Les résultats des méta-analyses concluent à l'efficacité de la thérapie cognitivo-comportementale des psychoses (TCCp) sur les symptômes persistants. Cependant, la validité externe reste à explorer. L'application de la TCCp aux psychoses débutantes (c'est-à-dire, les 5 premières années suivant le diagnostic) paraît particulièrement pertinente, compte tenu de l'effet possible sur l'évolution au long cours. Cependant, les quelques études ayant expérimenté la TCCp auprès de cette population ont eu des résultats décevants. Toutes ont introduit la thérapie en phase psychotique aiguë et la plupart ont effectué un nombre limité de séances. Ainsi, la présente étude ouverte d'implantation vise à évaluer l'efficience d'un programme de TCCp australien de 25 séances, introduit en phase stable, auprès de patients de Québec souffrant de psychoses débutantes.
Méthode:
Le programme Active Cognitive Psychotherapy for Early Psychosis a été offert à 20 patients âgés de 14 ans et plus, à raison d'une séance hebdomadaire pendant 6 mois.
Résultats:
Le taux d'acceptation était de 75 %, le taux moyen d'observance des séances de 84 %, et les participants étaient satisfaits du programme. Les analyses d'avant et d'après la TCCp rapportent des améliorations statistiquement significatives de la symptomatologie psychotique, lesquelles sont maintenues au suivi de 6 mois. L'autocritique est également améliorée de façon statistiquement significative après la TCCp.
Conclusion:
La TCCp semble applicable à nos milieux cliniques, notamment chez les adolescents. De plus, la posologie employée semble favoriser l'observance des rencontres.
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