Delayed Treatment Initiation in Early-Onset Schizophrenia: A Case Demonstrating the Role of CBTp Following Pharmacological Stabilization

Amity Institute of Psychology and Allied Sciences, Amity University Noida, India

*Corresponding Author: Tamana A Bhat, Amity Institute of Psychology and Allied Sciences, Amity University Noida, 125, Noida, Uttar Pradesh 201301, India, Phone: +91-7889675075, ORCID: 0009-0001-9917-6545, Email: [email protected]

Received Date: March 24, 2026

Published Date: April 20, 2026

Citation: Bhat TA, et al. (2026). Delayed Treatment Initiation in Early-Onset Schizophrenia: A Case Demonstrating the Role of CBTp Following Pharmacological Stabilization. Mathews J Case Rep. 11(1):220.

Copyrights: Bhat TA, et al. © (2026).

ABSTRACT

Background: Delusions in schizophrenia are difficult to treat. Direct confrontation often worsens outcomes. Cognitive Behavioral Therapy for Psychosis (CBTp) offers a collaborative, distress-focused alternative. Case presentation: A 28-year-old male from rural South Kashmir with chronic persecutory and religious delusions (90–95% conviction) and intact executive function received 10 weekly CBTp sessions following antipsychotic stabilization. Intervention: CBTp emphasized emotional validation, metacognitive reflection, and distress reduction without directly disputing delusional content. Outcomes: Delusional conviction fell from 90% to 55%. PANSS positive subscore reduced by 30%. Sleep increased from 4–5 to 7 hours/night. Academic and social functioning improved. No relapse at 3 months. Conclusion: Non-confrontational, culturally sensitive CBTp combined with pharmacotherapy improved distress, function, and insight without requiring complete belief elimination.

Keywords: Schizophrenia, CBT for Psychosis, Persecutory Delusions, Religious Delusions, Cultural Formulation, Recovery-Oriented Care.