Supplementing Psychosis Therapy

Peter M. Yellowlees, MBBS, MD


September 13, 2017

This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees.

Negative symptoms observed in patients with psychotic disorders undermine their quality of life and functioning. While we know that antipsychotic medications have only a limited impact by themselves, a team of investigators[1] from McGill University in Canada has recently undertaken a meta-analytic and systematic review of the literature on the effectiveness of nonbiological treatments for negative symptoms in psychotic disorders. A total of 95 studies met the review criteria and 72 had complete quantitative data. Compared with treatment as usual, cognitive-behavioral therapy, skills-based training, exercise, and music treatments provided significant benefit. The authors concluded that these specific psychological and psychosocial interventions had utility in ameliorating negative symptoms in psychosis but noted that more effective treatments for negative symptoms need to be developed.

Given that negative symptoms are a major cause of disability, it is clear that these specific approaches to treatment should be included in rehabilitation programs for patients with psychotic disorders and combined with evidence-based medication management. Not surprisingly, the treatments that were found to be useful to address core needs of this group of patients were symptom and life skills improvement, as well as physical fitness and creative expression. There is now a strong argument for modifying current rehabilitation programs to increase their focus in these directions.

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