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Reassessing the evidence: does CBT truly benefit individuals with treatment-resistant schizophrenia?
  1. Ofer Agid
  1. Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
  1. Correspondence to Professor Ofer Agid; ofer.agid{at}camh.ca

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Commentary on: Salahuddin, NH, Schütz, A, Pitschel-Walz, G et al (2024). Psychological and psychosocial interventions for treatment-resistant schizophrenia: a systematic review and network meta-analysis. Lancet Psychiatry, 11(7), 545–553.

Implications for practice and research

  • Clinicians should be aware of certain psychological and psychosocial interventions, for example, cognitive behavioural therapy for psychosis, that demonstrate a significant reduction in overall symptoms of patients with treatment-resistant schizophrenia.

  • The results of this study suggest a future direction for research aimed at tailoring psychosocial interventions for this challenging treatment-refractory subset of patients with schizophrenia.

Context

While antipsychotic medications are the cornerstone of treatment for schizophrenia, there is a subset of patients whose condition cannot be adequately managed with these pharmacological compounds. In other words, for this group, the core symptom domain of schizophrenia—namely, positive or psychotic symptoms—remains uncontrolled. This subset, comprising a significant portion of individuals with schizophrenia, is referred to as having treatment-resistant schizophrenia (TRS). The persistence of their symptoms despite antipsychotic treatment leads to considerable psychological and economic burdens for the patients, their …

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Footnotes

  • Competing interests OA: Disclosure 2024 Advisory Board/Consultant for Janssen-Ortho (Johnson & Johnson), Otsuka, Lundbeck, Allergan/Abbvie and Mylan/Viatris; Teva Speaking engagements: Janssen-Ortho (Johnson & Johnson), Lundbeck, Otsuka, Mylan/Viatris, HLS therapeutics and Allergan/Abbvie; Research contracts: Janssen-Ortho (Johnson & Johnson), Lundbeck, Otsuka and Boehringer Ingelheim.

  • Provenance and peer review Commissioned; internally peer reviewed.