Achieving recovery in patients with schizophrenia through psychosocial interventions: A retrospective study

Abstract

Aim: Recovery, or functional remission, represents the ultimate treatment goal in schizophrenia. Despite its importance, a standardized definition of remission is still lacking, thus reported rates significantly vary across studies. Moreover, the effects of rehabilitative interventions on recovery have not been thoroughly investigated. This study aimed to evaluate recovery in a sample of patients with chronic schizophrenia engaged in rehabilitation programs and to explore contributing factors, with a focus on sociocognitive rehabilitative interventions.Methods: Data from 104 patients with schizophrenia treated either with a standard rehabilitation program, including cognitive remediation (n = 46), or the latter plus a specific sociocognitive intervention (n = 58), and assessed for psychopathology, cognition, social cognition, and Quality of Life Scale, were retrospectively analyzed for this study.Results: Recovery, evaluated with the Quality of Life Scale, was achieved by 56.76% of patients in our sample. While no effects were observed for clinical, cognitive, or sociocognitive variables, participation in the sociocognitive rehabilitative interventions was positively associated with recovery. Conclusion:Our results indicate that high rates of recovery can be achieved in patients treated with psychosocial interventions and suggest that rehabilitative programs targeting social cognition may further facilitate the process of recovery. If confirmed, these results may have relevant implications for daily clinical practice and service provision, allowing clinicians to develop and optimize specific rehabilitation programs in order to promote recovery.

Improvement of psychiatrists’ clinical knowledge of the treatment guidelines for schizophrenia and major depressive disorders using the ‘Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)’ project: A nationwide dissemination, education, and evaluation study

“…Moreover, comprehensive treatment guidelines, including psychosocial interventions and pharmacological treatment for achieving recovery, should be developed. 24 In conclusion, the EGUIDE project, a dissemination and education program for the 'Guideline for Pharmacological Therapy for Schizophrenia' and 'Treatment Guideline II: Major Depressive Disorder,' could help to improve clinical knowledge regarding the guidelines among psychiatrists. Further study will be needed to clarify the effects of the EGUIDE project on the improvement of inappropriate pharmacological treatment in clinical settings.…”

“…Hiroshige Fujishiro, MD, PhD, 21,22 Toshinori Nakamura, MD, 15 Kentaro Mizuno, MD, 23 Takahiko Inagaki, MD, 24,25 Eiichi Katsumoto, MD, 26 Hiroaki Tomita, MD, PhD, 27 Kazutaka Ohi, MD, PhD, 28 Hiroyuki Muraoka, MD, PhD, 29 Kiyokazu Atake, MD, PhD, 12 Hitoshi Iida, MD, 30 Tatsuya Nagasawa, MD, PhD, 28 Junichi Fujita, MD, PhD, 31 Satoshi Yamamura, MD, 32 Toshiaki Onitsuka, MD, PhD, 33 Atsunobu Murata, MS, 34 Yoichiro Takayanagi, MD, PhD, 35 Hokuto Noda, MD, 36 Yukiko Matsumura, MD, 37 Kenji Takezawa, MD, PhD, 38 Jun-ichi Iga, MD, PhD, 39 Kayo Ichihashi, MD, 40 Kazuyoshi Ogasawara, MD, PhD, 21,41 Hisashi Yamada, MD, PhD, 4,42 Ken Inada, MD, PhD 29 and Ryota Hashimoto, MD, PhD 4,43 * Aim: Although treatment guidelines for pharmacological therapy for schizophrenia and major depressive disorder have been issued by the Japanese Societies of Neuropsychopharmacology and Mood Disorders, these guidelines have not been well applied by psychiatrists throughout the nation. To address this issue, we developed the 'Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)' integrated education programs for psychiatrists to disseminate the clinical guidelines.…”

Cognitive and clinical predictors of community functioning across the psychoses

“…Recent efforts to improve functional outcomes by targeting social cognition and negative symptoms may show promise. Programs such as sociocognitive training (Buonocore et al, ), facial‐affect recognition training (Frommann, Streit, & Wölwer, ), and cognitive remediation programs, particularly those paired with other rehabilitative elements (Wykes, Huddy, Cellard, McGurk, & Czobor, ), have been able to demonstrate engagement of social and cognitive targets, and improvements in community outcomes. Programs such as cognitive enhancement therapy (CET; Eack, Hogarty, Greenwald, Hogarty, & Keshavan, ) and functional remediation (Torrent et al, ), which include social cognition targets and/or group‐based formats encouraging social skills and social practice, tend to show both greater improvement in untrained social cognitive outcomes and greater transfer to daily functioning (Bonnin et al, ; Eack, Mesholam‐Gately, Greenwald, Hogarty, & Keshavan, ).…”

Eye movement characteristics in schizophrenia: A recent update with clinical implications

“…However, only a few studies have examined the relationship between eye movements and social/cognitive aspects of mental illness . Not only clinical symptoms but also social/cognitive impairments are known to be a cause of great distress in mental illness and are important factors in therapeutic interventions . We have recently reported eye movement characteristics of schizophrenia and their relationship with cognitive and social measures .…”

“…To elucidate the mechanisms of mental illnesses and brain function important factors in therapeutic interventions. 75,76 We have recently reported eye movement characteristics of schizophrenia and their relationship with cognitive 77 and social measures. 78 These studies have shown that in schizophrenia, eye movement measures such as scanpath length, visual cognition such as perceptual organization, and social functioning measured by total work hours per week may have a hierarchical relationship, where eye movement characteristics lead to changes in cognition or social functioning.…”