***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: BACKGROUND Cognitive Behaviour Therapy for Psychosis ( CBTp ) has a strong evidence base and is practised widely in the Western World . Psycho-social interventions , on the other h and , including Cognitive Behaviour Therapy ( CBT ) are hardly used in the low and middle income countries for psychosis . It has been suggested that adaptations in content , format and delivery are needed before CBT can be used outside the Western cultures . We describe preliminary evaluation of Culturally Adapted Cognitive Behaviour Therapy for Psychosis ( CaCBTp ) in in-patient setting s in Lahore , Pakistan . AIMS We aim ed to evaluate the efficacy of culturally adapted CBT for psychosis ( CaCBTp ) in Pakistan in a pilot project . METHOD In a r and omized controlled trial we tested CaCBTp against treatment as usual ( TAU ) in in-patient setting s in Pakistan . Those diagnosed with schizophrenia according to the DSM-IV-TR , and who fulfilled the inclusion criteria , were recruited into the study . Patients ( n = 42 ) were r and omized into two equal groups , i.e. CaCBTp and TAU . Assessment s were carried out both at the baseline and then at the end of the therapy by raters blind to the groupings . Psychopathology was measured using PANSS ( Positive and Negative Syndrome Scale of Schizophrenia ) , PSYRATS ( Psychotic Symptom Rating Scales ) , and the Insight Scale . RESULTS Patients receiving CaCBTp showed statistically significant improvement on measures of positive symptoms ( p = .000 ) , negative symptoms ( p = .000 ) , overall psychotic symptoms ( p = .000 ) , hallucinations ( p = .000 ) , delusions ( p = .000 ) and insight ( p = .000 ) at the end of the therapy . CONCLUSIONS The CaCBTp was effective in reducing symptoms of psychosis and in improving insight in in-inpatient setting s in Pakistan Evidence for the effectiveness of Culturally adapted CBT for psychosis in Low And Middle Income Countries ( LAMIC ) is limited . Therefore , brief Culturally adapted CBT for psychosis ( CaCBTp ) targeted at symptoms of schizophrenia for out patients plus treatment as usual ( TAU ) is compared with TAU .  A total of 116 participants with schizophrenia were recruited from 2 hospitals in Karachi , Pakistan , and r and omized into two groups with 1:1 allocation ( CaCBTp plus TAU=59 , TAU=57 ) . A brief version of CaCBTp ( 6 individual sessions with the involvement of main carer , plus one session for the family ) was provided over 4months . Psychopathology was measured using Positive and Negative Syndrome Scale of Schizophrenia ( PANSS ) , Psychotic Symptom Rating Scales ( PSYRATS ) , and the Schedule for Assessment of Insight ( SAI ) at baseline and end of therapy . Participants in treatment group , showed statistically significant improvement in all measures of psychopathology at the end of the study compared with control group . Participants in treatment group showed statistically significant improvement in Positive Symptoms ( PANSS , Positive Symptoms Subscale ; p=0.000 ) , Negative Symptoms ( PANSS , Negative Symptoms subscales ; p=0.000 ) , Delusions ( PSYRATS , Delusions Subscale ; p=0.000 ) , Hallucinations ( PSYRATS , Hallucination Subscale ; p=0.000 ) and Insight ( SAI ; p=0.007 ) . The results suggest that brief , Culturally adapted CBT for psychosis can be an effective treatment when provided in combination with TAU , for patients with schizophrenia in a LAMIC setting . This is the first trial of CBT for psychosis from outside the western world . These findings need replicating in other low and middle income countries This study evaluated mindfulness-based cognitive therapy ( MBCT ) , a group intervention design ed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence . Recovered recurrently depressed patients ( n = 145 ) were r and omized to continue with treatment as usual or , in addition , to receive MBCT .  Relapse/recurrence to major depression was assessed over a 60-week study period . For patients with 3 or more previous episodes of depression ( 77 % of the sample ) , MBCT significantly reduced risk of relapse/recurrence . For patients with only 2 previous episodes , MBCT did not reduce relapse/recurrence .  MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients AIM AND OBJECTIVES The aim of the study was to identify the predictors of functioning in Chinese people with serious mental illness . BACKGROUND Mental healthcare services for people suffering from serious mental illness are delivered to not only minimise their psychiatric symptoms but also enhance their levels of functioning in the community . Yet , there is insufficient research directed towards the associated or predictive factors that may influence different aspects of functioning , particularly in terms of patients ' psychosocial variables . DESIGN A longitudinal , prospect i ve cohort study design was adopted . METHODS A clustered r and om sample of 395 of 611 out patients with serious mental illness completed the same set of question naires at baseline and at 12 months . Changes in patients ' functioning as measured by self-maintenance , social functioning and community living skills were recorded over 12 months . Potential relationships between their level of functioning and symptom severity , self-esteem , self-efficacy , perceived negative familial response , negative self-stigma towards mental illness , re-hospitalisation rate and socio-demographic characteristics were investigated . RESULTS Most participants reported moderate to moderately high levels of overall functioning , self-efficacy , self-stigma and perceived negative familial response at baseline and there were significant observed correlations between these variables . Results of multiple regression models indicated that while symptom severity predicted functioning in patients with psychotic and affective disorders , a negatively perceived familial response only predicted negative changes in social functioning of the patients with psychotic disorders ( β = -0·25 ) . In addition , improvements in self-efficacy ( β = 0·23 ) and reduction in self-stigma ( β = -0·15 ) positively predicted changes in the community living skills of patients with affective disorders . CONCLUSION The findings indicate the significance of psychiatric patients ' symptom management and factors such as self-efficacy and self-stigma to predict their functioning over a 12-month follow-up . RELEVANCE TO CLINICAL PRACTICE Mental healthcare services should consider giving priority to self-stigma reduction and empowerment to manage illness especially in this population of patients and their families , thus effectively enhancing their self-care ability to cope with their illness and /or difficult life situations Family interventions for first-episode psychosis ( FEP ) are an integral component of treatment , with positive effects mainly on patients ’ mental state and relapse rate . However , comparatively little attention has been paid to the effects of family interventions on caregivers ’ stress coping and well-being , especially in non-Western countries . We aim ed to test the effects of a 5-month clinician-supported problem-solving bibliotherapy ( CSPSB ) for Chinese family caregivers of people with FEP in improving family burden and carers ’ problem-solving and caregiving experience , and in reducing psychotic symptoms and duration of re-hospitalizations , compared with those only received usual outpatient family support ( UOFS ) . A r and omized controlled trial was conducted across 2 early psychosis clinics in Hong Kong , where there might be inadequate usual family support services for FEP patients . A total of 116 caregivers were r and omly selected , and after baseline measurement , r and omly assigned to the CSPSB or UOFS . They were also assessed at 1-week and 6- and 12-month post-intervention . Intention-to-treat analyses were applied and indicated that the CSPSB group reported significantly greater improvements in family burden and caregiving experience , and reductions in severity of psychotic symptoms and duration of re-hospitalizations , than the UOFS group at 6- and 12-month follow-up . CSPSB produces moderate long-term benefits to caregivers and FEP patients , and is a low-cost adjunct to UOFS Dementia caregivers often experience loss and grief related to general caregiver burden , physical , and mental health problems . Through qualitative content analysis , this study analyzed intervention strategies applied by therapists in a r and omized-controlled trial in Germany to assist caregivers in managing losses and associated emotions . Sequences from 61 therapy sessions that included interventions targeting grief , loss , and change were transcribed and analyzed . A category system was developed deductively , and the intercoder reliability was satisfactory . The identified grief intervention strategies were recognition and acceptance of loss and change , addressing future losses , normalization of grief , and redefinition of the relationship . Therapists focused on identifying experienced losses , managing associated feelings , and fostering acceptance of these losses . A variety of cognitive – behavioral therapy – based techniques was applied with each strategy . The findings contribute to underst and ing how dementia caregivers can be supported in their experience of grief and facilitate the development of a manualized grief intervention R and omization as a method of experimental control has been extensively used in human clinical trials and other biological experiments . It prevents the selection bias and insures against the accidental bias . It produces the comparable groups and eliminates the source of bias in treatment assignments . Finally , it permits the use of probability theory to express the likelihood of chance as a source for the difference of end outcome . This paper discusses the different methods of r and omization and use of online statistical computing web programming ( www.graphpad.com/quickcalcs or www.r and omization.com ) to generate the r and omization  schedule . Issues related to r and omization are also discussed in this paper Caring for young people with first-episode psychosis ( FEP ) is challenging and can adversely affect carer well-being , with limited evidence -based support material s available . We aim ed to examine whether completion of a self-directed problem-solving bibliotherapy among carers of young people with FEP led to a better experience of caring , less distress and expressed emotion , and better general health than carers who only received treatment as usual ( TAU ) . A r and omized controlled trial was conducted across two early-intervention psychosis services in Melbourne , Australia . A total of 124 carers were r and omized to problem-solving bibliotherapy intervention ( PSBI ) or TAU and assessed at baseline , 6-week and 16-week follow-up . Intent-to-treat analyses were carried out and indicated that recipients of PSBI had a more favorable experience of caring than those receiving TAU , and these effects were sustained at both follow-up time points . Across the other measures , both groups demonstrated improvements by week 16 , although the PBSI group tended to improve earlier . The PSBI group experienced a greater reduction in negative emotional evaluations of the need to provide additional support to young people with FEP than the TAU group by week 6 , while the level of psychological distress decreased at a greater rate from baseline to 6 weeks in the PSBI compared with the TAU group . These findings support the use of problem-solving bibliotherapy for first-time carers , particularly as a cost-effective adjunct to TAU 
    Output:
    
The pooled CBFI effect on four service user outcomes including overall positive symptoms , delusions , overall negative symptoms , and general psychopathology were significantly improved at post-treatment , compared with TAU .
Whereas effects on hallucinations and insight were equivocal .
DISCUSSION The findings reveal that CBFI is superior to TAU in treating positive and negative symptoms immediately following the intervention .
However , there is currently no substantial evidence that the intervention is effective over the longer term