The gender differences demonstrated in the study suggest gender specific treatment interventions in order to provide optimal treatment for both male and female patients.
During recent decades, the field of treatment of schizophrenia has lacked empirical, systematic outcome studies that support psychodynamic psychotherapy as an evidence-based intervention for patients with schizophrenia. The Danish schizophrenia project (DNS) compared psychodynamic psychotherapy for psychosis with standard treatment in patients with a first-episode schizophrenia spectrum disorder. The study was designed as a prospective, comparative, longitudinal multi-site investigation of consecutively referred patients who were included during two years. The patients were treated with either manualized individual supportive psychodynamic psychotherapy (SPP) in addition to treatment as usual or with treatment as usual alone (TaU). Symptoms and functional outcomes were measured using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning scale (GAF). The study included 269 consecutively admitted patients, age 18-35, of whom 79% remained in the study after two years. The intervention group improved significantly on measures of both PANSS and GAF scores, with large effect sizes at two years follow-up after inclusion. Further, improvement on GAF(function) (p = 0.000) and GAF(symptom) (p = 0.010) significantly favored SPP in combination with TaU over TaU alone. In spite of limitations, this study speaks in favor of including supportive psychodynamic psychotherapy in the treatment for patients with schizophrenic first-episode psychoses.
Integrated treatment and supportive psychodynamic psychotherapy in addition to treatment as usual may improve outcome after 1 year of treatment for people with first-episode psychosis, compared with treatment as usual alone.
677 active members of the bricklayers' trade union in Aarhus have been investigated with regard to unemployment and hospitalization during the period April 1, 1972-March 31, 1978. Information concerning unemployment was obtained through the bricklayers' trade union, and information about hospitalization from the hospital administration registry of three counties of Northern Jutland and from the Danish Central Psychiatric Register. Using logit analysis it was found that admission to a hospital increased the risk of unemployment, and that unemployment increased the risk of hospitalization. Admission to a psychiatric department appeared within a latency period of 0-1 years. A latency period of 1/2-11/2 years was observed before admission to a medical department. Admission to a surgical department occurred 1/2-21/2 years after accumulated unemployment. The risk of admission to a psychiatric department was seven times as high for bricklayers who have been unemployed more than 50% of the time compared with those who have been unemployed less of the time, although the calculation was based on relatively few individuals. The risk of admission to medical wards was twice as high, and the risk of admission to surgical wards was almost twice as high among those with much unemployment.
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