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.
The small sample limits the conclusions, but the Rorschach variables may have problems reflecting major changes in psychotic symptoms and social functioning. With short protocols, PTI seems at risk of being unnecessarily insensitive and PTI may benefit from changes in the scoring procedures.
Objective To compare psychological test and retest results of 34 first‐episode psychotic patients.
Material Patients included in ‘The Danish National Schizophrenia Project’.
Method Six WAIS‐R subtests (Information, Vocabulary, Similarities, Picture Completion. Picture Arrangement, Block Design) and the Rorschach Test according to Exner's Comprehensive System (CNS) were given to the patient shortly after admission and 2 years later.
Results Preliminary results from the retest show higher scores on the six WAIS‐R subtests, but no corresponding positive difference in the cognitive findings on the Rorschach Test.
Conclusion Cognitive functions tested by WAIS‐R and Rorschach, respectively, need to be examined further.
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