ABSTRACT
BACKGROUND: While there is a growing body of evidence on the efficacy of psychological interventions for schizophrenia, this meta-analysis improves upon previous systematic and meta-analytical reviews by including a wider range of randomized controlled trials and providing comparisons against both standard care and other active interventions. METHOD: Literature searches identified randomized controlled trials of four types of psychological interventions: family intervention, cognitive behavioural therapy (CBT), social skills training and cognitive remediation. These were then subjected to meta-analysis on a variety of outcome measures. This paper presents results relating to the first two. RESULTS: Family therapy, in particular single family therapy, had clear preventative effects on the outcomes of psychotic relapse and readmission, in addition to benefits in medication compliance. CBT produced higher rates of 'important improvement' in mental state and demonstrated positive effects on continuous measures of mental state at follow-up. CBT also seems to be associated with low drop-out rates. CONCLUSIONS: Family intervention should be offered to people with schizophrenia who are in contact with carers. CBT may be useful for those with treatment resistant symptoms. Both treatments, in particular CBT, should be further investigated in large trials across a variety of patients, in various settings. The factors mediating treatment success in these interventions should be researched.
Subject(s)
Cognitive Behavioral Therapy , Family Therapy , Schizophrenia/therapy , Schizophrenic Psychology , Adolescent , Adult , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: Social skills training and cognitive remediation are psychological techniques with considerable face validity for the treatment of negative symptoms of schizophrenia and their consequences. This paper provides a meta-analytical review of these treatments. It includes an appreciable number of randomized controlled trials, using comparisons against both standard care and other active interventions. However, the assessment of particular outcomes sometimes had to be based on single studies. METHOD: A detailed search strategy was used to identify randomized controlled trials of social skills training and cognitive remediation, primarily employing electronic databases. Randomized controlled trials (RCTs) that met predefined criteria were then subjected to meta-analysis on a variety of outcome measures. RESULTS: There was no clear evidence for any benefits of social skills training on relapse rate, global adjustment, social functioning, quality of life or treatment compliance. Cognitive remediation had no benefit on attention, verbal memory, visual memory, planning, cognitive flexibility or mental state. CONCLUSIONS: Social skills training and cognitive remediation do not appear to confer reliable benefits for patients with schizophrenia and cannot be recommended for clinical practice.
Subject(s)
Cognitive Behavioral Therapy , Schizophrenia/therapy , Schizophrenic Psychology , Social Adjustment , Social Behavior Disorders/therapy , Adolescent , Adult , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Randomized Controlled Trials as Topic , Social Behavior Disorders/psychologyABSTRACT
The authors describe the results of an outcome study of 87 psychiatric inpatients and outpatients using a generic assessment and outcome measurement tool, the FACE Core Assessment. The results suggest that the multiaxial structure of the assessment tool has the potential to be used for the routine measurement of clinical outcomes as well as for multidisciplinary assessment.
Subject(s)
Disability Evaluation , Documentation , Mental Disorders/therapy , Outcome and Process Assessment, Health Care , Psychoanalytic Therapy , Adult , Cost-Benefit Analysis , Female , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/economics , Mental Disorders/psychology , Middle Aged , Patient Care Team , Psychoanalytic Therapy/economics , Referral and Consultation/economics , Social AdjustmentABSTRACT
OBJECTIVES: Previous research into schizotypy has shown that certain groups of people have similar experiences to the positive symptoms of schizophrenia but remain functioning members of society, such as those with profound religious experiences (Jackson & Fulford, 1997). METHOD: The focus of the present study was to explore the incidence of delusional ideation in New Religious Movements (NRMs). Hare Krishnas and Druids were compared to two control groups (non-religious and Christian), and to deluded, psychotic in-patients on two delusions measures. RESULTS: As predicted, individuals from the NRMs scored significantly higher than the control groups on all the delusional measures apart from levels of distress. They did not show as much florid symptomatology as the psychotic patients, but could not be differentiated from the deluded group on the number of delusional items endorsed on the Peters et al. Delusions Inventory (PDI; Peters, Day & Garety, 1996), or on levels of conviction. However, they were significantly less distressed and preoccupied by their experiences. No differences were found between the two control groups on any of the delusional measures, suggesting that religious beliefs per se do not account for the NRMs members' scores. DISCUSSION: These findings provide further support for, first, the notion of a continuum between normality and psychosis and, second, for the necessity to consider the multidimensionality of delusional beliefs.
