Context Antipsychotic drugs are limited in their ability to improve the overall outcome of schizophrenia. Adding psychosocial treatment may produce greater improvement in functional outcome than does medication treatment alone. Objective To evaluate the effectiveness of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia. Design Randomized controlled trial. Setting Ten clinical sites in China. Participants Clinical sample of 1268 patients with early-stage schizophrenia treated from January 1, 2005, through October 31, 2007. Intervention Patients were randomly assigned to receive antipsychotic medication treatment only or antipsychotic medication plus 12 months of psychosocial intervention consisting of psychoeducation, family intervention, skills training, and cognitive behavior therapy administered during 48 group sessions. Main Outcome Measures The rate of treatment discontinuation or change due to any cause, relapse or remission, and assessments of insight, treatment adherence, quality of life, and social functioning. Results The rates of treatment discontinuation or change due to any cause were 32.8% in the combined treatment group and 46.8% in the medication-alone group. Comparisons with medication treatment alone showed lower risk of any-cause discontinuation with combined treatment (hazard ratio, 0.62; 95% confidence interval, 0.52-0.74; P P P P  = .002), activities of daily living ( P P  ≤ .02). Furthermore, a significantly higher proportion of patients receiving combined treatment obtained employment or accessed education ( P  = .001). Conclusion Compared with those receiving medication only, patients with early-stage schizophrenia receiving medication and psychosocial intervention have a lower rate of treatment discontinuation or change, a lower risk of relapse, and improved insight, quality of life, and social functioning. Trial Registration clinicaltrials.gov Identifier:NCT00654576

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/210870/yoa05013_895_904.pdf

Effect of Antipsychotic Medication Alone vs Combined With Psychosocial Intervention on Outcomes of Early-Stage Schizophrenia: A Randomized, 1-Year Study

A systematic review of randomised controlled trials of interventions reporting outcomes for relatives of people with psychosis

Family interventions for mental disorders: efficacy and effectiveness.

Pharmacotherapy can improve some of the symptoms of schizophrenia but has limited effect on the social impairments that characterize the disorder and limit functioning and quality of life. Through computerized literature searches and bibliographies of published reports we identified peer reviewed studies of group, family, and individual therapy with schizophrenia and schizoaffective disorder patients. We identified 70 studies: 26 on group therapy, 18 on family therapy, and 11 on individual therapy. Additionally, treatment models were compared in 4 studies and combined in 11 others. Controls were included in 61 and all studies included medication. Benefits in symptoms as well as social and vocational functioning were associated with psychosocial treatments. Family therapy demonstrated the most promising findings and traditional social skills treatment yielded the least robust results. Adjunctive psychosocial treatments augment the benefits of pharmacotherapy and enhance functioning in psychotic disorders. Although these positive results have led to increased enthusiasm about psychosocial treatments for schizophrenia, questions remain about comparative benefits of specific treatment methods and additional benefits of multiple treatments.

Psychosocial treatments in schizophrenia: a review of the past 20 years.

Background Much of China lacks well-developed services for people with schizophrenia and their families, and most of the existing services focus on hospitals. There is a need for culturally sensitive family treatments offered by nurses. Aims To conduct a longitudinal experimental study examining the effect of patient and family education in a sample of Chinese people with schizophrenia. Method A randomised controlled trial was conducted in a large hospital with a sample of 101 patients with schizophrenia and their families. Data were collected at admission and at discharge, and then at 3 and 9 months after discharge. The intervention group received family education, and data on their knowledge about schizophrenia, symptoms, functioning, psychosocial behaviour, relapse and medication adherence were collected and compared with the control group. Results There was a significant improvement in knowledge about schizophrenia in the experimental group and a significant difference in symptom scores and functioning at 9 months after discharge. Patients who were non-adherent to medication regimens were more likely to relapse. Conclusions Family education on schizophrenia by nurses in China was effective in improving knowledge and promoting improvement in patients' symptoms.

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Family education for people with schizophrenia in Beijing, China: randomised controlled trial.

In order to assess the feasibility and acceptability of group psychosocial education for the relatives of schizophrenics in the community, a 2-year project was carried out in two cities: Jinan and Shanghai, China. The completed sample included 682 cases in the experimental group and 366 cases in the control group. The experimental group received group psychotherapy including 14 lectures and five group discussions with conventional services, and the control group had conventional services only. The annual relapse rate in the experimental group was much lower than that in the control group (17.6 and 23.2%, P < 0.01) and the rate of regular work in the experimental group was higher than that in the control group (37.5 and 30.0%, P < 0.05). At the end of the second year, the relatives in the experimental group had less care burden, better mental and physical health status and more knowledge of caring for schizophrenics than those in the control group. This approach was well accepted by both mental health workers and relatives of schizophrenics and the rate of drop-out was 18.4% only during the 2-year period.

Group psychoeducation of relatives of schizophrenic patients : Two-year experiences

Background: There are a large number of psychological problems caused by Internet addiction. We aimed to explore the intervention effect of narrative therapy in combination with Pilates exercise on Internet addiction among adolescents. Method: From July 2021 to October 2021, 42 adolescents with Internet addiction selected from four communities in Yiyang City of China were randomly divided into the intervention and control groups with 21 members in each group. The intervention group participated in the intervention of narrative therapy in combination with Pilates exercise eight times, whereas the control group did not receive any intervention. The 12-item General Health Questionnaire, Self-rating Young’s Diagnostic Questionnaire of Internet Addiction, and Positive Affect Subscale were used to measure the psychological indexes of the adolescents before and after the intervention. Results: Compared with those in the control group, the adolescents in the intervention group had an obvious decrease in the degree of Internet addiction with a statistically significant difference before and after the intervention (P < 0.001). After the intervention, the intervention group had significantly higher mental health scores and significantly lower scores for anxiety, depression, social dysfunction, and loss of interest than the control group. After the intervention, the intervention group showed an obvious increase in the score for positive affect with a statistically significant difference before and after the intervention (P < 0.001). Conclusion: The intervention method proposed in this study could effectively solve the problem of Internet addiction among adolescents.

Yangling He

Papers

Group psychoeducation of relatives of schizophrenic patients : Two-year experiences

Effect of Narrative Therapy-Based Group Psychological Counseling on Internet Addiction among Adolescents