Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-16T07:41:56.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Effectiveness of cognitive therapy for delusions in routine clinical practice

Published online by Cambridge University Press:  31 January 2018

Simon Jakes ,
John Rhodes  and
Trevor Turner
Simon Jakes*
Affiliation:
Clinical Psychology Department, Gablestones, Dartford, Kent
John Rhodes
Affiliation:
Clinical Psychology Department, St Ann's Hospital, Tottenham, London
Trevor Turner
Affiliation:
Division of Psychiatry, Homerton Hospital, London
*
Simon Jakes, Clinical Psychology Department, Gablestones, Stone House, Cotton Lane. Dartford, Kent DA2 6AU
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Previous studies have suggested that cognitive therapy is effective in modifying delusions.

Aims

To assess the effectiveness of cognitive therapy on patients seen in routine clinical work.

Method

Eighteen patients with chronic delusions were treated using cognitive therapy, after the method of Chadwick and Lowe. A single-case multiple-baseline experimental design was used, including a control treatment. Each subject was used as their own control.

Results

Six patients reduced conviction in their delusions during cognitive therapy and not during the control treatment. Seven patients' conviction ratings did not change. Five patients showed a variable response. Degree of conviction did not fall to zero in any patient. All patients reported that the therapy had been helpful; six spontaneously mentioned changes in psychotic thinking.

Conclusions

One-third of patients with chronic delusions whom we treated responded to delusion modification with a reduction in degree of belief. Change within therapy sessions predicted outcome, as did variation in the conviction during baseline. Cognitive therapy with delusions should aim at reducing distress as well as conviction.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 4 , October 1999 , pp. 331 - 335
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Declaration of interest

All authors were employed by City and Hackney NHS Trust. No external funding was provided.

References

Angrist, B., Sathananthan, G., Wilks, S., et al (1974) Amphetamine psychosis: behavioural and biochemical aspects. Psychiatric Journal, 11, 13–23.Google Scholar
Chadwick, P. & Lowe, C. (1990) Measurement and modification of delusional beliefs. Journal of Consulting and Clinical Psychology. 58, 225–232.CrossRefGoogle ScholarPubMed
Chadwick, P., Birchwood, M. & Trower, P. (1996) Cognitive Therapy for Hallucinations, Delusions and Paranoia. Chichester: Wiley.Google Scholar
de Shazer, S. (1988) Clues: Investigating Solutions in Brief Therapy. New York: Norton.Google Scholar
Drury, V., Birchwood, M., Cochrane, R., et al (1996) Cognitive therapy and recovery from acute psychosis: a controlled trial. I. Impact on psychotic symptoms. British Journal of Psychiatry, 169, 593–601.Google Scholar
Friedman, M. (1937) The use of ranks to avoid the assumption of normality implicit in the analysis of variance. Journal of the American Statistical Association, 32, 675–701.CrossRefGoogle Scholar
Hermle, L., Finfgeld, M., Oepen, G., et al (1992) Mescaline-induced psychopathological, neuropsychological and neurometabolic effects in normal subjects: experimental psychosis as a tool for psychiatric research. Biological Psychiatry 32, 976–991.Google Scholar
Kingdon, D. & Turkington, D. (1994) The Cognitive Therapy of Schizophrenia. Hove: Lawrence Erlbaum.Google Scholar
Krystal, J., Karper, L., Seibyl, J., et al (1994) Subanaesthetic effects of the non-competitive NMDA antagonist ketamine in human: psychotomimetic, perceptual, cognitive and neuroendocrine responses. Archives of General Psychiatry, 51, 199–214.CrossRefGoogle Scholar
Kuipers, E., Garety, P., Fowler, D. et al (1997) London–East Anglia randomised controlled trial of cognitive–behavioural therapy for psychosis. I: Effects of the treatment phase. British Journal of Psychiatry, 171, 319–327.Google Scholar
Kuipers, E., Fowler, D., Garety, P., et al (1998) London–East Anglia randomised controlled trial of cognitive–behavioural therapy for psychosis. III: Follow-up and economic evaluation at 18 months. British Journal of Psychiatry, 173, 61–68.CrossRefGoogle ScholarPubMed
Maher, B. (1988) Anomalous experience and delusional thinking: the logic of explanations. In Delusional Beliefs (ed. Maher, T.), pp. 15–33. New York: John Wiley & Sons.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The brief psychiatric rating scale. Psychological Reports, 10, 799–812.Google Scholar
Shapiro, M. & Ravenetta, A. (1959) A preliminary experiment on paranoid delusions. Journal of Mental Science, 105, 295.Google Scholar
Siegal, S. & Castellan, N. J. (1988) Non-Parametric Statistics for the Behavioural Sciences (2nd edn). New York: McGraw-Hill.Google Scholar
Sharp, H. M., Fear, C. F., Williams, J. M., et al (1996) Delusional phenomenology – dimensions of change. Behaviour Research and Therapy, 34, 123–142.Google Scholar
Tarrier, N., Yusupoff, L., Kinney, C., et al (1998) Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia. British Medical Journal, 317, 303–307.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.