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A psychosocial skills training approach in Mexican out-patients with schizophrenia

Published online by Cambridge University Press:  02 May 2007

MARCELO VALENCIA ,
MARIA LUISA RASCON ,
FRANCISCO JUAREZ  and
ESTHER MUROW
MARCELO VALENCIA*
Affiliation:
Division of Epidemiology and Psychosocial Research, National Institute of Psychiatry, Mexico City, Mexico
MARIA LUISA RASCON
Affiliation:
Division of Epidemiology and Psychosocial Research, National Institute of Psychiatry, Mexico City, Mexico
FRANCISCO JUAREZ
Affiliation:
Division of Epidemiology and Psychosocial Research, National Institute of Psychiatry, Mexico City, Mexico
ESTHER MUROW
Affiliation:
Division of Clinical Services, National Institute of Psychiatry, Mexico City, Mexico
*
*Address for correspondence: Dr Marcelo Valencia, Psychosocial Treatment Research Programme for Patients with Schizophrenia, Instituto Nacional de Psiquiatría Ramón de la Fuente, Calzada Mexico-Xochimilco 101, Colonia San Lorenzo Huipulco, Tlalpan, Mexico City, Mexico. (Email: [email protected])
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Abstract

Background

The effectiveness of a psychosocial skills training (PSST) approach applied to chronic out-patients with schizophrenia was examined. We hypothesized that the PSST programme, which included treatment as usual (TAU), PSST and family therapy (FT), would reduce positive and negative symptoms, prevent relapse and rehospitalization, and improve psychosocial functioning (PSF), global functioning and treatment adherence.

Method

Eighty-two patients were randomly assigned to receive either TAU [antipsychotic medication (AP); n=39] or the PSST approach (TAU+PSST+FT; n=43). The two groups were assessed at intake and after completion of 1 year of treatment.

Results

There were statistically significant differences between the two groups. Patients in the PSST group improved their symptomatology, psychosocial and global functioning (symptoms and psychological, social and occupational functioning), showed lower relapse, rehospitalization and drop-out rates, a higher level of compliance with AP medication, and a high level of therapeutic adherence in comparison with TAU patients, whose symptoms also improved although they showed no improvement in any of the clinical or psychosocial variables. A comparison of the standardized effect sizes showed a medium and a large effect size of PSF and global functioning for the PSST group and a non-effect size for the TAU group.

Conclusions

A higher level of effectiveness was demonstrated when combining TAU, PSST and FT in comparison with AP medication alone. The PSST approach should be recommended for clinical practice.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 10 , October 2007 , pp. 1393 - 1402
Copyright
Copyright © Cambridge University Press 2007

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