Evidence map›Paper›PMID 39004927›Full record

Trial reportSchizophrenia bulletin2025

Cognitive Behavioral Psychotherapy as an Add-on in Comprehensive Outpatient Care of Non-affective Psychoses: A Multicenter Randomized-Controlled Effectiveness Trial in a Naturalistic Setting.

Carolin Steuwe, Silvia Carvalho Fernando, Ingo Runte, Stefan Bender, Wolfgang Heiler, Fabian Klein, Klaus Kronmüller, Kathrin Volmert, Christine Norra, Stefan Engelbrecht and 1 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Schizophrenia bulletin, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Carolin SteuweDepartment of Psychiatry and Psychotherapy, Ev. Klinikum Bethel, Universität Bielefeld, Bielefeld, Germany.ORCID 0009-0007-6236-1150
Silvia Carvalho FernandoDepartment of Psychiatry and Psychotherapy, Ev. Klinikum Bethel, Universität Bielefeld, Bielefeld, Germany.
Ingo RunteDepartment of Psychiatry and Psychotherapy, Ev. Klinikum Bethel, Universität Bielefeld, Bielefeld, Germany.
Stefan BenderDepartment of Psychiatry and Psychotherapy, LWL-Klinikum Marsberg, Marsberg, Germany.
Wolfgang HeilerDepartment of Psychiatry and Psychotherapy, LWL-Klinikum Marsberg, Marsberg, Germany.
Fabian KleinDepartment of Psychiatry and Psychotherapy, LWL-Klinikum Gütersloh, Gütersloh, Germany.
Klaus KronmüllerDepartment of Psychiatry and Psychotherapy, LWL-Klinikum Gütersloh, Gütersloh, Germany.
Kathrin VolmertDepartment of Psychiatry, Psychotherapy and Psychosomatics, LWL-Klinik Paderborn, Germany.
Christine NorraDepartment of Psychiatry, Psychotherapy and Psychosomatics, LWL-Klinik Paderborn, Germany.
Stefan EngelbrechtAusbildungszentrum OWL gGmbH, Bielefeld, Germany.
Martin DriessenDepartment of Psychiatry and Psychotherapy, Ev. Klinikum Bethel, Universität Bielefeld, Bielefeld, Germany.

Funding

Akademie Psychiatrie und Psychotherapie Ostwestfalen-Lippe
6 · The paper itself

Abstract

background and hypothesisNon-affective psychoses (NAP) are associated with severe consequences with regard to social functioning, physical health, employment, and suicidality. Treatment guidelines recommend cognitive behavioral therapy for psychosis (CBTp) as an effective additional treatment strategy to psychopharmacology. We hypothesized that outpatient CBTp has an add-on effect in individuals with NAP who already receive comprehensive outpatient care (COC) in Germany. STUDY

designIn a randomized-controlled effectiveness trial, 6 months of COC + CBTp were compared to COC. The primary outcomes were change of symptom severity as assessed by the Positive and Negative Symptom Scale (pre-/post-treatment and 6-month follow-up). Mixed linear models and effect sizes were used to compare changes across treatment groups. Additionally, the number of readmissions was compared. STUDY

resultsN = 130 individuals with chronic NAP were recruited (COC + CBTp: n = 64, COC: n = 66). COC + CBTp participants significantly improved more regarding positive symptom severity (estimated mean difference at follow-up: -2.33, 95% CI: -4.04 to -0.61, P = .0083, d = 0.32) and general psychopathology (estimated mean difference at follow-up: -4.55, 95% CI: -7.30 to -1.81, P = .0013, d = 0.44) than the COC group. In both groups, negative symptom severity did not change significantly over time nor did groups differ regarding readmissions.

conclusionThe results underline an add-on benefit of CBTp in chronically ill individuals with NAP. Superiority of CBTp was demonstrated in comparison with high-quality comprehensive care and may also be true in different comprehensive care settings. CLINICAL TRIALS REGISTRATION: DRKS00015627.

Indexed as

Ambulatory CareCognitive Behavioral TherapyOutcome Assessment, Health CarePsychotic DisordersSchizophreniaAdultCombined Modality TherapyFemaleFollow-Up StudiesGermanyHumansMaleMiddle AgedYoung Adultclinical trialRCTschizophreniatreatment effects

Identifiers

PMID39004927
PMCPMC12061656

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.