***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The study aim ed to test two hypotheses . Firstly , that participants who relapsed during the 12-month follow-up period of our r and omized controlled trial , would show increased negative beliefs about their illness and reduced self-esteem , in comparison to the non-relapsed participants . Secondly , that cognitive behavioural therapy ( CBT ) for early signs of relapse would result in a reduction in negative beliefs about psychosis and an improvement in self-esteem at 12 months . DESIGN AND METHODS A total of 144 participants with schizophrenia or a related disorder were r and omized to receive either treatment as usual ( TAU ; N=72 ) or CBT ( N=72 ) . Participants completed the Personal Beliefs about Illness Question naire ( PBIQ ; Birchwood , Mason , MacMillan , & Healy , 1993 ) and the Rosenberg Self-Esteem Scale ( RSES ; Rosenberg , 1965 ) at entry , 3 months , 6 months , and 12 months . RESULTS At 12 months , relapsers showed greater increase in scores for PBIQ entrapment compared with non-relapsers . In addition , after controlling for baseline covariates ( treatment group and PBIQ self versus illness ) , relapsers also showed greater increase in scores for PBIQ self versus illness at 12 months . Furthermore , in comparison to treatment as usual , participants who received CBT showed greater improvement in PBIQ loss and in Rosenberg self-esteem . CONCLUSIONS The study provides evidence that relapse is associated with the development of negative appraisal s of entrapment and self-blame ( self vs. illness ) . In addition , this is the first study to show that CBT reduces negative appraisal s of loss arising from psychosis and improvements in self-esteem . Implication s for future research and treatment are discussed Comm and hallucinations represent a special problem for the clinical management of psychosis . While compliance with both non-harmful and harmful comm and s can be problematic , sometimes in the extreme , active efforts to resist comm and s may also contribute to their malignancy . Previous research suggests Cognitive Behaviour Therapy ( CBT ) to be a useful treatment for reducing compliance with harmful comm and hallucinations . The purpose of this trial was to evaluate whether CBT augmented with acceptance-based strategies from Acceptance and Commitment Therapy could more broadly reduce the negative impact of comm and hallucinations .  Forty-three participants with problematic comm and hallucinations were r and omized to receive 15 sessions of the intervention " TORCH " ( Treatment of Resistant Comm and Hallucinations ) or the control , Befriending , then followed up for 6 months . A sub- sample of 17 participants was r and omized to a waitlist control before being allocated to TORCH or Befriending . Participants engaged equally well with both treatments . Despite TORCH participants subjectively reporting greater improvement in comm and hallucinations compared to Befriending participants , the study found no significant group differences in primary and secondary outcome measures based on blinded assessment data . Within-group analyses and comparisons between the combined treatments and waitlist suggested , however , that both treatments were beneficial with a differential pattern of outcomes observed across the two conditions To address the effects of dysfunctional cognitions on vocational outcome of people with schizophrenia spectrum disorders , we developed the Indianapolis Vocational Intervention Program ( IVIP ) , a cognitive-behavioral program of group and individual interventions . Fifty participants with schizophrenia or schizoaffective disorder were offered 6-month work placements and r and omized  to  receive IVIP ( n = 25 ) or st and ard support services ( n = 25 ) .  Hours worked were measured weekly , and work performance was assessed biweekly with the use of the Work Behavior Inventory . Hope and self-esteem were assessed at baseline and at 5 months with the Beck Hopelessness Scale and the Rosenberg Self-Esteem Schedule . Analysis of variance ( ANOVA ) revealed that the IVIP group worked significantly more weeks and had better average work performance than the st and ard support group . Repeated measures ANOVA of baseline and follow-up scores indicated that the IVIP group sustained baseline levels of hope and self-esteem through follow-up , while the st and ard support group experienced declines . Results provide initial evidence of the effectiveness of the IVIP BACKGROUND Many patients with psychotic disorders have persistent paranoid ideation and avoid social situations because of suspiciousness and anxiety . We investigated the effects of virtual-reality-based cognitive behavioural therapy ( VR-CBT ) on paranoid thoughts and social participation . METHODS In this r and omised controlled trial at seven Dutch mental health centres , out patients aged 18 - 65 years with a DSM-IV-diagnosed psychotic disorder and paranoid ideation in the past month were r and omly assigned ( 1:1 ) via  block r and omisation to VR-CBT ( in addition to treatment as usual ) or the waiting list control group ( treatment as usual ) . VR-CBT consisted of 16 individual therapy sessions ( each 1 h long ) . Assessment s were done at baseline , after treatment ( ie , 3 months from baseline ) , and at a 6 month follow-up visit . The primary outcome was social participation , which we operationalised as the amount of time spent with other people , momentary paranoia , perceived social threat , and momentary anxiety . Analysis was by intention to treat . This trial was retrospectively registered with IS RCT N , number 12929657 . FINDINGS Between April 1 , 2014 , and Dec 31 , 2015 , 116 patients with a psychotic disorder were r and omly assigned , 58 to the VR-CBT group and 58 to the waiting list control group . Compared with the control , VR-CBT did not significantly increase the amount of time spent with other people at the post-treatment assessment . Momentary paranoid ideation ( b=-0·331 [ 95 % CI -0·432 to -0·230 ] , p<0·0001 ; effect size -1·49 ) and momentary anxiety ( -0·288 [ -0·438 to -0·1394 ] ; p=0·0002 ; -0·75 ) were significantly reduced in the VR-CBT group compared with the control group at the post-treatment assessment , and these improvements were maintained at the follow-up assessment . Safety behaviour and social cognition problems were mediators of change in paranoid ideation . No adverse events were reported relating to the therapy or assessment s. INTERPRETATION Our results suggest that the addition of VR-CBT to st and ard treatment can reduce paranoid ideation and momentary anxiety in patients with a psychotic disorder . FUNDING Fonds NutsOhra , Stichting tot Steun VCVGZ Internalised stigma is problematic for people who experience psychosis therefore psychological interventions are required . This study examine the feasibility and acceptability of a brief Cognitive Behavioural Therapy ( CBT ) intervention for internalised stigma with psychiatric in patients experiencing psychosis . A feasibility r and omised controlled trial was conducted , comparing CBT with a psychoeducational ( PE ) control arm .  Thirty participants ( aged 18 - 65 , with psychosis , and currently admitted to a psychiatric hospital ) were r and omised to one of two conditions . Participants were assessed at baseline , post-intervention ( two weeks ) and at follow-up ( one month ) . Both interventions incorporated two hours of sessions over a two week period . The outcomes examined were internalised stigma ( primary outcome ) , stigma , attitudes toward mental health problems , personal recovery , depression and self-esteem . Recruitment was conducted over a seven month period from five psychiatric wards . Forty five potential participants were approached and 30 ( 66 % ) consented to take part . Fifteen participants were r and omised to CBT and 15 to PE .  Feasibility data demonstrated that both the research process and interventions were feasible and acceptable . Examination of outcomes demonstrated that there was no identified benefit of one intervention type over another . There were no adverse events related to study participation . A future definitive trial is required with improved method ological rigor Summary Background Little evidence is available for head-to-head comparisons of psychosocial interventions and pharmacological interventions in psychosis . We aim ed to establish whether a r and omised controlled trial of cognitive behavioural therapy ( CBT ) versus antipsychotic drugs versus a combination of both would be feasible in people with psychosis . Methods We did a single-site , single-blind pilot r and omised controlled trial in people with psychosis who used services in National Health Service trusts across Greater Manchester , UK . Eligible participants were aged 16 years or older ; met ICD-10 criteria for schizophrenia , schizoaffective disorder , or delusional disorder , or met the entry criteria for an early intervention for psychosis service ; were in contact with mental health services , under the care of a consultant psychiatrist ; scored at least 4 on delusions or hallucinations items , or at least 5 on suspiciousness , persecution , or gr and iosity items on the Positive and Negative Syndrome Scale ( PANSS ) ; had capacity to consent ; and were help-seeking . Participants were assigned ( 1:1:1 ) to antipsychotics , CBT , or antipsychotics plus CBT . R and omisation was done via a secure web-based r and omisation system ( Sealed Envelope ) , with r and omised permuted blocks of 4 and 6 , stratified by gender and first episode status . CBT incorporated up to 26 sessions over 6 months plus up to four booster sessions . Choice and dose of antipsychotic were at the discretion of the treating consultant . Participants were followed up for 1 year . The primary outcome was feasibility ( ie , data about recruitment , retention , and acceptability ) , and the primary efficacy outcome was the PANSS total score ( assessed at baseline , 6 , 12 , 24 , and 52 weeks ) . Non-neurological side-effects were assessed systemically with the Antipsychotic Non-neurological Side Effects Rating Scale . Primary analyses were done by intention to treat ; safety analyses were done on an as-treated basis . The study was prospect ively registered with IS RCT N , number IS RCT N06022197 . Findings Of 138 patients referred to the study , 75 were recruited and r and omly assigned—26 to CBT , 24 to antipsychotics , and 25 to antipsychotics plus CBT .  Attrition was low , and retention high , with only four withdrawals across all groups . 40 ( 78 % ) of 51 participants allocated to CBT attended six or more sessions . Of the 49 participants r and omised to antipsychotics , 11 ( 22 % ) were not prescribed a regular antipsychotic . Median duration of total antipsychotic treatment was 44·5 weeks ( IQR 26–51 ) . PANSS total score was significantly reduced in the combined intervention group compared with the CBT group ( –5·65 [ 95 % CI −10·37 to −0·93 ] ; p=0·019 ) . PANSS total scores did not differ significantly between the combined group and the antipsychotics group ( –4·52 [ 95 % CI −9·30 to 0·26 ] ; p=0·064 ) or between the antipsychotics and CBT groups ( –1·13 [ 95 % CI −5·81 to 3·55 ] ; p=0·637 ) . Significantly fewer side-effects , as measured with the Antipsychotic Non-neurological Side Effects Rating Scale , were noted in the CBT group than in the antipsychotics ( 3·22 [ 95 % CI 0·58 to 5·87 ] ; p=0·017 ) or antipsychotics plus CBT ( 3·99 [ 95 % CI 1·36 to 6·64 ] ; p=0·003 ) groups . Only one serious adverse event was thought to be related to the trial ( an overdose of three paracetamol tablets in the CBT group ) . Interpretation A head-to-head clinical trial of CBT versus antipsychotics versus the combination of the two is feasible and safe in people with first-episode psychosis . Funding National Institute for Health Research Objective : The objective of this study was to investigate the efficacy of group-based cognitive-behavioural therapy ( CBT ) for social anxiety in schizophrenia . Method : Patients with schizophrenia ( 20 ) with comorbid social anxiety were r and omly assigned to the group-based CBT or wait-list control condition . Pre- , post- and 6-week follow-up ratings included measures of social anxiety and avoidance , mood and quality of life . Results : The intervention group improved on all outcome measures and the control group showed no change in symptomatology . Conclusions : Group-based CBT is effective in treating social anxiety in schizophrenia BACKGROUND Little evidence exists for the effects of psychological treatment on voices even though it is clear that CBT does affect delusions and symptoms overall . This study tested whether a group based on cognitive behavioural principles could produce beneficial effects on hallucinations . AIM To test the effectiveness of group CBT on social functioning and severity of hallucinations . METHOD Participants were included if they had a diagnosis of schizophrenia and experienced distressing auditory hallucinations ( rated on the PANSS ) . They were r and omly allocated to group CBT ( N = 45 ) or a  control group who received treatment as usual ( N = 40 ) . The two main outcomes were social functioning as measured by the Social Behaviour Schedule and the severity of hallucinations as measured by the 
    Output:
    
However , there was insufficient evidence regarding the long-term effects of CBT on personal recovery .
Conclusions CBT is an effective therapy with meaningful clinical effect sizes on personal recovery and some aspects of personal recovery of schizophrenia after treatment .
However , the effect is relatively immediate and rapidly decreases as time progresses .