Condition category
Mental and Behavioural Disorders
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting

Plain English Summary

Background and study aims
The NHS spends over £2 billion a year on treating schizophrenia, including expensive in-patient care. Consequently the development of cost-effective psychological therapies for schizophrenia is an NHS priority. Although government guidelines recommend cognitive behavioural therapy (CBT) as a treatment, the NHS struggles to meet this demand. Due to the wide range of presentations associated with a diagnosis of schizophrenia, the relevant CBT training is still generic and lengthy. There is a need for treatment protocols which target specific forms of schizophrenic presentation. These interventions are easier to disseminate within the NHS, and are likely to be more cost-effective. People diagnosed with schizophrenia are particularly likely to have suffered traumatic life events, and up to 40% may suffer from symptoms of posttraumatic stress disorder (PTSD). This ‘co-morbid’ condition is associated with severe symptoms, abusing illicit drugs and alcohol, and frequent hospital admissions. There have been no studies of any treatment for PTSD within this group. As standard CBT for PTSD is considered to be unsuitable for people with schizophrenia, a CBT package has been carefully designed for this purpose. A pilot study suggests a high level of patient acceptability. The potential for benefits in patient wellbeing and reduced healthcare costs suggest that the intervention should be evaluated within an NHS setting. The aim of this study is to test whether CBT, delivered to patients with co-morbid schizophrenia and PTSD, in addition to standard psychiatric care will result in a reduced level of PTSD and psychotic symptoms.

Who can participate?
Patients aged between 18 and 65 diagnosed with schizophrenia and PTSD.

What does the study involve?
Participants will be randomly allocated to receive either the CBT package or standard psychiatric care. Existing NHS clinicians will be trained to conduct the CBT package as part of their routine clinical work. Assessments will be carried out at the beginning of the treatment, the end of treatment and after a 6-month follow-up. Levels of symptoms and health care use will be compared between the two groups. The acceptability of the intervention to the patients will be assessed through an interview conducted at the end of treatment.

What are the possible benefits and risks of participating?
There are no perceived risks, whilst the CBT programme may provide the benefit of a reduction within the symptoms of posttraumatic stress.

Where is the study run from?
University of Reading (UK).

When is the study starting and how long is it expected to run for?
From January 2010 to September 2011.

Who is funding the study?
National Institute for Health Research (NIHR) (UK).

Who is the main contact?
Dr Craig Steel

Trial website

Contact information



Primary contact

Dr Craig Steel


Contact details

Department of Psychology
PO Box 238
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

The acceptability and effectiveness of cognitive behavioural therapy for the treatment of post-traumatic stress disorder within schizophrenia: a randomised interventional treatment trial


Study hypothesis

Sixty-two participants who are diagnosed with schizophrenia/schizo-affective disorder/schizophreniform disorder and post-traumatic stress disorder (PTSD) will be randomly allocated to receive either the proposed cognitive behavioural therapy (CBT) package or routine psychiatric care. The CBT package includes 16 sessions to be conducted within a 6-month period. Currently employed NHS clinicians will be trained to conduct the intervention as part of their routine clinical practice. Symptoms and level of use of NHS services will be assessed at baseline (week 0), end of therapy (6 months) and after a 6-month follow-up period (12 months). The primary outcome will be level of PTSD symptoms at end of treatment, as measured by the Clinician Administered PTSD scale (CAPS). Acceptability of the intervention will be assessed through a service-user led interview.

The principal research questions to be addressed:
The main hypothesis to be tested is that CBT, delivered to patients with co-morbid schizophrenia and PTSD, in addition to standard psychiatric care will result in a reduced level of PTSD symptomatology. The subsidiary hypothesis is that reduction in PTSD symptoms will mediate a reduction in psychotic symptomatology and service-use.

Ethics approval

Berkshire Research Ethics Committee (REC), 01/03/2010, ref: 09/H0505/85

Study design

Randomised interventional treatment trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Topic: Mental Health Research Network; Subtopic: Schizophrenia; Disease: Schizophrenia, post-traumatic stress disorder (PTSD);


The trial compares standard psychiatric care alone with CBT treatment in addition to standard care.

Standard psychiatric care in the UK is based on the care programme approach to case management and includes antipsychotic medication, outpatient and community follow-up, and access to community-based rehabilitative activities such as day centres and drop ins.

CBT intervention consists of several important parts.
1. Establish safety: Issues such as suicidality, self-harming behaviour

Intervention type



Not Applicable

Drug names

Primary outcome measures

PTSD symptoms, assessed through the Clinician Administered PTSD Scale (CAPS), measured at baseline, 6 months and 12 months

Secondary outcome measures

Post-traumatic Cognitions, assessed using the Post-traumatic Cognitions Inventory (PTCI), measured at baseline, 6 months and 12 months

Overall trial start date


Overall trial end date


Reason abandoned


Participant inclusion criteria

1. Provides consent
2. Current Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) diagnosis of schizophrenia or schizo-affective disorder
3. Present with symptoms consistent with a DSM-IV diagnosis of PTSD
4. Aged between 18 and 65 years, either sex

Participant type


Age group




Target number of participants

Planned Sample Size: 62; UK Sample Size: 62

Participant exclusion criteria

1. Organic disorder
2. Unable to read and write in English
3. Learning disability

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

University of Reading
United Kingdom

Sponsor information


University of Reading (UK)

Sponsor details

Winnicott Rsearch Unit
School of Psychology
PO Box 238
United Kingdom

Sponsor type




Funder type


Funder name

National Institute for Health Research (NIHR) (UK) - Research for Patient Benefit (RfPB) Programme

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

Publication citations

Additional files

Editorial Notes