Neuroscience
Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: A randomised controlled trial
Recently I have commented on what I see as methodologically poor, biased and spun studies of CBT for psychosis - every time I want to blog on someting else, out comes another questionable study - this time 'in press' at Schizophrenia Research, which I think requires comment - in particular, the gap between the reality and presentation of findings
This is an RCT looking at the use of CBT in UK minority groups with a diagnosis of schizophrenia
A total, n = 33 participants, who were randomly allocated to CBT for psychosis (CBTp n = 16) and treatment as usual (TAU n = 17). Although a relatively small study, the authors did a power analysis based on previous pilot studies and suggest that a minimum of 12 per arm of the trial would be sufficiently powered - obviously they exceed this expectation.
Did the CBT group show any benefit (i.e. reduction of symptoms) over the TAU group?
Well, the authors say yes in the abstract:
The key aspect here though is the bolded statement, added casually at the end of the results about 'adjustment'. Table 1 from the paper presented below indicates (as the authors rightly admit) that the TAU group were older, had longer duration of illness and greater medication and they duly adjusted analyses for these variables
However, the abstract results all refer to unadjusted scores - see the Table 2 below - all are taken from the non-adjusted column. If you glance to the final column (Adjusted reduction from baseline) - not a single comparison is significant!
Table 2 Results
Maybe someone can explain to me, what is happening here? Is it blatant author spinning to get further funding (as they mention this in the discussion). Is it collusion from reviewers, who let this through? Failure to spot the obvious by reviewers?
Perhaps I am overly critical - letters on a postcard (in the comments section please)
- Meta-matic: Meta-analyses Of Cbt For Psychosis
Meta analyses are not a 'ready-to-eat' dish that necessarily satisfy our desire for 'knowledge' - they require as much inspection as any primary data paper and indeed, afford closer inspection...as we have access to all of the data....
- Satellites Of Love: Uninterpretable Results
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Neuroscience
Significantly nonsignificant
In the morning I'd awake and I couldn't remember
What is love and what is hate? - the calculations error
What is love and what is hate? - the calculations error
Flaming Lips (Morning of the Magicians)
Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: A randomised controlled trial
Shanaya Rathod, Peter Phiri, Scott Harris, Charlotte Underwood, Mahesh Thagadur, Uma Padmanabi & David Kingdon
Recently I have commented on what I see as methodologically poor, biased and spun studies of CBT for psychosis - every time I want to blog on someting else, out comes another questionable study - this time 'in press' at Schizophrenia Research, which I think requires comment - in particular, the gap between the reality and presentation of findings
This is an RCT looking at the use of CBT in UK minority groups with a diagnosis of schizophrenia
A total, n = 33 participants, who were randomly allocated to CBT for psychosis (CBTp n = 16) and treatment as usual (TAU n = 17). Although a relatively small study, the authors did a power analysis based on previous pilot studies and suggest that a minimum of 12 per arm of the trial would be sufficiently powered - obviously they exceed this expectation.
Did the CBT group show any benefit (i.e. reduction of symptoms) over the TAU group?
Well, the authors say yes in the abstract:
Results: Post-treatment, the intervention group showed statistically significant reductions in symptomatology on overall CPRS scores, CaCBTp Mean (SD) = 16.23 (10.77), TAU = 18.60 (14.84); p = 0.047,with a difference in change of 11.31 (95% CI:0. 14 to 22.49); Schizophrenia change: CaCBTp = 3.46 (3.37); TAU = 4.78 (5.33) diff 4.62 (95% CI: 0.68 to 9.17); p = 0.047 and positive symptoms (delusions; p = 0.035, and hallucinations; p = 0.056). At 6 months follow-up, MADRAS change = 5.6 (95% CI: 2.92 to 7.60); p < 0.001. Adjustment was made for age, gender and antipsychotic medication.
Conclusion: Participants in the CaCBTp group achieved statistically significant results post-treatment compared to those in the TAU group with some gains maintained at follow-up. High levels of satisfaction with the CaCBTp were reported
Flaming Lips - In the Morning of the Magicians
The key aspect here though is the bolded statement, added casually at the end of the results about 'adjustment'. Table 1 from the paper presented below indicates (as the authors rightly admit) that the TAU group were older, had longer duration of illness and greater medication and they duly adjusted analyses for these variables
Table 2 Results
Maybe someone can explain to me, what is happening here? Is it blatant author spinning to get further funding (as they mention this in the discussion). Is it collusion from reviewers, who let this through? Failure to spot the obvious by reviewers?
Perhaps I am overly critical - letters on a postcard (in the comments section please)
- Meta-matic: Meta-analyses Of Cbt For Psychosis
Meta analyses are not a 'ready-to-eat' dish that necessarily satisfy our desire for 'knowledge' - they require as much inspection as any primary data paper and indeed, afford closer inspection...as we have access to all of the data....
- Satellites Of Love: Uninterpretable Results
In llama land there's a one-man band And he'll toot his flute for you Come on fly with me, let's take off in the blueFrank Sinatra (Come Fly with Me) Cognitive Behavioral Therapy for negative symptoms in psychotic disorders: a pilot...
- In A Manner Of Speaking
In a Manner of speaking I just want to say That I could never forget the way You told me everything By saying nothingIn a Manner of Speaking (by Tuxedo Moon) I was recently asked to write an article on some of the problems associated with psychological...
- Cbt: She's Lost Control(s) Again
And of a voice that told her when and where to act, She said I've lost control againJoy Division (Shes Lost Control Again) Cognitive therapy for people with a schizophrenia spectrum diagnosis not taking antipsychotic medication: an exploratory...
- Cbt: You Spin Me Round
Although we failed to show a statistically significant effect of the intervention we cannot rule out a beneficial effect of the cognitive therapy on transition rate (although it could be argued that the sample size required to show such an effect,...