Terapia cognitivo-conductual grupal en el tratamiento de la sintomatología positiva de pacientes esquizofrénicos crónicos. Un estudio preliminar

Resum

Numerous experimental studies support the efficacy of cognitive-behavioural techniques, along with psychopharmacological treatments, in the treatment of schizophrenia. Although most investigations have focused on individual therapy, it is considered necessary to deepen the knowledge of the usefulness of group therapy for these symptoms. The final sample used in this preliminary study consists of 7 male patients with diagnosis of psychotic spectrum disorders, admitted to a long-stay unit during an average of approximately 9 years, and with an average level of functioning of 59, as assessed by the GAF. All participants had at least primary education and received psychopharmacological treatment which did not vary during the group therapeutic procedure. There were 26 sessions of 45 to 60 minutes based on cognitive-behavioural techniques (rational emotive therapy, cognitive restructuring and behavioural experiments) and aimed basically at delusions and hallucinations. To test the results, a set of tests was administered at the start and at the end of the group; these tests focused on productive symptoms (PSYRATS and IVI), symptoms of psychosis (PANSS) and attitudes towards medication (DAI). The treatment implemented led to a significant improvement in the overall positive symptoms, general psychopathology, frequency of auditory hallucinations, amount of negative content in hallucinations, frequency of anxiety caused by hallucinations, intensity of anxiety and/or impact of hallucinations in daily life, as well as control exerted over the voices. There were also improvements in the attitudes towards medication, which would denote an increase of insight. These results are consistent with those of other studies, and they point towards the need to further deepen the investigation of the effectiveness of these techniques, in both group and individual format, by defining their usefulness, both jointly and separately.