Cognitive therapy for patients with schizophrenia - Authors' reply

摘要

Our trial1 was not designed to change clinical practice. It was a preliminary trial, which needs to be followed up by a larger, pragmatic multicentre study. It is important not to over-interpret our data, and we explicitly advised against discontinuation of medication. We claimed the trial showed that cognitive therapy was safe and acceptable, not safe and effective. No participants Were included on the basis of attenuated psychotic symptoms (our entry criteria included positive symptoms above a threshold on the positive and negative syndrome scale [PANSS]). Our combined sample had a mean baseline PANSS score of 72, with the recommended cutoffs for mildly ill being 58 and moderately ill being 75; therefore, our sample consists of people with both levels of difficulty. Duration of psychosis and other sample characteristics are reported elsewhere.2 We can clarify that the proportion of patients starting medication in each group was 27%. An investigation of the components of therapy is being undertaken and will be published.