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ItemEarly intervention in psychosis: a response to McGorry et al. (2010)Castle, D ; Bosanac, P ; Patton, G (CAMBRIDGE UNIV PRESS, 2010-12-01)The Commentary of McGorry et al. (2010) on our Editorial in the March 2010 edition of the Journal 2108 Correspondence (Bosanac et al. 2010), used the opportunity to promote the early intervention agenda. Unfortunately it did not adequately address the challenges we raised. It is instead an example of how the early intervention agenda has been so successful in influencing policy – a simple solution to a complex problem, argued with passion.
ItemCognitive Behavioural Therapy for Auditory Hallucinations: Effectiveness and Predictors of Outcome in a Specialist ClinicThomas, N ; Rossell, S ; Farhall, J ; Shawyer, F ; Castle, D (CAMBRIDGE UNIV PRESS, 2011-03-01)BACKGROUND: Cognitive behavioural therapy has been established as an effective treatment for residual psychotic symptoms but a substantial proportion of people do not benefit from this treatment. There has been little direct study of predictors of outcome, particularly in treatment targeting auditory hallucinations. METHOD: The Psychotic Symptom Rating Scales (PSYRATS) and Positive and Negative Syndrome Scale (PANSS) were administered pre- and post-therapy to 33 people with schizophrenia-related disorders receiving CBT for auditory hallucinations in a specialist clinic. Outcome was compared with pre-therapy measures of insight, beliefs about the origin of hallucinations, negative symptoms and cognitive disorganization. RESULTS: There were significant improvements post-treatment on the PSYRATS and PANSS Positive and General Scales. Improvement on the PSYRATS was associated with lower levels of negative symptoms, but was unrelated to overall insight, delusional conviction regarding the origins of hallucinations, or levels of cognitive disorganization. CONCLUSIONS: Lack of insight and presence of formal thought disorder do not preclude effective cognitive-behavioural treatment of auditory hallucinations. There is a need to further understand why negative symptoms may present a barrier to therapy.