In-home psychosocial skills training for patients with schizophrenia

Department of Psychology, University of Cordoba (Spain), Cordoue, Andalusia, Spain
Psychiatric Services (Impact Factor: 1.99). 03/2006; 57(2):260-2. DOI: 10.1176/
Source: PubMed

ABSTRACT The purpose of this study was to test an intervention that adapted the University of California, Los Angeles (UCLA) social and independent living skills program for application in the patient's home and in an outpatient setting in Spain.
An intervention group of 32 patients with schizophrenia was selected for comparison with a matched control group of patients who were undergoing conventional outpatient treatment for schizophrenia during six-month treatment periods. The Positive and Negative Syndrome Scale (PANSS) scoring system was used to compare the two groups, with a pretest-posttest design.
Analysis of variance indicated a significant phase-by-treatment interaction effect of the intervention on PANSS scores.
The results of this study suggest that a combination of outpatient follow-up care and in-home care centered on psychosocial skills training is more effective than conventional treatment in improving general symptoms among individuals with schizophrenia.

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    ABSTRACT: APA's Practice Guideline for the Treatment of Patients With Schizophrenia, Second Edition, was published in April 2004 (1). This watch highlights key research studies published since that date. The studies were identified by a MEDLINE literature search for meta-analyses and randomized, con-trolled trials published between 2002 and 2008, using the same key words used for the literature search performed for the 2004 guideline. With regard to pharmacotherapy, there have been sev-eral important randomized trials of antipsychotics. For chronic schizophrenia, trials include the National Insti-tute of Mental Health (NIMH) Clinical Antipsychotic Trial for Intervention Effectiveness (CATIE) and the United Kingdom–funded Cost Utility of the Latest Antipsychotics in Schizophrenia (CUtLASS). For first-episode schizophrenia, there are two industry-funded trials, the European First Episode Schizophrenia Trial (EUFEST)—funded by AstraZeneca, Pfizer, and Sanofi-Aventis—and the Comparison of Atypicals for First Epi-sode Schizophrenia (CAFE)—funded by AstraZeneca. For early-onset schizophrenia, there is one trial, the NIMH-funded Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS). These trials point to a re-consideration of treatment with the antipsychotics per-phenazine and molindone and by extension other first-generation antipsychotics, with the possible exception of haloperidol, for which some trials have shown greater rates of extrapyramidal side effects or less favorable clinical re-sponse (2). In addition, a recent population-based cohort study (3) that encompassed 11 years of follow-up showed decreased rates of mortality with perphenazine as compared with other first-and second-generation antipsychotic agents; only clozapine use was associated with lower rates of overall mortality. For the period April 2008 to August 2009, Dr. Dixon reports attending a consultation meeting for Janssen and receiving a grant from Bristol-Meyers-Squibb for investigator-initiated research, Dr. Perkins reports receiving research funding from Janssen (ended Janu-ary 2009) and reports receiving income for consulting for Dainippon (data safety monitoring board on lurasidone studies) and for serving on speakers bureaus for Eli Lilly, and Dr. Calmes reports no competing interests. The Executive Committee on Practice Guidelines reviewed this watch and found no evidence of influence from these relationships. The American Psychiatric Association's (APA's) practice guidelines are developed by expert work groups using an explicit meth-odology that includes rigorous review of available evidence, broad peer review of iterative drafts, and formal approval by the APA Assembly and Board of Trustees. APA practice guidelines are intended to assist psychiatrists in clinical decision making. They are not intended to be a standard of care. The ultimate judgment regarding a particular clinical procedure or treatment plan must be made by the psychiatrist in light of the clinical data presented by the patient and the diagnostic and treatment options available. Guideline watches summarize significant developments in practice since publication of an APA practice guideline. Watches may be authored and reviewed by experts associated with the original guideline development effort and are approved for publication by APA's Executive Committee on Practice Guidelines. Thus, watches represent opinion of the authors and approval of the Executive Committee but not policy of the APA. This guideline watch was published in September 2009.