenia and schizoaffective disorder were categorized into deficit and nondeficit groups an average of 3.8 years after having been previously categorized. RESULTS: There was 83% agreement between initial and blind follow-up designations of deficit status and 88% agreement on the nondeficit categorization. CONCLUSIONS: These results provide evidence for the long-term stability of the deficit syndrome in patients with schizophrenia and the reliability of the deficit/nondeficit categorization when diagnosed by those with appropriate training. Furthermore, they validate the method of categorizing deficit patients by using cross-sectional and retrospective data.