Thérapies cognitives et comportementales après les premiers épisodes psychotiques

Cognitive behavior therapy (CBT) is recommended for the treatment of first-episode psychosis (FEP) patients. It can be offered in acute state or during the remission of the episode. Up to date, effects of CBT have been examined in several controlled and randomized trials in FEP. Combined with antipsychotic medications, results have demonstrated that CBT decreases positive psychotic symptoms, enhances quality of live, self-esteem and insight, and diminishes the intensity of comorbide symptoms, such as trauma or suicide behavior. CBT might be particularly efficient in individuáis wishing to reintégrate premorbide functioning and those with low duration of untreated psychosis. Despite these encouraging results, psychosis orientated CBT are underused in France. The validation of group CBT specifically designed for FEP should enhance the range of patients receiving this treatment. Moreover, early CBT interventions for people at ultra high-risk for psychosis and assertive community treatments should be developed.