Open Access, Peer-reviewed
pISSN 1015-4817
eISSN 2289-0963
    J Korean Neuropsychiatr Assoc. 2013 Jan;52(1):26-32. Korean.
    Published online Jan 31, 2013.
    https://doi.org/10.4306/jknpa.2013.52.1.26
    Copyright © 2013 Korean Neuropsychiatric Association
    Original Article

    The Effect of Cognitive Behavioral Therapy in Drug-Resistant Patients with Schizophrenia

    Dong Eun Lee, MD, PhD,1 Hwa Jung Lee,1 Ok Sim Yoon,1 In Young Choi,1 Jung Bae Jo,1 Kwang Ju Kang, MA,2 Nan Young Moon,2 and Sung Hyouk Park, MD, PhD1
      • 1Department of Psychiatry, Chookryoung Evangelical Hospital, Namyangju, Korea.
      • 2Halfway House Neulpureun-jip, Seoul, Korea.
    • Address for correspondence: Dong-Eun Lee, MD, PhD. Department of Psychiatry, Chookryoung Evangelical Hospital, 174 Oebang-ri, Sudong-myeon, Namyangju 472-853, Korea. Tel +82-31-592-6661, Fax +82-31-592-6755, Email: abraxas2@hanmail.net
    Received May 24, 2012; Revised October 11, 2012; Accepted November 28, 2012.

    Abstract

    Objectives

    Cognitive behavioral therapy of schizophrenia has been developed as a psychological therapy for drug resistant patients with schizophrenia. However, there are some controversial issues regarding the size and mode of the therapeutic effect. The aim of this study is to compare the effect of cognitive behavioral therapy with supportive therapy after treatment.

    Methods

    Patients with drug resistant schizophrenia were randomly allocated, and stratified according to two mental health institutes to two different therapy groups. We used four assessment scales to evaluate residual symptoms of patients in detail. Patients were assessed twice by a blind rater, at baseline and after treatment.

    Results

    No significant differences in the change of PANSS (Positive and Negative Syndrome Scale) scores were observed between the cognitive behavioral therapy and supportive therapy groups at one month after treatment. There was no significant difference in change of K-PSYRATS (Korean-Psychotic Symptom Rating Scale)-Delusion score, however, a trend toward significance in K-PSYRATS - Hallucination was observed between the two groups. In the aspect of insight, a significant difference in the change of SDMD-K (The Scale to assessment Unawareness of Mental Disorder-Korean version) score was observed between the two groups after treatment.

    Conclusion

    Despite remarkable development of pharmacotherapy for schizophrenia, many patients still suffer from residual symptoms. Findings of this study showed that cognitive behavioral therapy can improve the insight of patients and reduce the severity of residual positive symptoms, especially hallucination. Cognitive behavioral therapy should be practiced effectively in the psychiatric clinic and community mental health system.

    Keywords
    Schizophrenia; Cognitive behavioral therapy; Drug resistant patient; K-PSYRATS (Korean-Psychotic Symptom Rating Scale); SUMD-K (The Scale to assessment Unawareness of Mental Disorder-Korean version)

    Tables

    Table 1
    Basic characteristics of CBT and ST group

    Table 2
    Main prescribed antipsychotics and minimum dosage in CBT and ST group at baseline

    Table 3
    K-PSYRATS score change of patients without and with change of antipsychotics dosage

    Table 4
    Mean baseline scores and mean change between CBT and ST group. Negative changes indicate improvement

    Table 5
    Multivariate regression analysis for change of K-PSYRATS-Hallucination and SUDM-K scores

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    MeSH Terms
    Academies and Institutes
    Cognitive Therapy
    Hallucinations
    Humans
    Mental Health
    Schizophrenia
    Weights and Measures
    Metrics
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