Volume 29, Issue 2 (Spring 2021)                   Avicenna J Nurs Midwifery Care 2021, 29(2): 146-159 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Kashani Lotfabadi M, Aboozarian S S, Farnosh M, Mohammadi A, Hashemi B M, Salarhaji A. The Effectiveness of Cognitive-Behavioral Group Therapy on Symptoms of Depression and Anxiety in Women with Chronic Schizophrenia Admitted to Hejazi Hospital in Mashhad. Avicenna J Nurs Midwifery Care 2021; 29 (2) :146-159
URL: http://nmj.umsha.ac.ir/article-1-2231-en.html
1- Psychiatry and Behavioral Sciences Research Center, Ibn-Sina psychiatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
2- Msc in Psychology, Payam Noor University of Garmsar, Garmsar, Iran , Sara.Aboozarian@gmail.com
3- Msc in Counseling, Islamic Azad University of Quchan, Quchan, Iran
4- MSc in Psychiatric Nursing, Psychiatry and Behavioral Sciences Research Center, Ibne-Sina psychiatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
5- Ms in Islamic Psychology, Payam Noor University of Gonabad, Gonabad, Iran
6- PhD Student in Nursing, Student Research Committee, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract:   (3799 Views)

Introduction: Considering the negative effects of depressive symptoms and anxiety on the course of schizophrenia, it seems that the combination of cognitive-behavioral group therapy with self-care skills can increase the effectiveness of this treatment in reducing the distress of patients with chronic schizophrenia. Therefore, a study was designed and conducted to determine the effect of cognitive-behavioral therapy group of self-care skills on the symptoms of anxiety and depression in women with chronic schizophrenia.
Method: This randomized controlled clinical trial was performed on 30 women with chronic schizophrenia admitted to Hejazi Psychiatric Hospital in Mashhad. The intervention group (n = 15) underwent cognitive-behavioral therapy group of self-care skills during 10 sessions of one and a half hours and the control group (n = 15) received a routine care. The data collection tool was the Hamilton Anxiety and Depression Scale which was completed in three stages. Data were analyzed using repeated measures analysis of variance and independent t-test.
Results: There was a significant decrease between the intervention and control groups in terms of changes in mean anxiety before and after the intervention (P<0.001) but in terms of changes in mean anxiety before and six months after the intervention and changes in mean depression during the stages there was no significant difference (P>0.05).
Conclusion: Cognitive-behavioral group therapy can be effective in reducing anxiety symptoms, but to increase the duration of its effect, the duration of sessions should be increased.

Persian Full-Text [PDF 503 kb]   (1573 Downloads) |   |   Extended Abstract (HTML)  (890 Views)  

✅ Cognitive-behavioral group therapy can be effective in reducing anxiety symptoms, but to increase the duration of its effect, the duration of sessions should be increased.

Type of Study: Original Research | Subject: Nursing
Received: 2020/09/7 | Accepted: 2020/09/24 | Published: 2020/11/28

1. Orrico-Sánchez A, López-Lacort M, Muñoz-Quiles C, Sanfélix-Gimeno G, Díez-Domingo J. Epidemiology of schizophrenia and its management over 8-years period using real-world data in Spain. BMC Psychiatry. 2020;20:1-9. [DOI:10.1186/s12888-020-02538-8] [PMID] [PMCID]
2. Kanchanatawan B, Sirivichayakul S, Thika S, Ruxrungtham K, Carvalho AF, Geffard M, et al. Physio-somatic symptoms in schizophrenia: association with depression, anxiety, neurocognitive deficits and the tryptophan catabolite pathway. Metab Brain Dis. 2017;32(4):1003-16. [DOI:10.1007/s11011-017-9982-7] [PMID]
3. Sun MM, Yang LM, Wang Y, Feng X, Cui KY, Liu LF, et al. BDNF Val66Met polymorphism and anxiety/depression symptoms in schizophrenia in a Chinese Han population. Psychiatr Genet. 2013;23(3):124-9. [DOI:10.1097/YPG.0b013e328360c866] [PMID]
4. Kaplan B, Sadock vA, Ruiz P. Synopsis of Psychiatry Behavioral Sciences/ Clinical Psychiatry. Tehran: Arjmand; 2015. 827 p
5. Ghalehbandi MF. Textbook of Clinical Psychiatry & Behavioral Sciences. Tehran: Arjmand; 2017. 760 p
6. Gannon JM, Brar J, Rai A, Chengappa KNR. Effects of a standardized extract of Withania somnifera (Ashwagandha) on depression and anxiety symptoms in persons with schizophrenia participating in a randomized, placebo-controlled clinical trial. Ann Clin Psychiatry. 2019;31(2):123-9.
7. Chiang YH, Beckstead JW, Lo SC, Yang CY. Association of auditory hallucination and anxiety symptoms with depressive symptoms in patients with schizophrenia: A three-month follow-up. Arch Psychiatr Nurs. 2018;32(4):585-90. [DOI:10.1016/j.apnu.2018.03.014] [PMID]
8. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13(2):261-76. [DOI:10.1093/schbul/13.2.261] [PMID]
9. Pallanti S, Cantisani A, Grassi G. Anxiety as a core aspect of schizophrenia. Curr Psychiatry Rep. 2013;15(5):354. [DOI:10.1007/s11920-013-0354-7] [PMID]
10. Tsai YF, Chen CY. Self-care symptom management strategies for auditory hallucinations among patients with schizophrenia in Taiwan. Appl Nurs Res. 2006;19(4):191-6. [DOI:10.1016/j.apnr.2005.07.008] [PMID]
11. Kanchanatawan B, Thika S, Sirivichayakul S, Carvalho AF, Geffard M, Maes M. In Schizophrenia, Depression, Anxiety, and Physiosomatic Symptoms Are Strongly Related to Psychotic Symptoms and Excitation, Impairments in Episodic Memory, and Increased Production of Neurotoxic Tryptophan Catabolites: a Multivariate and Machine Learning Study. Neurotox Res. 2018;33(3):641-55. [DOI:10.1007/s12640-018-9868-4] [PMID]
12. Kanchanatawan B, Sirivichayakul S, Carvalho AF, Anderson G, Galecki P, Maes M. Depressive, anxiety and hypomanic symptoms in schizophrenia may be driven by tryptophan catabolite (TRYCAT) patterning of IgA and IgM responses directed to TRYCATs. Prog Neuro-Psychopharmacol Biol Psychiatry. 2018;80:205-16. [DOI:10.1016/j.pnpbp.2017.06.033] [PMID]
13. Braga RJ, Reynolds GP, Siris SG. Anxiety comorbidity in schizophrenia. Psychiatry Res. 2013;210(1):1-7. [DOI:10.1016/j.psychres.2013.07.030] [PMID]
14. Tsai J, Rosenheck RA. Psychiatric comorbidity among adults with schizophrenia: A latent class analysis. Psychiatry Res. 2013;210(1):16-20. [DOI:10.1016/j.psychres.2013.05.013] [PMID] [PMCID]
15. Hou C-L, Ma X-R, Cai M-Y, Li Y, Zang Y, Jia F-J, et al. Comorbid moderate-severe depressive symptoms and their association with quality of life in Chinese patients with schizophrenia treated in primary care. Community Ment Health J. 2016;52(8):921-6. [DOI:10.1007/s10597-016-0023-5] [PMID]
16. Temmingh H, Stein DJ. Anxiety in Patients with Schizophrenia: Epidemiology and Management. CNS Drugs. 2015;29(10):819-32. [DOI:10.1007/s40263-015-0282-7] [PMID]
17. Rahim T, Rashid R. Comparison of depression symptoms between primary depression and secondary-to-schizophrenia depression. Int J Psychiatry Clin Pract. 2017;21(4):314-7. [DOI:10.1080/13651501.2017.1324036] [PMID]
18. Howells FM, Kingdon DG, Baldwin DS. Current and potential pharmacological and psychosocial interventions for anxiety symptoms and disorders in patients with schizophrenia: structured review. Hum Psychopharmacol. 2017;32(5). [DOI:10.1002/hup.2628] [PMID]
19. Chen SR, Chien YP, Kang CM, Jeng C, Chang WY. Comparing self-efficacy and self-care behaviours between outpatients with comorbid schizophrenia and type 2 diabetes and outpatients with only type 2 diabetes. J Psychiatr Ment Health Nurs. 2014;21(5):414-22. [DOI:10.1111/jpm.12101] [PMID]
20. Donato K. Self-Care as a Burdened Virtue. Episteme. 2017;28(1):3.
21. Rathod S, Phiri P, Kingdon D. Cognitive behavioral therapy for schizophrenia. Psychiatr Clin North Am. 2010;33(3):527-36. [DOI:10.1016/j.psc.2010.04.009] [PMID]
22. Laws KR, Darlington N, Kondel TK, McKenna PJ, Jauhar S. Cognitive Behavioural Therapy for schizophrenia - outcomes for functioning, distress and quality of life: a meta-analysis. BMC Psychol. 2018;6(1):32. [DOI:10.1186/s40359-018-0243-2] [PMID] [PMCID]
23. Jones C, Hacker D, Meaden A, Cormac I, Irving CB, Xia J, Zhao S, Shi C, Chen J. Cognitive behavioural therapy plus standard care versus standard care plus other psychosocial treatments for people with schizophrenia. Cochrane Database of Systematic Reviews. 2018(11). [DOI:10.1002/14651858.CD008712.pub3] [PMCID]
24. Opoka SM, Lincoln TM. The Effect of Cognitive Behavioral Interventions on Depression and Anxiety Symptoms in Patients with Schizophrenia Spectrum Disorders: A Systematic Review. Psychiatr Clin North Am. 2017;40(4):641-59. [DOI:10.1016/j.psc.2017.08.005] [PMID]
25. Upthegrove R, Marwaha S, Birchwood M. Depression and Schizophrenia: Cause, Consequence, or Trans-diagnostic Issue? Schizophr Bull. 2017;43(2):240-4.
26. Lodha P, De Sousa A. Cognitive Behavioural Therapy and Its Role in the Outcome and Recovery from Schizophrenia. Schizophrenia Treatment Outcomes: Springer; 2020. p. 299-312 [DOI:10.1007/978-3-030-19847-3_26]
27. Addington J, Epstein I, Liu L, French P, Boydell KM, Zipursky RB. A randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis. Schizophr Res. 2011;125(1):54-61. [DOI:10.1016/j.schres.2010.10.015] [PMID]
28. Bible LJ, Casper KA, Seifert JL, Porter KA. Assessment of self-care and medication adherence in individuals with mental health conditions. J Am Pharm Assoc (2003). 2017;57(3S):S203-S10 e3. [DOI:10.1016/j.japh.2017.02.023] [PMID]
29. Orfanos S, Banks C, Priebe S. Are Group Psychotherapeutic Treatments Effective for Patients with Schizophrenia? A Systematic Review and Meta-Analysis. Psychother Psychosom. 2015;84(4):241-9. [DOI:10.1159/000377705] [PMID]
30. Sadock BJ, Sadock VA, Ruiz P. Synopsis of psychiatry: behavioral sciences. New York: Wolters Kluwer; 2015.
31. Halperin S, Nathan P, Drummond P, Castle D. A cognitive-behavioural, group-based intervention for social anxiety in schizophrenia. Aust N Z J Psychiatry. 2000;34(5):809-13. [DOI:10.1080/j.1440-1614.2000.00820.x] [PMID]
32. Kunikata H, Yoshinaga N, Nakajima K. Effect of cognitive behavioral group therapy for recovery of self-esteem on community-living individuals with mental illness: Non-randomized controlled trial. Psychiatry Clin Neurosci. 2016;70(10):457-68. [DOI:10.1111/pcn.12418] [PMID]
33. Penn DL, Meyer PS, Evans E, Wirth RJ, Cai K, Burchinal M. A randomized controlled trial of group cognitive-behavioral therapy vs. enhanced supportive therapy for auditory hallucinations. Schizophr Res. 2009;109(1-3):52-9. [DOI:10.1016/j.schres.2008.12.009] [PMID]
34. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50-5. [DOI:10.1111/j.2044-8341.1959.tb00467.x] [PMID]
35. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56-62. [DOI:10.1136/jnnp.23.1.56] [PMID] [PMCID]
36. Hawton K. Cognitive behaviour therapy for psychiatric problems (a practical guide). Tehran: Arjmand; 1989.
37. Freedland KE, Carney RM, Rich MW, Steinmeyer BC, Rubin EH. Cognitive Behavior Therapy for Depression and Self-Care in Heart Failure Patients: A Randomized Clinical Trial. JAMA Intern Med. 2015;175(11):1773-82. [DOI:10.1001/jamainternmed.2015.5220] [PMID] [PMCID]
38. Vancampfort D, De Hert M, Knapen J, Maurissen K, Raepsaet J, Deckx S, et al. Effects of progressive muscle relaxation on state anxiety and subjective well-being in people with schizophrenia: a randomized controlled trial. Clin Rehabil. 2011;25(6):567-75. [DOI:10.1177/0269215510395633] [PMID]
39. Kingsep P, Nathan P, Castle D. Cognitive behavioural group treatment for social anxiety in schizophrenia. Schizophr Res. 2003;63(1-2):121-9. [DOI:10.1016/S0920-9964(02)00376-6]
40. Baruah A, Bhaduri A, Deuri S. Effect of psycho-educative intervention on knowledge about illness and self-care in patients with schizophrenia. Nurs J India. 2012;103(4):188.
41. Hsu Y-C, Lin W-Q, Kuo H-W. Schizophrenic Patients' Poor Perception in Personal Hygiene. Ment Health Fam Med. 2017;13(1):369-74. [DOI:10.25149/1756-8358.1301006]
42. Ayres H, Ngo H, John AP. Limited changes in activities of daily life performance ability among people with schizophrenia at clinical settings and the factors moderating the changes. Schizophr Res: Cognition. 2019;16:29-35. [DOI:10.1016/j.scog.2018.12.001] [PMID] [PMCID]
43. Storch EA, Arnold EB, Lewin AB, Nadeau JM, Jones AM, De Nadai AS, et al. The effect of cognitive-behavioral therapy versus treatment as usual for anxiety in children with autism spectrum disorders: A randomized, controlled trial. J Am Acad Child Adolesc Psychiatry. 2013;52(2):132-42. e2. [DOI:10.1016/j.jaac.2012.11.007] [PMID]
44. Krynicki CR, Upthegrove R, Deakin J, Barnes TR. The relationship between negative symptoms and depression in schizophrenia: a systematic review. Acta Psychiatr Scand. 2018;137(5):380-90. [DOI:10.1111/acps.12873] [PMID]
45. Chen T-H, Lu R-B, Chang A-J, Chu D-M, Chou K-R. The evaluation of cognitive-behavioral group therapy on patient depression and self-esteem. Arch Psychiatr Nurs. 2006;20(1):3-11. [DOI:10.1016/j.apnu.2005.08.005] [PMID]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Avicenna Journal of Nursing and Midwifery Care

Designed & Developed by : Yektaweb