Motivational interviewing plus CBT eases negative symptoms in schizophrenia

Motivational interviewing (MI) in combination with cognitive behavioural therapy (CBT) improves negative symptoms in patients with schizophrenia, reports a study. These symptoms are initially thought of as resistant to any intervention.

“Negative symptoms are a primary cause of disability in schizophrenia for which there are no established pharmacotherapies,” said the researchers, who then set out to explore a novel psychosocial intervention that combined two evidence-based practices—MI and CBT—for the treatment of this condition.

This randomized controlled trial comparing the 12-session MI-CBT treatment with a mindfulness control condition included 79 patients with schizophrenia and moderate-to-severe motivational negative symptoms. They examined the participants at three time points throughout the study period, which included 12 weeks of active treatment and 12 weeks of follow-up.

Motivational negative symptoms and community functioning were the primary outcome measures, while secondary outcomes included a posited biomarker of negative symptoms, namely pupillometric response to cognitive effort.

Over the cute treatment period, patients in the MI-CBT group had a significantly greater improvement in motivational negative symptoms than those in the control group. Gains achieved by these participants relative to baseline persisted at follow-up, but the differential benefit relative to controls was lessened.

In addition, nonsignificant effects were observed for improvements in community functioning and differential change in the pupillometric markers of cognitive effort.

“Motivational negative symptoms not only responded to the novel treatment, but the gains were maintained over the follow-up period,” the researchers said. “Implications for future studies and for improving the generalization of the negative symptom gains to daily functioning domains are discussed.”