Cognitive-behavioural therapy and motivational intervention for schizophrenia and substance misuse. 18-month outcomes of a randomised controlled trial.

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Abstract

BACKGROUND: Comorbid substance misuse in people with schizophrenia is associated with poor clinical and social outcomes. There are few studies of psychological treatments for this population and little long-term follow-up of their benefits. AIMS: To investigate symptom, substance use, functioning and health economy outcomes for patients with schizophrenia and their carers 18 months after a cognitive-behavioural treatment (CBT) programme. METHOD: Patients with dual diagnosis from a randomised controlled trial of motivational intervention, individual CBT and family intervention were assessed on multiple outcomes at 18-month follow-up. Carers were assessed on symptom, functioning and needs over 12 months. Health economy data were collected over 18 months. RESULTS: There were significant improvements in patient functioning compared with routine care over 18 months. No significant differences between treatment groups were found in carer or cost outcomes. CONCLUSIONS: The treatment programme was superior to routine care on outcomes relating to illness and service use, and the cost was comparable to the control treatment.

Keyword(s)

Diagnosis, Dual (Psychiatry); Female; Humans; Male; Middle Aged; Motivation; Psychiatric Status Rating Scales; Recurrence; Research Support, Non-U.S. Gov't; Schizophrenic Psychology; Treatment Outcome; economics: Mental Health Services; methods: Cognitive Therapy; methods: Costs and Cost Analysis; psychology: Caregivers; psychology: Substance-Related Disorders; therapy: Schizophrenia

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