Relapse prevention and recovery in the treatment of schizophrenia.
ABSTRACT Nonadherence to medication is a predictor of relapse in patients diagnosed with schizophrenia, and preventing relapse is crucial to achieving the goal of recovery. Long-term treatment with antipsychotics can be effective, although long-term patient response to medication may be difficult to predict from trials that measure response, remission, and relapse rates because they are often too short. Longer trials are needed to fully understand the implications of adherence and symptom remission in patient outcome. Recovery, however, is contingent on the stabilization of the symptoms of schizophrenia and the acquisition of the skills necessary to function in society. Psychosocial interventions, such as family psychoeducation, social skills training, and cognitive-behavioral therapy, used in conjunction with pharmacotherapy are effective in helping to prevent symptom relapse and promote functional recovery in patients with schizophrenia.
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ABSTRACT: Schizophrenia is a serious and prolonged illness between whose psychosocial treatments one of the most effective is the psychoeducation. This treatment involves the family and succeeds in reducing rates of relapse and improves the course of the illness. The Psychiatry Service of Zamora years ago develops an intervention of this kind. In Zamora, the geographical and transport are obstacles who characterize its territory, and cause of some difficulties in access of families to this important therapy. In view of this circumstances an alternative is develop a distance therapy founded in internet. This work is an approach to test this possibility. This research conducted an exhaustive review of the literature regarding psychoeducation as e-therapy. Analyzed the results of the traditional treatment previously made by the Service of Zamora, and explored the difficulties of access for their users. The results indicate that the intervention traditional in Zamora increases knowledge and requires some improvement; also described the difficulties that families have accessing to the intervention (mainly distance and transportation). Finally, both families and professionals would be prepared to use a therapy at a distance based on Internet. This research has developed a methodology for analysis of the instruments used in the Service of Zamora; has known the outcome of the psychoeducational intervention; have been identified the difficulties in access to interventions and; have been explored the possible acceptances of an e-therapy. These results are the foundation and justification to develop a psychoeducational program called PsicoED that fits the pattern of service to the needs of its population.01/2008, Degree: Salamanca, Supervisor: Franco, M.; Jiménez, F.
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ABSTRACT: Objective Patients with schizophrenia often become non-adherent following negative treatment experiences as antipsychotics'side-effects. The objective of this study was to propose an alternative measure of patients’perception of atypical antipsychotics'side-effects on weight, as weight is a major concern reported by patients. Method We used a computer-assisted method called Alceste, which is a pragmatic analysis of speech. We selected three groups of ten patients respectively treated by three different atypical antipsychotics: aripiprazole, olanzapine and risperidone. Participants were administered an interview. All speeches were retranscribed and structured in a set of texts, called a corpus. Regarding antipsychotic treatment, we constituted three corpuses of ten speeches. We analyzed separately the three corpuses with the software Alceste. Results Our findings revealed the presence of a specific class dealing with treatment and illness in the speech of patients, regardless of their treatment. We found weight-related words in all three-treatment groups. The examination of the context of use showed this notion was differently employed in each treatment group: if weight was statistically associated with the notion of loss in the aripiprazole group, the reverse was found (notion of gain) in the two other treatment groups. Conclusion Our findings are valuable because they contribute to validate this speech analysis method. Actually our results, which are mathematically obtained through speech analysis, are convergent with those objectively observed by clinicians. Thus we hypothesize the Alceste-software is a relevant tool to evaluate the perceptions of antipsychotic side-effects.L Encéphale 12/2011; 37:S143–S150. DOI:10.1016/S0013-7006(11)70042-2 · 0.60 Impact Factor
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ABSTRACT: The objective of this study was to report the long-term remission results from the ConstaTRE relapse prevention trial, in which clinically stable adults with schizophrenia or schizoaffective disorder treated with oral risperidone, olanzapine, or oral conventional antipsychotics were randomized to risperidone long-acting injectable (RLAI) or oral quetiapine, dosed according to package-insert recommendations. In the ConstaTRE trial, efficacy and tolerability were recorded for up to 24 months. This post hoc analysis presents remission data, defined, according to the Schizophrenia Working Group criteria, as achieving and maintaining eight core symptoms of schizophrenia that are mild or less over 6 months. Additional secondary outcome measures are also presented. A total of 710 patients were randomized to RLAI (n = 355) or quetiapine (n = 355). Mean mode ± standard deviation (SD) drug doses were RLAI 33 ± 10 mg every 2 weeks and quetiapine 413 ± 159 mg daily. Full remission was achieved by 51.1% of patients with RLAI and 39.3% with quetiapine (p = 0.003). Mean ± SD of full remission durations were not significantly different with RLAI (540 ± 181 days) and quetiapine (508 ± 188 days). Overall tolerability was similar between treatment groups. Among stable patients with schizophrenia or schizoaffective disorder, remission was more likely after switching to RLAI than quetiapine.Therapeutic Advances in Psychopharmacology 08/2013; 3(4):191-9. DOI:10.1177/2045125313479127 · 1.53 Impact Factor