NICE guidance on CBT and schizophrenia

NICE, the National Institute for Health and Care Excellence, has issued new guidance on treatment for schizophrenia. It says that people who are exhibiting early symptoms of psychosis and schizophrenia should be offered CBT (cognitive behavioural therapy) rather than antipsychotic drugs.

There is quite a wide range of behaviours that can indicate the ‘prodromal stage’ which comes before most first episodes of psychosis. These include withdrawal, a shorter attention span than usual, and the individual behaving in unusual ways or sharing unusual thoughts.

CBT is often described in A Level psychology textbooks as an effective treatment for depression and social anxiety, but as being less effective for schizophrenia. It is important to note that NICE recommends that oral antipsychotic medication is used once someone has their first psychotic episode – together with a psychological intervention, which could be CBT or another recognised psychotherapy.

CBT doesn’t have the unpleasant side effects of antipsychotic medication and it is also a lot cheaper. But the mental health charity Mind points out that it often takes a long time for people to get access to CBT, while the research shows that early intervention works best if people can get treatment within 28 days of symptoms being recognised.