This presentation by Anthony Morrison is from the BPS DCP Conference, 2012 – after the publication of the Exploratory Study below, but before the publication of the Pilot Study results [see a pilot…, slim pickings…, and above the din…]
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Well, he’s not the sharpest tack in the box. He completely bungled the discussion of Number Needed to Treat (at 7:00 into the session). When academic investigators cannot grasp such an elementary concept then I don’t feel like trusting any fancy multivariate statistics they might throw out.
Most of this talk seemed to be preaching to the BPS choir – recall that Morrison is one of the authors of the much criticized BPS report on understanding psychosis and schizophrenia. We were not given any robust evidence from well controlled studies that cognitive therapy is effective for patients with schizophrenia spectrum diagnoses who were not taking drugs.
Speaking of diagnoses, the case study that Dr. Morrison described at the end is remarkable for the absence of a stated diagnosis. Following the BPS style, only a list of the patient’s perceived problems was presented. The missing diagnosis is understandable because there was no formal mental status examination. That’s like proceeding to treatment of a medical problem without a standard physical examination. Worse, the problem list and description of this case clearly suggested a mood disorder with anxiety rather than a “schizophrenia spectrum diagnosis.” There was not even an attempt at differential diagnosis for the “voices” – did these reflect a psychotic depression or the prodrome of schizophrenia or a dissociative disorder related to trauma or did they have a primary medical basis? Who knows? Apparently, nobody thought to ask.
I come away thinking that if this case is typical of those Dr. Morrison is enrolling in his funded research on cognitive therapy for schizophrenia spectrum diagnoses then the funds would be better deployed elsewhere.