Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-21T22:38:23.709Z Has data issue: false hasContentIssue false
  • English
  • Français

Targeting anxiety to improve quality of life in patients with schizophrenia

Published online by Cambridge University Press:  23 March 2020

M. Buonocore ,
M. Bosia ,
M. Bechi ,
M. Spangaro ,
S. Cavedoni ,
F. Cocchi ,
L. Bianchi ,
C. Guglielmino ,
A.R. Mastromatteo  and
R. Cavallaro
M. Buonocore*
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy
M. Bosia
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy Università Vita-Salute San Raffaele, Milan, Italy
M. Bechi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy
M. Spangaro
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy Università Vita-Salute San Raffaele, Milan, Italy
S. Cavedoni
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy
F. Cocchi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy
L. Bianchi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy
C. Guglielmino
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy
A.R. Mastromatteo
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy Università Vita-Salute San Raffaele, Milan, Italy
R. Cavallaro
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d’Ancona 20, 20127Milan, Italy Università Vita-Salute San Raffaele, Milan, Italy
*
*Corresponding author. E-mail address:[email protected] (M. Buonocore).
Get access

Abstract

Background:

Several studies suggested that anxiety can significantly affect the outcome of schizophrenia. Despite this evidence, non-pharmacological interventions targeting anxiety are still heterogenous. This study aims to test the efficacy of a novel training specifically designed to target anxiety in patients with schizophrenia. Innovatively, this training, beyond psychoeducation and problem solving, also targets Theory of Mind, as it provides coping strategies.

Method:

Twenty-seven outpatients with schizophrenia received a novel rehabilitative training targeting anxiety (Anxiety Management Group [AMG]) combined with a Computer-Assisted Cognitive Remediation (CACR), and twenty received CACR plus a control intervention (Control Newspaper discussion Group [CNG]). All patients were assessed at baseline and after treatment for quality of life, neurocognition and anxiety.

Results:

After training, patients treated with AMG + CACR showed significantly greater improvements on anxiety. A significant increase in quality of life was observed only for AMG + CACR group. Moreover, the participants’ appraisal showed a significant difference between treatment groups with higher ratings among patients who received the AMG + CACR.

Conclusions:

This study thus suggests feasibility and efficacy of the proposed intervention, that could be implemented in rehabilitative programs for patients with schizophrenia with potential benefits also on disease course and outcome.

Keywords

Stress managementPsychosisRehabilitationCognitive remediationCognitionState Trait Anxiety Inventory
Type
Original article
Information
European Psychiatry , Volume 45 , September 2017 , pp. 129 - 135
Copyright
Copyright © European Psychiatric Association 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bosanac, PCastle, DHow should we manage anxiety in patients with schizophrenia?. Australas Psychiatry 2015; 23: 374–377. http://dx.doi.org/10.1177/1039856215588207.CrossRefGoogle ScholarPubMed
Temmingh, HStein, DJAnxiety in patients with schizophrenia: epidemiology and management. CNS Drugs 2015; 29: 819–832. http://dx.doi.org/10.1007/s40263-015-0282-7.CrossRefGoogle Scholar
Braga, RJReynolds, GPSiris, SGAnxiety comorbidity in schizophrenia. Psychiatry Res 2013; 210: 1–7. http://dx.doi.org/10.1016/j.psychres.2013.07.030.CrossRefGoogle Scholar
Cohen, CIHassamal, SKBegum, NGeneral coping strategies and their impact on quality of life in older adults with schizophrenia. Schizophr Res 2011; 127: 223–228. http://dx.doi.org/10.1016/j.schres.2010.12.023.CrossRefGoogle ScholarPubMed
Lysaker, PHSalyers, MPAnxiety symptoms in schizophrenia spectrum disorders: associations with social function, positive and negative symptoms, hope and trauma history. Acta Psychiatr Scand 2007; 116: 290–298. http://dx.doi.org/10.1111/j.1600-0447.2007.01067.x.CrossRefGoogle ScholarPubMed
Moritz, SKöther, UHartmann, MLincoln, TMStress is a bad advisor. Stress primes poor decision making in deluded psychotic patients. Eur Arch Psychiatry Clin Neurosci 2015; 265: 461–469. http://dx.doi.org/10.1007/s00406-015-0585-1.CrossRefGoogle ScholarPubMed
Myin-Germeys, IVan Os, JSchwartz, JStone, ADelespaul, PEmotional reactivity to daily life stress in psychosis. Arch Gen Psychiatry 2001; 58: 1137–1144. http://dx.doi.org/10.1001/archpsyc.58.12.1137.CrossRefGoogle ScholarPubMed
Myin-Germeys, Ivan Os, JStress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clin Psychol Rev 2007; 27: 409–424. http://dx.doi.org/10.1016/j.cpr.2006.09.005.CrossRefGoogle ScholarPubMed
El Sheshtawy, E.A.M.Coping with stress and quality of life in schizophrenic patients. Asian J Psychiatr 2011; 4: 51–54. http://dx.doi.org/10.1016/j.ajp.2010.09.003.CrossRefGoogle ScholarPubMed
Phillips, LJFrancey, SMEdwards, JMcMurray, NStrategies used by psychotic individuals to cope with life stress and symptoms of illness: a systematic review. Anxiety Stress Coping 2009; 22: 371–410. http://dx.doi.org/10.1080/10615800902811065.CrossRefGoogle ScholarPubMed
Ritsner, MBen-Avi, IPonizovsky, ATiminsky, IBistrov, EModai, IQuality of life and coping with schizophrenia symptoms: Quality of life and coping. Qual Life Res 2003; 12: 1–9. http://dx.doi.org/10.1023/A:1022049111822.CrossRefGoogle ScholarPubMed
Lysaker, PHDavis, LWLightfoot, JHunter, NStasburger, AAssociation of neurocognition, anxiety, positive and negative symptoms with coping preference in schizophrenia spectrum disorders. Schizophr Res 2005; 80: 163–171. http://dx.doi.org/10.1016/j.schres.2005.07.005.CrossRefGoogle ScholarPubMed
Kingsep, PNathan, PCastle, DCognitive behavioural group treatment for social anxiety in schizophrenia. Schizophr Res 2003; 63: 121–129. http://dx.doi.org/10.1016/S0920-9964(02)00376-6.CrossRefGoogle Scholar
Awad, AGVoruganti, LNHeslegrave, RJMeasuring quality of life in patients with schizophrenia. Pharmacoeconomics 1997; 11: 32–47. http://dx.doi.org/10.2165/11594470-000000000-00000.CrossRefGoogle ScholarPubMed
Bradshaw, WBrekke, JSSubjective experience in schizophrenia: factors influencing self-esteem, satisfaction with life, and subjective distress. Am J Orthopsychiatry 1999; 69: 254–260. http://dx.doi.org/10.1037/h0080427.CrossRefGoogle ScholarPubMed
Lysaker, PHBryson, GJMarks, KGreig, TCBell, MDCoping style in schizophrenia: associations with neurocognitive deficits and personality. Schizophr Bull 2004; 30: 113–121. http://dx.doi.org/10.1093/oxfordjournals.schbul.a007056.CrossRefGoogle Scholar
Ventura, JNuechterlein, KHSubotnik, KLGreen, MFGitlin, MJSelf-efficacy and neurocognition may be related to coping responses in recent-onset schizophrenia. Schizophr Res 2004; 69: 343–352. http://dx.doi.org/10.1016/j.schres.2003.09.002.CrossRefGoogle ScholarPubMed
Wilder-Willis, KEShear, PKSteffen, JJBorkin, JThe relationship between cognitive dysfunction and coping abilities in schizophrenia. Schizophr Res 2002; 55: 259–267. http://dx.doi.org/10.1016/S0920-9964(01)00211-0.CrossRefGoogle Scholar
Vancampfort, DDe Hert, MVansteenkiste, MDe Herdt, AScheewe, TWSoundy, A, et al.The importance of self-determined motivation towards physical activity in patients with schizophrenia. Psychiatry Res 2013; 210: 812–818. http://dx.doi.org/10.1016/j.psychres.2013.10.004.CrossRefGoogle ScholarPubMed
Starkey, DDeleone, HFlannery, RBStress management for psychiatric patients in a state hospital setting. Am J Orthopsychiatry 1995; 65: 446–450http://psycnet.apa.org/doi/10.1037/h0079698.CrossRefGoogle Scholar
Norman, R.M.G.Malla, AKMcLean, TSMcIntosh, EMNeufeld, R.W.J.Voruganti, LP, et al.An evaluation of a stress management program for individuals with schizophrenia. Schizophr Res 2002; 58: 293–303. http://dx.doi.org/10.1016/S0920-9964(01)00371-1.CrossRefGoogle ScholarPubMed
Bechi, MBosia, MSpangaro, MBuonocore, MCocchi, FPigoni, A, et al.Combined social cognitive and neurocognitive rehabilitation strategies in schizophrenia: neuropsychological and psychopathological influences on Theory of Mind improvement. Psychol Med 2015; 45: 3147–3157. http://dx.doi.org/10.1017/S0033291715001129.CrossRefGoogle ScholarPubMed
American Psychiatric Association American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision, American Psychiatric Association; 2000.Google Scholar
Spielberger, CDManual for the State-Trait Anxiety Inventory (STAI Form Y); 1983. http://dx.doi.org/10.1002/9780470479216.corpsy0943.CrossRefGoogle Scholar
Stein, FNikolic, STeaching stress management techniques to a schizophrenic patient. Am J Occup Ther 1989; 43: 162–169. http://dx.doi.org/10.5014/ajot.43.3.162.CrossRefGoogle ScholarPubMed
Park, IHKim, J.-J.Ku, JJang, HJPark, S.-H.Kim, C.-H., et al.Characteristics of social anxiety from virtual interpersonal interactions in patients with schizophrenia. Psychiatry 2009; 72: 79–93. http://dx.doi.org/10.1521/psyc.2009.72.1.79.CrossRefGoogle ScholarPubMed
Vancampfort, DDe Hert, MKnapen, JWampers, MDemunter, HDeckx, S, et al.State anxiety, psychological stress and positive well-being responses to yoga and aerobic exercise in people with schizophrenia: a pilot study. Disabil Rehabil 2011; 33: 684–689. http://dx.doi.org/10.3109/09638288.2010.509458.CrossRefGoogle Scholar
Heinrichs, DWHanlon, TECarpenter, WTThe Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 1984; 10: 388–398. http://dx.doi.org/10.1093/schbul/10.3.388.CrossRefGoogle ScholarPubMed
Moritz, SWoodward, TSMetacognitive training in schizophrenia: from basic research to knowledge translation and intervention. Curr Opin Psychiatry 2007; 20: 619–625. http://dx.doi.org/10.1097/YCO.0b013e3282f0b8ed.CrossRefGoogle ScholarPubMed
Moritz, SKerstan, AVeckenstedt, RRandjbar, SVitzthum, FSchmidt, C, et al.Further evidence for the efficacy of a metacognitive group training in schizophrenia. Behav Res Ther 2011; 49: 151–157. http://dx.doi.org/10.1016/j.brat.2010.11.010.CrossRefGoogle Scholar
Kay, SRFiszbein, AOpler, LThe positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261–276.CrossRefGoogle Scholar
Anselmetti, SPoletti, SErmoli, EBechi, MCappa, SVenneri, A, et al.The brief assessment of cognition in schizophrenia. Normative data for the Italian population. Neurol Sci 2008; 29: 85–92. http://dx.doi.org/10.1007/s10072-008-0866-9.CrossRefGoogle ScholarPubMed
Keefe, R.S.E.Goldberg, TEHarvey, PDGold, JMPoe, MPCoughenour, LThe brief assessment of cognition in schizophrenia: reliability, sensitivity, and comparison with a standard neurocognitive battery. Schizophr Res 2004; 68: 283–297. http://dx.doi.org/10.1016/j.schres.2003.09.011.CrossRefGoogle ScholarPubMed
Cavallaro, RAnselmetti, SPoletti, SBechi, MErmoli, ECocchi, F, et al.Computer-aided neurocognitive remediation as an enhancing strategy for schizophrenia rehabilitation. Psychiatry Res 2009; 169: 191–196. http://dx.doi.org/10.1016/j.psychres.2008.06.027.CrossRefGoogle ScholarPubMed
Poletti, SAnselmetti, SBechi, MErmoli, EBosia, MSmeraldi, E, et al.Computer-aided neurocognitive remediation in schizophrenia: durability of rehabilitation outcomes in a follow-up study. Neuropsychol Rehabil 2010; 20: 659–674. http://dx.doi.org/10.1080/09602011003683158.CrossRefGoogle ScholarPubMed
Aghotor, JPfueller, UMoritz, SWeisbrod, MRoesch-Ely, DMetacognitive training for patients with schizophrenia (MCT): feasibility and preliminary evidence for its efficacy. J Behav Ther Exp Psychiatry 2010; 41: 207–211. http://dx.doi.org/10.1016/j.jbtep.2010.01.004.CrossRefGoogle ScholarPubMed
Bechi, MRiccaboni, RAli, SFresi, FBuonocore, MBosia, M, et al.Theory of mind and emotion processing training for patients with schizophrenia: preliminary findings. Psychiatry Res 2012; 198: 371–377. http://dx.doi.org/10.1016/j.psychres.2012.02.004.CrossRefGoogle ScholarPubMed
Bechi, MSpangaro, MBosia, MZanoletti, AFresi, FBuonocore, M, et al.Theory of Mind intervention for outpatients with schizophrenia. Neuropsychol Rehabil 2013; 23: 383–400. http://dx.doi.org/10.1080/09602011.2012.762751.CrossRefGoogle ScholarPubMed
Buonocore, MBosia, MRiccaboni, RBechi, MSpangaro, MPiantanida, M, et al.Combined neurocognitive and metacognitive rehabilitation in schizophrenia: effects on bias against disconfirmatory evidence. Eur Psychiatry 2015; 30: 615–621. http://dx.doi.org/10.1016/j.eurpsy.2015.02.006.CrossRefGoogle ScholarPubMed
Medalia, ARevheim, NCasey, MThe remediation of problem-solving skills in schizophrenia. Schizophr Bull 2001; 27: 259–267. http://dx.doi.org/10.1093/oxfordjournals.schbul.a006872.CrossRefGoogle Scholar
StaSoft Inc, StatSoft. Stat Data Anal Softw Syst 8; 2007.Google Scholar
Halperin, SNathan, PDrummond, PCastle, DA cognitive-behavioural intervention for social anxiety in schizophrenia. Aust N Z J Psychiatry 2000; 34: 809–813. http://dx.doi.org/10.1046/j.1440-1614.2000.00820.x.CrossRefGoogle Scholar
Heimberg, RGJuster, HRHope, DAMattia, JICognitive-behavioral group treatment: description, case presentation, and empirical support. Soc Phobia Clin Res Perspect 1995; 293–321.Google Scholar
Hawkins, RC2nd, Doell, SRLindseth, PJeffers, VSkaggs, SR.C., H2nd, et al.Anxiety reduction in hospitalized schizophrenics through thermal biofeedback and relaxation training. Percept Mot Skills 1980; 51: 475–482. http://dx.doi.org/10.2466/pms.1980.51.2.475.CrossRefGoogle ScholarPubMed
van Hassel, JHBloom, LJGonzalez, AMAnxiety management with schizophrenic outpatients. J Clin Psychol 1982; 38: 280–285. http://dx.doi.org/10.1002/1097-4679(198204)38:2<280::AID-JCLP2270380208>3.0.CO;2-R.3.0.CO;2-R>CrossRefGoogle ScholarPubMed
Woolfolk, RLRichardson, FCBehavior therapy and the ideology of modernity. Am Psychol 1984; 39: 777–786. http://dx.doi.org/10.1037//0003-066X.39.7.777.CrossRefGoogle ScholarPubMed
Corrigan, PWToomey, RInterpersonal problem solving and information processing in schizophrenia. Schizophr Bull 1995; 21: 395–403.CrossRefGoogle Scholar
Penn, DLvan der Does, AJSpaulding, WDGarbin, CPLinszen, DDingemans, PInformation processing and social cognitive problem solving in schizophrenia. Assessment of interrelationships and changes over time. J Nerv Ment Dis 1993; 181: 13–20.CrossRefGoogle ScholarPubMed
Bryce, SSloan, ELee, SPonsford, JRossell, SCognitive remediation in schizophrenia: a methodological appraisal of systematic reviews and meta-analyses. J Psychiatr Res 2016; 75: 91–106. http://dx.doi.org/10.1016/j.jpsychires.2016.01.004.CrossRefGoogle ScholarPubMed
Saperstein, AMThysen, JMedalia, AThe measure of insight into cognition: reliability and validity of clinician-rated and self-report scales of neurocognitive insight for schizophrenia. Schizophr Res 2012; 134: 54–58. http://dx.doi.org/10.1016/j.schres.2011.10.002.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.