Critical appraisal
This study population is not representative of all patients with schizophrenia but is representative of those patients who are on the case-loads of community mental health team members. There was no difference between the groups at baseline in terms of general characteristics, medication dose or type, or severity of illness as indicated by number of visits or days in hospital. It is clear, therefore, that medication and illness severity are ruled out as confounding factors, which might explain the study results. Similarly, there was no difference in these parameters over the study period. However, the differential drop-out rate between the groups may have influenced these results. It is important to remember that the TAU comparison group does not control for the non-specific effects of the nurse's contact time with the patient. Although attempts were made to protect blinding, there remains the possibility of compromised blinding of ratings due to inadvertent patient disclosure of therapy material.