Cognitive and behavioural therapy in ultra-high risk group for psychosis – a review
Agnieszka Pawełczyk1, Tomasz Pawełczyk1,2, Dorota Pabich-Zrobek2, Artur Kołakowski3, Jolanta Rabe-Jabłońska1,2

Pursuant to the neurodevelopmental concept, schizophrenia is understood as a pathological process, starting with the genetic susceptibility in childhood and gradually progressing, which is initially accompanied by the occurrence of nonspecific symptoms and dysfunctions. A culmination of the described course of events is the occurrence of full-symptom psychosis. The discernible symptomatic premorbid period occurs in 75% of patients in the first episode of schizophrenia. It may vary in length, but the studies indicate that the average duration of symptomatic premorbid period in schizophrenia reaches 5 years, whereas in highly developed countries – at least 2 years. Numerous studies indicate that a late diagnosis of the disease is an independent risk factor of adverse course of schizophrenia. Therefore, many researchers paid attention to those stages of the disease which precede the occurrence of acute psychosis, characterized by schizophrenia image, which gave rise to distinguishing a group of people exhibiting an increased, as compared to the general population, ultra-high risk syndrome (UHRS). So far, few interventional studies have been carried out to evaluate various strategies applied to the group of patients with UHRS of psychosis. Available foreign guidelines and experts’ recommendations point to a priority of psychosocial activities, especially the cognitive-behavioural therapy (CBT). The article presents a review of studies on the efficacy of CBT in the UHRS group. It indicates that the severity of symptoms in patients often requires pharmacotherapy, and the use of CBT entails a lower risk of the development of adverse effects than is the case with implementation of pharmacotherapy. The results of studies, obtained by various research teams, allow to state that the CBT may be effective in reduction of symptoms accompanying the high risk of the development of schizophrenia. Besides, CBT by monitoring the patient’s mental state enables a faster diagnosis of the transition into psychosis, thereby abbreviating the duration of untreated psychosis, which constitutes an acknowledged negative predictor of the course of schizophrenic psychoses.