IntroductionOne of the criticisms of rehabilitation techniques is their limited application to the patient’s daily life. In the past, cinema has been used as a psychiatric rehabilitation tool, with the primary objective of facilitating training in social abilities and communication. In this study, we consider the use of film not only as a clinical recovery tool but also as a novel cognitive recovery tool for additional rehabilitation not only for communication and social abilities but also for all of the basic cognitive and social cognition processes.MethodsIn this randomized clinical trial, 48 patients with schizophrenia were assigned to an experimental or control group. Both of the groups received treatment sessions that included viewing episodes of the television series The Sopranos. Next, the experimental group participated in a structured cognitive training session that featured questions and exercises based on the episodes. The control group participated in an idea-sharing session (of the same duration and frequency) about what the group members saw in the episode.ResultsAt the end of the treatment, both the positive and negative clinical symptoms of the experimental group improved significantly compared with the control group. However, this improvement was not observed in basic or social cognitive functions.DiscussionA brief intervention based on transforming the activities of daily life can be an effective tool for psychiatric rehabilitation. However, the study’s current characteristics and sample did not produce benefits in cognitive parameters.
IntroductionCultural formulation (CF) of the DSM-IV is the cultural assessment tool promoted by the APA, not fully developed, that has limitations in clinical practice. An abridged cultural development, integrated into the overall clinical development of the case, might be more operational.ObjectivesDevelop an abridged CF of a clinical case, focusing only on relevant cultural elements for the proper understanding of the case diagnosis and therapeutic approach.Patients/ methodsA 43 year old woman from Hispanic Caribbean was admitted to a psychiatric unit, diagnosed with cycloid psychosis. She had been hospitalized twice before, with diagnosis of acute polymorphic psychotic episode. The three episodes seemed reactive to stress - loneliness, isolation, lack of protection - all on an abnormal development of personality with a clear overdevelopment of professional self versus other aspects of the self. The knowledge of sociopolitical conditions of her country, provided by a key informant, was necessary to deepen the narrative sense that the patient gave her disease.ResultsThe diagnostic formulation including an abridged CF, made by introducing cultural elements, lead to a better understanding of the underlying psychopathology and sense of anomalous behaviour, develop an explanation of the disease acceptable to the patient and improve the therapeutic alliance, ensuring adherence to treatment and satisfaction with it.ConclusionsCognitive neuroscience and anthropological theories have to mix their methods to offer a more valid and reliable instrument than currently available. Future instruments must be compatible with work of a clinical psychiatrist and demonstrate cost-effectiveness of their use.
Fiction films offer unexplored opportunities of rehabilitation for schizophrenia and other psychoses. Schizophrenia produces deficits y distortions in the perception and comprehension of reality, also expressed in the perception and comprehension of films. After a year of an “ad hoc” experience, the following technique was developed:Selecting a fiction film for its narrative, affective, cognitive and social cognitive contentBriefly presenting of the film to a group of 8-16 patients with diverse psychosis.Screening of the film to the patients and the therapeutic team.Summarizing of the plot by a patient. Group correcting of distortions and deficits caused by problems of attention and working memory, as well as positive, negative, affective and social cognitive symptoms (emotional perception, theory of mind, attributive style)Selecting 1-2 sequences by each patient, and group commenting using the same technique.Field recording of all the commentaries obtained.Second screening of the film two days after, repeating points 2 to 6.Comparing both field records.An experimental study using this technique is presented. 8 patients with schizophrenia and other psychoses watched 4 fiction films (“The 39 Steps”, “Charade”, “M”, “The General”). The differences founded in both viewings by two external evaluators (using CGI and analogical scales of the main variables) are presented and commented. An evaluation of the perceived usefulness and satisfaction of the participants was included.
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