Effect of Group Rumination-Focused Cognitive Behavior Therapy on Depressive Symptoms in People With Schizophrenia: A Randomized Controlled Trial

J Nurs Res. 2025 Mar 17. doi: 10.1097/jnr.0000000000000665. Online ahead of print.

ABSTRACT

BACKGROUND: Prolonged depressive symptoms in individuals with schizophrenia not only diminish their quality of life but also significantly increase their risk of suicide. This, in turn, may lead to a lower average life expectancy among people with schizophrenia compared to the general population.

PURPOSE: This study was designed to examine the effectiveness of rumination-focused cognitive behavior therapy (RFCBT) on depressive symptoms in individuals with schizophrenia.

METHODS: This study was conducted between July 2019 and March 2020. Seventy-seven participants, all of whom had been diagnosed with schizophrenia, were randomly divided into the experimental group (n = 38) and control group (n = 39). The experimental group underwent a 12-week, six-session RFCBT regimen, whereas the control group received six sessions of psychosocial education. Outcomes were measured using the Beck Depression Inventory-II and the revised short form of the Chinese Response Style Questionnaire at three time points: baseline, postintervention, and at the 3-month follow-up. Statistical analyses were conducted using chi-square tests, independent t tests, and generalized estimating equations, with the generalized estimating equations model assessing between-group differences over time after adjusting for 13 covariates.

RESULTS: No effect on depressive symptoms was observed immediately following RFCBT. However, at the 3-month follow-up, the mean Beck Depression Inventory-II score had reduced significantly in the experimental group (from 17.24 to 15.56) and increased in the control group (from 17.59 to 23.03; p = .016). Chinese Response Style Questionnaire-10 scores, which are used to represent ruminative responses, did not differ significantly between the groups at any of the three time points.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE: These findings offer compelling preliminary evidence in support of RFCBT as a potentially effective treatment strategy for alleviating depressive symptoms in patients with schizophrenia. The efficacy of RFCBT was demonstrated in terms of preventing the exacerbation of depressive symptoms. The findings have notable implications for clinicians, researchers, and policymakers with regard to developing more effective treatment strategies and enhancing outcomes for individuals with schizophrenia.

PMID:40085129 | DOI:10.1097/jnr.0000000000000665