Predictors of adherence to cognitive-behavioural therapy in first-episode psychosis

Can J Psychiatry. 2009 Oct;54(10):710-8. doi: 10.1177/070674370905401008.


Objective: To investigate predictors of adherence with a cognitive-behavioural intervention in first-episode psychosis (FEP) patients.

Method: Predictors of adherence to cognitive-behavioural therapy (CBT) were longitudinally investigated in the experimental arm of a randomized controlled trial designed to evaluate the effectiveness of a CBT intervention for relapse prevention early in the course of psychosis when compared with treatment as usual within 2 high quality, youth oriented, specialist FEP programs (the EPISODE II trial).

Results: Longer duration of untreated psychosis (DUP) and poorer level of insight predicted poor adherence to CBT. This association remained significant after controlling for potential confounders.

Conclusions: Treatment delay may decrease adherence with CBT in FEP patients. Reducing DUP and promoting insight early in the course of psychosis are likely to enhance adherence with CBT.

Publication types

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

MeSH terms

  • Adolescent
  • Antipsychotic Agents / therapeutic use
  • Awareness
  • Cognitive Behavioral Therapy*
  • Combined Modality Therapy
  • Family Therapy
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Patient Compliance / psychology*
  • Prognosis
  • Prospective Studies
  • Psychotic Disorders / psychology
  • Psychotic Disorders / therapy*
  • Secondary Prevention
  • Single-Blind Method
  • Treatment Outcome
  • Young Adult


  • Antipsychotic Agents