Cognitive therapy for delusions in patients with paranoid schizophrenia

Pages: 224-227
Krishnan Gireesh (Clinical Psychologist, Harisree Institute of Mental Health and Neurosciences (HIMHANS), Kollam, Kerala)

Delusions are common and severely incapacitating symptom in severe mental disorders. Delusional beliefs are heterogeneous and occur in numerous clinical desires such as schizophrenia, delusional disorders, dementia and severe mood disorders (APA, 19087). There has been a growing interest in studying particular symptoms of psychosis (Beranbanm, Oltmauns, & Gaterman, 1985; Slade & Bent, 1988). However, in spite of the fact that delusions are extremely common in psychosis, this symptoms has suffered experimental neglect (Ollturanus, 1988; Winters & Neale’s, 1983, IPSS, WHO, 1973). Pharmacological intervention has limited success in controlling delusional beliefs, the drug resistant, persistent delusion poses a clinical challenge and hence alterative psychological treatments have been developed. Operant methods and belief modification procedures have been used with limited success. Cognitive therapy has recently being used by therapists and researches in severe mental disorders. The present study examined the effectiveness of cognitive behaviour therapy in delusions of patients with paranoid schizophrenia. The study examined the efficacy of cognitive therapy on different variables of delusions -Convictions, pre-occupations and reaction to hypothetical contradictions. A single case study design was adopted with pre and post intervention assessments carried out by an independent rater. 10 patients with ICD10 diagnosis of paranoid schizophrenia underwent 48 sessions of cognitive therapy. The results showed that cognitive therapy was effective in improving insight and changing convictions pre occupations and reactions to hypothetical contradictions of persistent delusion. The present study shows the usefulness of Cognitive Therapy as a main therapeutic method in delusions of patients with paranoid schizophrenia in the Indian context.