Predictors of Adherence to Cognitive-Behavioural Therapy in First-Episode Psychosis

Abstract

OBJECTIVE: To investigate predictors of adherence with a cognitive-behavioural intervention in first-episode psychosis (FEP) patients. METHOD: Predictors of adherence to cognitive-behavioural therapy (CBT) were longitudinally investigated in the experimental arm of a randomized controlled trial designed to evaluate the effectiveness of a CBT intervention for relapse prevention early in the course of psychosis when compared with treatment as usual within 2 high quality, youth oriented, specialist FEP programs (the EPISODE II trial). RESULTS: Longer duration of untreated psychosis (DUP) and poorer level of insight predicted poor adherence to CBT. This association remained significant after controlling for potential confounders. CONCLUSIONS: Treatment delay may decrease adherence with CBT in FEP patients. Reducing DUP and promoting insight early in the course of psychosis are likely to enhance adherence with CBT.