Evaluation of a psychoeducational intervention adapted from the Falloon model for first episode psychosis: a one-year follow-up real-world study.

AIM: To evaluate the effectiveness of the Falloon Psychoeducational Family Intervention (PFI), originally developed for the management of schizophrenia, afterwards adapted for early psychosis, in terms of adherence to the treatment, low relapse rate, improvement social functioning and stress management. METHODS: This is a one-year, pragmatic, real-world observational study with subjects consecutively recruited at the Campobasso psychiatry ward (SPDC) or Mental Health Center (MHC) starting in November 2020 over an 18 month period. Patients recruited were asked for consent for family members' participation. The effectiveness of the intervention was evaluated in terms of treatment adherence, discontinuity, relapse rates, clinical symptoms assessed by BPRS and PANSS, improvement in social functioning and stress management. RESULTS: 13 subjects were recruited; 10 males and 3 females, all singles, with a DUP inferior to one year. At the end of the intervention, significant improvements in treatment adherence, absence of drop-outs and relapses, statistically significant improvements in clinical symptoms, social functioning and stress management were found. DISCUSSION AND CONCLUSIONS: The results clearly show that family psychoeducational intervention according to the adapted Falloon model, specifically focused on crisis and early stress management, is effective in improving treatment adherence, clinical outcome and social life of first-episode psychotic patients. The limit is the lack of a control and randomization.

Positive impact of InteGRO, a new salutogenic psychoeducational intervention, in managing covid-19 pandemic and lockdown aftermath.

AIM: The covid-19 pandemic/lockdown had a great impact on Severe Mental Illnesses (SMI) on the following variables: adherence to protective measures, infection, Covid-related psychopathology, stress related symptoms exacerbation, social relationship loss and higher mortality risk. InteGRO, a new effective salutogenic-psychoeducational approach, has been designed to help people with SMI manage their life-stress and achieve personal recovery goals through improved social functioning. Positive outcomes after pandemic/lockdown in patients trained with InteGRO and also their opinion about its usefulness are discussed. METHODS: All above mentioned variables were collected in a 1-year observational study (March 2020-2021) for all patients trained with InteGRO. In April 2021 patients were asked to respond to: an ad hoc semi-structured in-depth telephone interview, the Stress-Scale, the Brief Psychiatric Rating-Scale, the Personal and Social Performance Scale. RESULTS: 37 people out of 41 underwent the observational study. The overall outcome was good: one patient with asymptomatic infection, 40/41 vaccinated, a very low (2/37) trend of hospital admissions similar to previous years, very high personal and social functioning as well as low level of stress. In the interview, patients answered they found the InteGRO Training very useful, above all the meetings concerning Defining Goal and Problem-Solving. They often felt their desire to socialize was prompted by InteGRO training. CONCLUSIONS: These results suggest InteGRO had a good impact on SMI patients to face pandemic/lockdown, with high level of personal and social functioning. They also suggest using structured salutogenic psychoeducational programs in public health services can be useful to promote life-skills to face traumatic events. Further studies are needed to understand the duration of these improvements and outcomes.

Long term outcome study of a salutogenic psychoeducational recovery oriented intervention (Inte.G.R.O.) in severe mental illness patients.

AIM: Inte.G.R.O. is a standardized Salutogenic-Psychoeducational intervention designed to help people with severe mental illness manage their life-stress and achieve personal recovery goals through the improvement of social functioning. The aim of this study is to evaluate the long-term outcome of this approach, characterized by health promotion rather than correction of dysfunctional strategies. METHODS: 41 people underwent an observational study with a three time-point evaluation (t0, pre- treatment; t1, 12 months; t2, 36 months). At each time point, social functioning was assessed as primary outcome by the Personal and Social Functioning scale (PSP); furthermore, psychopathological status was assessed by Brief Psychiatric Rating Scale (BPRS), stress management was measured by means of Stress-Scale and cognitive flexibility variables were assessed by Modified Five-Point Test (M-FPT). RESULTS: Personal and Social Functioning increased at t1 and t2 vs t0; psychopathological status improved at t2 vs t0; stress management improved at t2 vs t1; cognitive flexibility improved at t2 vs t0. CONCLUSIONS: these results substantially confirm after a three-year follow-up the improvements in functioning, psychopathology, stress management and cognitive flexibility seen in previous studies. Furthermore, they show a complex time-dependent fashion. Overall, they confirm a remarkable and long-term impact of Inte.G.R.O. on key Recovery variables. Further studies are needed to address extent and duration of these improvements.

Description and impact of a structured psychoeducational and salutogenetic approach (InteGRO) to support the recovery of people with severe mental disorders / Descrizione e impatto di un approccio psicoeducativo strutturato (InteGRO) di salutogenesi per sostenere il percorso di recovery delle persone con disturbo mentale grave

Aim: In mental health services there is an increasing attention to the recovery of people with severe mental illness. Consequently there is a growing literature on this topic focused above-all on the description of excellence paths that often include variables related to the organizational aspects of the service. Less attention is given to specific interventions to foster all the goals that are essential to improve the living conditions, including defining and planning goal, emotional perception, effective communication for negotiation, practical interpersonal and intrapersonal problem-solving. The aim of this paper is to describe an innovative and salutogenetic approach and to illustrate the results of the impact after a year of "active intervention". Methods: We used a "quasi-experiment" design-study with a pre-post assessment without a control group on 21 subjects with schizophrenia or bipolar disorder according to DSM-IV-TR criteria. We used to evaluate Functioning, the primary outcome, the Personal and Social Performance Scale. For the secondary outcome measures we used the Stress-Scale, the Modified Five-Point Test for cognitive flexibility, the APEN/G e APEP/G Scale for perceived self-efficacy, the Integrative Hope Scale, the items "subjective and objective load" of the "Aid received, Needs and Burden" self-filled questionnaire. The clinical assessment was made by the Brief Psychyatric Rating Scale, while we used the Repeatable Battery for the Assessment of Neuropsychological Status. Results: Of the 21 subjects included, 18 completed the assessment. Significant improvements were noted for all variables considered, with particular relevance for Personal and Social Functioning (p<0.001). Predictive variables for this dimension were the level of stress and perceived self-efficacy (p<0.05). Conclusions: The observed data confirm the effectiveness of this innovative approach, above all on Personal and Social Functioning where there has been improvement from two or more marked dysfunction areas to one area.