Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-22T23:59:58.384Z Has data issue: false hasContentIssue false
  • English
  • Français

Two-year study of relapse prevention by a new education program in schizophrenic patients treated with the same antipsychotic drug

Published online by Cambridge University Press:  16 April 2020

Jean-Paul Chabannes ,
Nadine Bazin ,
Denis Leguay ,
Philippe Nuss ,
Charles-Siegfried Peretti ,
Patrick Tatu ,
Ahcene Hameg ,
Ricardo P. Garay  and
Maurice Ferreri
Jean-Paul Chabannes
Affiliation:
Saint Egreve Hospital, Grenoble, France
Nadine Bazin
Affiliation:
Department of Psychiatry, Mignot Hospital, Versailles, France
Denis Leguay
Affiliation:
Cesame Hospital, Angers, France
Philippe Nuss
Affiliation:
Department of Psychiatry, Hospital Center of Saint Antoine, AP-HP, Université Paris VI, Paris, France
Charles-Siegfried Peretti
Affiliation:
Department of Psychiatry, Hospital Center of Saint Antoine, AP-HP, Université Paris VI, Paris, France
Patrick Tatu
Affiliation:
Department of Psychiatry, Centre Hospital Centre of Saint Etienne, Saint Etienne, France
Ahcene Hameg
Affiliation:
Psychiatric Department, Sanofi-Aventis, Paris, France
Ricardo P. Garay*
Affiliation:
EA2381, Université Paris VII, Paris, France
Maurice Ferreri
Affiliation:
Department of Psychiatry, Hospital Center of Saint Antoine, AP-HP, Université Paris VI, Paris, France
*
*Corresponding author. 46bis, rue du Maréchal Galliéni, 91360 Villemoisson-sur-Orge, France. E-mail address: [email protected] (R.P. Garay).
Get access

Abstract

It is not clear whether patient's psycho-education enhances compliance to antipsychotic treatments and reduces the number of relapses. Here we investigated the impact of a new psycho-educational program (SOLEDUC®) on the one- and two-years rate of relapse (primary outcome measure) and a number of clinical assessments (secondary outcome measures). This was a multicentric French clinical trial (51 centers) of Phase IV, open, controlled, randomized, consisting in two parallel groups: the Soleduc group (N = 111) and the control group (N = 109). All subjects received a variable dose over the 2-year period of the same antipsychotic drug (amisulpride). Soleduc consisted of a 7-session program (1 h per session), presented three times (at baseline, 6-months and 12-months). Patients in the control group received a non-specific psychosocial training for an equivalent period of time. The models of Andersen-Gill (AG) and Prentice, Williams and Peterson (PWP) were used to analyze relapses. Patients in the Soleduc group attended 14.8 ± 6.1 sessions (mean ± SD), including 17 patients who never attended a session. Intent to treat analysis showed less patients relapsing in the Soleduc group as compared to the control group (21.6% versus 28.4% after 1 year and 84.4% versus 90.8% after 2 years), but the differences were not statistically significant. Relapse risk was significantly reduced for patients who followed at least 7 modules (p = 0.015 AG-test; p < 0.001 PWP-test). In conclusion, no significant differences in relapse rates were found between patients attending the Soleduc program and the control group. Attendance of at least 7 out of 21 program sessions was required to see a modest, but significant two-year relapse prevention in schizophrenia. Other well designed studies are required to evaluate the medical impact of patient's education programs.

Keywords

SchizophreniaRelapsePatient educationPsycho-educational programsAmisulpride
Type
Original articles
Information
European Psychiatry , Volume 23 , Issue 1 , January 2008 , pp. 8 - 13
Copyright
Copyright © Elsevier Masson SAS 2008

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

Achard, S., Chignon, J.M., Poirier-Littre, M.F., Galinowski, A., Pringuey, D., Van Os, J.et al.Social adjustment and depression: value of the SAS-SR (Social Adjustment Scale Self-Report). Encephale 1995;21:107–116.Google Scholar
American Psychiatric Association, Practice guideline for the treatment of patients with schizophrenia. 2nd ed.Washington: Association AP, American Psychiatric Association; 2004.Google Scholar
Andersen, P.K., Gill, R.D.Cox(s regression model for counting processes: a large sample study. Ann Statist 1982;10:1100–1120.CrossRefGoogle Scholar
Ascher-Svanum, H., Whitesel, J.Randomized controlled study of two styles of group patient education about schizophrenia. Psychiatric Services 1999;50:926–930.CrossRefGoogle ScholarPubMed
Boczkowski, J.A., Zeichner, A., DeSanto, N.Neuroleptic compliance among chronic schizophrenic outpatients: an intervention outcome report. J Consult Clin Psychol 1985;53:666–671.CrossRefGoogle ScholarPubMed
Boyer, P., Lecrubier, Y., Puech, A.J., Dewailly, J., Aubin, F.Treatment of negative symptoms in schizophrenia with amisulpride. Br J Psychiatry 1995;166:68–72.CrossRefGoogle ScholarPubMed
Coukell, A.J., Spencer, C.M., Benfield Amisulpride, P.A review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the management of schizophrenia. Adis Int CNS Drugs 1996;6:237–256.CrossRefGoogle Scholar
Delcker, A., Schoon, M.L., Oczkowski, B., Gaertner, H.J.Amisulpride versus haloperidol in treatment of schizophrenic patients – results of a double-blind study. Pharmapsychiatry 1990;23:125–130.CrossRefGoogle ScholarPubMed
Dodds, F., Rebair-Brown, A., Parsons, S.A systematic review of randomized controlled trials that attempt to identify interventions that improve patient compliance with prescribed antipsychotic medication. Clin Effectiveness Nurs 2000;4(2):47–53.CrossRefGoogle Scholar
Dolder, C.R., Lacro, J., Leckband, S., Jeste, D.V.Interventions to improve antipsychotic medication adherence: review of recent literature. J Clin Psychopharmacol 2003;23:389–399.CrossRefGoogle ScholarPubMed
Fleurot, O., Bech, P., Turjanski, S.Amisulpride versus risperidone in the treatment of acute schizophrenia. Biol Psychiatry 1997;42:S1–S297.CrossRefGoogle Scholar
Goldstein, M.J.Psychoeducation and relapse prevention. Int J Psychopharmacol 1995;9(Suppl.5):59–69.CrossRefGoogle ScholarPubMed
Guillard-Bouhet, N., Lafay, N., Jourdain, M., Senon, J.L.Transversal study of the psychosocial rehabilitation and the quality of life of 75 schizophrenics under classical neuroleptics or atypical antipsychotic neuroleptics. Encephale 2005;31:653–665.CrossRefGoogle ScholarPubMed
Guy, W.Clinical global impression. Health NIoM, ECDEU assessment manual for psychopharmacology. Rockville, MD: National Institute of Mental Health; 1976.Google Scholar
Herz, M.I., Lamberti, J.S., Mintz, J., Scott, R., O'Dell, S.P., McCartan, L.et al.A program for relapse prevention in schizophrenia—a controlled study. Arch Gen Psychiatry 2000;57:277–283.CrossRefGoogle ScholarPubMed
Hillert, A., Phillip, M., Gattaz, W.F., Wetzel, H., Gründer, G., Sauer, H.et al.Amisulpride vs Flupenthixol in the treatment of schizophrenia with predominant positive symptomatology. Neuropsychopharmacology 103S, part 21994 S31 1994. 31SGoogle Scholar
Kay, S.R., Fiszbein, A., Opler, L.A.The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261–275.CrossRefGoogle Scholar
Klingberg, S., Buchkremer, G., Holle, R., Schulze Monking, H., Hornung, W.P.Differential therapy effects of psychoeducational psychotherapy for schizophrenic patients—results of a 2-year follow-up. Eur Arch Psychiatry Clin Neurosci 1999;249:66–72.CrossRefGoogle ScholarPubMed
Loo, H., Poirier Littre, M.F., Theron, M., Rein, W., Fleurot, O.Amisulpride versus placebo in the medium term treatment of the negative symptoms of schizophrenia. Br J Psychiatry 1997;170:18–22.CrossRefGoogle ScholarPubMed
McFarlane, W.R., Link, B., Dushay, R., Marchal, J., Crilly, J.Psychoeducational multiple family groups: four-year relapse outcome in schizophrenia. Fam Process 1995;34:127–144.CrossRefGoogle Scholar
McIntosh, A.M., Conlon, L., Lawrie, S.M., Stanfield, A.C.Compliance therapy for schizophrenia. Cochrane Database Syst Rev 2006.CrossRefGoogle Scholar
Merinder, L.B.Patient education in schizophrenia: a review. Acta Psychiatr Scand 2000;102(2):98–106.CrossRefGoogle ScholarPubMed
Motlova, L., Spaniel, F., Vanurová, I., Klaschkal, J.Psychoeducation and relapse of schizophrenia. Eur Psychiatry 2000;15(Suppl. 2):s349.CrossRefGoogle Scholar
Nose, M., Barbui, C., Gray, R., Tansella, M.Clinical interventions for treatment non-adherence in psychosis: meta-analysis. Br J Psychiatry 2003 September 1;183(3):197–206.CrossRefGoogle Scholar
Novak-Gubric, V., Tavcar, R.Predictors of noncompliance in males with first-episode schizophrenia, schizophreniform and schizoaffective disorder. Eur Psychiatry 2002;17:148–154.CrossRefGoogle Scholar
Paillère-Martinot, M.L., Lecrubier, Y., Martinot, J.L., Aubin, F.Improvement of some schizophrenic deficit symptoms with low doses of amisulpride. Am J Psychiatry 1995;152:130–133.Google ScholarPubMed
Pekkala, E., Merinder, L. Psychoeducation for schizophrenia. Cochrane Database Syst Rev 2002.CrossRefGoogle Scholar
Pitschel-Walz, G., Leucht, S., Bauml, J., Kissling, W., Engel, R.R.The effect of family interventions on relapse and rehospitalization in schizophrenia—a meta-analysis. Schizophr Bull 2001;27:73–92.CrossRefGoogle ScholarPubMed
Prentice, R.L., Williams, B.J., Peterson, A.V.On the regression analysis of multivariate failure time data. Biometrika 1981;68:373–379.CrossRefGoogle Scholar
Puschner, B., Born, A., Giessler, A., Helm, H., Leese, M., Bindman, J.P.et al.Adherence to medication and quality of life in people with schizophrenia: results of a European multicenter study. J Nerv Ment Dis 2006;194:746–752.CrossRefGoogle ScholarPubMed
Robert, P., Braccini, T., Vitali, P., Darcourt, G.Echelle d'aptitude psychosociale (EAPS). Présentation et validation. Psychologie Médicale 1987;19:1761–1765.Google Scholar
Rund, B.R., Moe, L., Sollien, T., Fjell, A., Borchgrevink, T., Hallert, M.et al.The Psychosis Project: outcome and cost-effectiveness of a psychoeducational treatment programme for schizophrenic adolescents. Acta Psychiatr Scand 1994;89:211–218.CrossRefGoogle ScholarPubMed
Sciolla, A., Patterson, T.L., Wetherell, J.L., McAdams, L.A., Jeste, D.V.Functioning and well-being of middle-aged and older patients with schizophrenia: measurement with the 36-item short-form (SF-36) health survey. Am J Geriatr Psychiatry 2003;11:629–637.Google ScholarPubMed
Weiden, P., Rapkin, B., Mott, T., Zygmunt, A., Goldman, D., Horvitz-Lennon, M.et al.Rating of Medication Influences (ROMI) scale in schizophrenia. Schizophr Bull 1994;20:297–310.CrossRefGoogle Scholar
Yamada, K., Watanabe, K., Nemoto, N., Fujita, H., Chikaraishi, C., Yamauchi, K.et al.Prediction of medication noncompliance in outpatients with schizophrenia: 2-year follow-up study. Psychiatry Res 2006;141:61–69.CrossRefGoogle ScholarPubMed
Zygmunt, A., Olfson, M., Boyer, C.A., Mechanic, D.Interventions to improve medication adherence in schizophrenia. Am J Psychiatry 2002 October 1;159(10):1653–1664.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.