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VADO approach efficacy in psychiatric rehabilitation: a controlled study

Published online by Cambridge University Press:  11 October 2011

Michela Vittorielli*
Affiliation:
IRCCS “Centro S. Giovanni di Dio-Fatebenefratelli”, Brescia
Rosaria Pioli
Affiliation:
IRCCS “Centro S. Giovanni di Dio-Fatebenefratelli”, Brescia
Luisa Brambilla
Affiliation:
IRCCS “Centro S. Giovanni di Dio-Fatebenefratelli”, Brescia
Luigina Archiati
Affiliation:
IRCCS “Centro S. Giovanni di Dio-Fatebenefratelli”, Brescia
Giuseppe Rossi
Affiliation:
IRCCS “Centro S. Giovanni di Dio-Fatebenefratelli”, Brescia
Charlotte Sleijpen
Affiliation:
IRCCS “Centro S. Giovanni di Dio-Fatebenefratelli”, Brescia
Lorenza Magliano
Affiliation:
Istituto di Psichiatria, Seconda Università di Napoli, Napoli
Franco Veltro
Affiliation:
Dipartimento di Salute Mentale di Campobasso, Campobasso
Pierluigi Morosini
Affiliation:
Istituto Superiore di Sanità, Laboratories di Epidemiologia e Biostatistica, Roma
Gruppo Di Lavoro
Affiliation:
Gruppo di Lavoro: M. Parmeggiani, M. Danesi, E. Bertocchi, I. Marcassoli, P. Giacomelli, F. Sordi, M. Marchesini, L. Valzorio, R. Battaglia, E. Gritti, A. Bosetti, A. Cattalini (IRCCS “Centro S. Giovanni di Dio-Fatebenefratelli”, Brescia), L. Basso L, I. Gualtieri, S. Tardio, E. Muzzana, L. Bacher, A. Plank, L. Inglese, P. Daini, M. Fratucello, C. De Michiel, G. Borzaga, C. Piccoli (Centro di Riabilitazione Psichiatrica c/o Clinica Grieserhof, Bolzano), E. Jori, M. Melli, P. Palvarini, M. Grossi, A. Anselmi, C. Pedron, E. Altemani, A. Vicari, P. Carpeggiani (Azienda Ospedaliera “C. Poma”, Unità Operativa di Psichiatria n. 27, Mantova), A. Aletti, G. Marenzi, M. Fiameni (Istituti Ospedalieri di Cremona, Unità Operativa di Psichiatria, Cremona), C. Meneghini, F. Biondino, A. Nanni, P. Keitmaier (Azienda Unità Sanitaria Locale, Centro Diurno Psichiatrico Città di Bologna, Bologna), M. Scirea M., K. Tiziani, V. Marzolini (Azienda Ospedaliera S. Gerardo, Unità Operativa di Psichiatria, Monza), E. Visani, C. La Marra, S. D'Agostino (Azienda Unità Sanitaria Locale Centro Salute Mentale, ASL Roma/A, Roma).
*
Address for correspondence: Dr.ssa M. Vittorielli, IRCCS Centro S. Giovanni di Dio, FBF-Brescia, Via Piastroni 4, 25125 Brescia. Fax: +39-030-353.3513 E-mail: [email protected]

Summary

Aims – Assessment of the efficacy of the rehabilitation approach that is recommended by the manual VADO (AAOS in English: Abilities Assessment and Objectives Setting) in schizophrenic syndromes. Methods – Controlled trial, partly with individual randomisation. Centres were invited to recruit 10 patients who in most centres were randomly allocated either to the VADO approach or to usual rehabilitation practice. At least two professionals for each centre attended a brief intensive training course. Patients were assessed at baseline and six months later with a) the FPS scale, which is an improvement on the DSMIV SOFAS; b) the BPRS 4.0; c) AR, a clinical tool that is contained in VADO. Results – 55 patients received the experimental interventions and 40 the control one. Six months later greater significant improvements were observed in the experimental group, both in social functioning and in psychopathology. Conclusions – The dissemination of structured rehabilitation approaches that are based on personalized definition of objective, intensive progress monitoring, patient's therapeutic education and validated strategies and do not imply additional costs, may be warranted. A longer follow–up is under way.

Declaration of Interest: this work was partly funded by the National Mental Health Project (PNSM) of the Istituto Superiore della Sanita.

Type
Original papers
Copyright
Copyright © Cambridge University Press 2003

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References

BIBLIOGRAFIA

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorder (4th ed.). American Psychiatric Association: Washington DC.Google Scholar
Amaddeo, F., Bacigalupi, M., de Girolamo, G., Di Munzio, W., Lora, A. & Semisa, D. (1998). Attività, interventi e strutture del Dipartimento di Salute Mentale. Epidemiologia e Psichiatria Sociale, Suppl. al n. 2, 936Google Scholar
Anthony, W.A., Cohen, M. & Farkas, M. (1990). Psychiatric Rehabilitaion. Centre for Psychiatric Rehabilitation, Boston University: Boston.Google Scholar
Bradshaw, W. (2000). Integrating cognitive-behavioural psychotherapy for person with schizophrenia into a psychiatric rehabilitation program: Results of a three year trial. Community Mental Health Journal 36(5), 491500.CrossRefGoogle Scholar
Brambilla, L., Archiati, L., David, A., Rossi, G., Tura, G.B. & Pioli, R. (2000). Introduction of a structured method for the planning and the evaluation of rehabilitative programmes: the experience of the VADO. In Abstracts of the VII World Congress, World Association for Psychosocial Rehabilitation, Paris, p. 192.Google Scholar
Buchkremer, G., Klingberg, S., Holle, R., Schulze-Monking, H. & Hornung, W.P. (1997). Psychoeducational psychotherapy for schizphrenic patients and their key relatives or care-givers: result of e two years follow-up. Acta Psychiatrica Scandinavica 96, 483491.CrossRefGoogle Scholar
Bustillo, J., Laurtiello, J., Horan, W. & Keith, S. (2001). The psychosocial treatment of schizophrenia: an update. American Journal of Psychiatry 158(2), 163175.CrossRefGoogle ScholarPubMed
Carpiniello, B. & Carta, M.G. (2002). La disabilità nella schizofrenia: fattori intrinseci e predizione dell'esito psicosociale. Epidemiologia e Psichiatria Sociale 11, 4558.CrossRefGoogle Scholar
de Girolamo, G. & Cozza, M. (2000). The Italian Psychiatric Reform: a 20 years perspective. International Journal of Law and Psychiatry 23 (3-4), 197214.CrossRefGoogle Scholar
de Girolamo, G. & Piccardi, A. (2000). Progetto Nazionale PROGRESS sulle Strutture Psichiatriche. Progetto Nazionale Salute Mentale, Laboratorio di Epidemiologia e Biostatistica, Istituto di Superiore di Sanità, Rapporti ISTISAN: Roma.Google Scholar
De Salvia, D. & Barbato, A. (1993). Recent trends in mental health service in Italy: an analysis of national and local data. Canadian Journal Psychiatry 38 (3), 185202.CrossRefGoogle ScholarPubMed
Drake, R.E., Goldman, H.H., Leff, H.S., Lehaman, A.F., Dixon, L., Mueser, K.T. & Torrey, W.C. (2001). Implementing evidence-based practices in routine mental health service setting. Psychiatric Services 52 (2), 179182CrossRefGoogle Scholar
Eckman, T.A., Wirshing, W.C., Marder, S.R., Liberman, R.P., Johnston-Cronk, K., Zimmermann, K. & Mintz, J. (1992). Technique for training schizophrenic patient in illness self-management: a controlled trial. American Journal of Psychiatry 149(11), 15491555.Google ScholarPubMed
Falloon, I. (1994). Intervento Psicoeducativo Integrato in Psichiatria: Guida al Lavoro con le Famiglie, 2. ed. rivista ed ampliata. Erickson: Trento.Google Scholar
Fowler, D., Garety, P. & Kuipers, E. (1995). Cognitive Behaviour Therapy for Psychosis: Theory and Pratice. Wiley: Chichester (Trad. It.: Terapia cognitivo comportamentale delle psicosi, 1998, Masson: Milano).Google Scholar
Lauriello, J., Bustillo, J. & Keith, S.J. (1999). A critical review of research on psychosocial treatment of schizophrenia. Biological Psychiatry 46 (10), 14091417.CrossRefGoogle ScholarPubMed
Lukoff, D., Nuechterlein, K.H. & Ventura, J. (1986). Manual for expanded Brief Psychiatric Scale. Schizophrenia Bulletin 12, 594602.Google Scholar
Magliano, L., Malangone, C., Guameri, M., Marasco, C., Fiorillo, A. & May, M. (2001). The condition of families with schizophrenia in Italy: burden, social network, and professional support. Epidemiologia e Psichiatria Sociale 10(2), 96106.CrossRefGoogle ScholarPubMed
Marshall, M., Crowther, R., Almaraz-Serrano, A., Creed, F., Sledge, W., Kluiter, H., Roberts, C., Hill, E., Weirsma, D., Bond, G.R., Huxley, P. & Tyrer, P. (2001). Systematic reviews of the effectiveness of day care for people with severe mental disorders: (1) acute day hospital versus admission; (2) vocational rehabilitation; (3) day hospital versus outpatient care. Health Technology Assessment 5(21), 175.CrossRefGoogle Scholar
Morosini, P. (1995). La valutazione degli esiti nell'attività di routine dei servizi psichiatrici. Epidemiologia e Psichiatria Sociale 4 (1), 110.CrossRefGoogle Scholar
Morosini, P., Magliano, L. & Brambilla, L. (1998). VADO Valutazione di Abilità e Definizione di Obiettivi. Erickson: Trento.Google Scholar
Morosini, P., Magliano, L., Brambilla, L. & Ugolini, S. (2000). Development, rehability and acceptability of a new version of the DSM IV Social and Occupational Functionig Assesment Scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica 101, 323329.Google Scholar
Mueser, K.T., Salyers, M.P. & Mueser, P.R. (2001). A prospective analysis of work in schizophrenia. Schizophrenic Bulletin 27 (2), 281296.CrossRefGoogle ScholarPubMed
Roeder, V., Brenner, H.D., Müller, D., Lächler, M., Zorn, P., Reisch, T., Bösch, J., Bridler, R., Christen, C., Jaspen, E., Schmidl, F. & Schwemmer, V. (2002). Development of specific social skills training programmes for schizophrenia patients: result of a multicentre study. Acta Psychiatrica Scandinavica 105, 363371.CrossRefGoogle Scholar
Roncone, R., Ventura, J., Impallomeni, M., Fallon, I.R., Morosini, P.L., Chiaravalle, E. & Casacchia, M. (1999). Reliability of an Italian standardized and expanded Brief Psychiatric Rating Scale (BPRS4.0) in raters with high vs. low clinical experience. Acta Psychiatrica Scandinavica 100, 229236.CrossRefGoogle ScholarPubMed
Smith, E.T., Bellack, A.S. & Liberman, R.P. (1996). Social skill training for schizophrenia: review and future direction. Clinical Psychology Review 16, 599617.CrossRefGoogle Scholar
Velligan, D.I., Bow-Thomas, C.C., Huntzinger, C., Ritch, J., Ledbetter, N., Prihoda, T.J. & Miller, A.L. (2000). Randomized controlled trial of the use of compensatory strategies to enhance adaptive functioning in outpatient with schizophrenia. American Journal of Psychiatry 157(8), 13171323.CrossRefGoogle ScholarPubMed