Effects of a Blended Digital Therapy Targeting Reasoning on
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Persistent paranoia is common among patients with psychosis. Cognitive-behavioral therapy for psychosis can be effective. This study shows that SlowMo, a digitally supported reasoning intervention, indicated secondary beneficial effects on paranoia.

This study was carried out with an objective to investigate the effects on paranoia and mechanisms of action of SlowMo plus usual care compared with usual care only.

This parallel-arm, assessor-blinded, randomized clinical trial recruited participants at UK community health services. Eligible participants consisted of a referral sample with schizophrenia-spectrum psychosis and distressing, persistent paranoia.

A total of 361 participants were included in the intention-to-treat analysis, of whom 252 were male and 249 were White; the mean age was 42.6 years. The results were;

--At 24 weeks, 332 participants provided primary outcome data. Of 181 participants in the SlowMo group, 145 completed therapy. SlowMo plus usual care was not associated with greater reductions than usual care in GPTS total score at 24 weeks.

--There were significant effects on secondary paranoia outcomes at 12 weeks, including GPTS total score, Part A score, and Part B score, and at 24 weeks, including Part B score but not Part A score.

--Improvements were observed in an observer-rated measure of persecutory delusions (PSYRATS delusion) at 12 weeks and 24 weeks and belief flexibility at 12 weeks and 24 weeks.

--There were no significant effects on jumping to conclusions. Improved belief flexibility and worry mediated paranoia change.

Overall, SlowMo did not demonstrate significant improvements in the primary measure of paranoia at 24 weeks; however, a beneficial effect of SlowMo on paranoia was indicated by the results on the primary measure at an earlier point and on observer-rated paranoia and self-reported persecution at 12 and 24 weeks.

Source: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2778159