Treating delusional disorder: a comparison of cognitive-behavioural therapy and attention placebo control

Can J Psychiatry. 2007 Mar;52(3):182-90. doi: 10.1177/070674370705200310.


Objective: Cognitive-behavioural therapy (CBT) has proved effective in treating delusions, both in schizophrenia and delusional disorder (DD). Clinical trials of DD have mostly compared CBT with either treatment as usual, no treatment, or a wait-list control. This current study aimed to assess patients with DD who received CBT, compared with an attention placebo control (APC) group.

Method: Twenty-four individuals with DD were randomly allocated into either CBT or APC groups for a 24-week treatment period. Patients were diagnosed on the basis of structured clinical interviews for mental disorders and the Maudsley Assessment of Delusion Schedule (MADS).

Results: Completers in both groups (n = 11 for CBT; n = 6 for APC) showed clinical improvement on the MADS dimensions of Strength of Conviction, Insight, Preoccupation, Systematization, Affect Relating to Belief, Belief Maintenance Factors, and Idiosyncrasy of Belief.

Conclusion: When compared with APC, CBT produced more impact on the MADS dimensions for Affect Relating to Belief, Strength of Conviction, and Positive Actions on Beliefs.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / therapeutic use*
  • Attention*
  • Cognitive Behavioral Therapy / methods*
  • Delusions / diagnosis
  • Delusions / drug therapy
  • Delusions / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pimozide / therapeutic use*
  • Risperidone / therapeutic use*
  • Surveys and Questionnaires
  • Treatment Outcome


  • Antipsychotic Agents
  • Pimozide
  • Risperidone