Evidence-Based Psychosocial Practices and Recovery from Schizophrenia

Shean, Glenn D.

doi:10.1521/psyc.2009.72.4.307

Cited by 20 publications

(8 citation statements)

References 46 publications

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“…Nonpharmacologic interventions for psychosis in older patients is a broad topic that has been reviewed previously, [144][145][146][147] but no studies, to our knowledge, have specifically evaluated nonpharmacologic interventions for primary psychoses of late onset. The aim of this section is to provide a brief overview of nonpharmacologic interventions for older adults with psychosis and, where applicable, to provide detail about their application to lateonset psychosis.…”

Section: Treatment: Nonpharmacologic Interventionsmentioning

confidence: 99%

“…145,147 Four general categories of psychosocial intervention for schizophrenia exist: cognitivebehavioral therapy (CBT), cognitive remediation therapy, family interventional therapy, and social-skills therapy. 145 CBT is the most widely used of these four and has been shown to improve both positive and negative symptoms, 148,149 and in some instances to increase medication compliance.…”

Section: Treatment: Nonpharmacologic Interventionsmentioning

confidence: 99%

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Psychosis in Later Life

Colijn

Nitta²,

Grossberg³

2015

Harvard Review of Psychiatry

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Psychosis is relatively common in later life and can present in a wide variety of contexts, including early-onset and late-onset schizophrenia, delusional disorder, mood disorders, and various dementias. It can also occur as the result of numerous medical and neurological diseases and from the use of certain medications. Although identifying the cause of psychosis in older patients can be challenging, the unique clinical features associated with the different disorders can help in making the diagnosis. Accurate diagnosis of psychosis in older populations is essential, as its treatment varies depending on the context in which it appears. Despite the safety concerns regarding the use of antipsychotics in older patients, certain pharmacological treatments appear to be both efficacious and reasonably safe in treating psychosis in older populations. Additionally, although research is limited, numerous psychosocial therapies appear promising. This review summarizes the literature on the epidemiology, clinical characteristics, neuroimaging, and treatment of psychosis in later life, and serves as an update to past reviews on this topic.

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Section: Treatment: Nonpharmacologic Interventionsmentioning

confidence: 99%

Section: Treatment: Nonpharmacologic Interventionsmentioning

confidence: 99%

Psychosis in Later Life

Colijn

Nitta²,

Grossberg³

2015

Harvard Review of Psychiatry

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“…Ejemplo de ello es el surgimiento de tratamientos efectivos integrales, farmacológicos y psicosociales, sustentados por la llamada "medicina basada en la evidencia". Diversas revisiones al respecto [19][20][21][22][23][24][25][26][27] concluyen que una persona con esquizofrenia debería beneficiarse con la combinación de varias alternativas de tratamiento: a) Dosis óptimas de fármacos antipsicó-ticos, b) intervenciones psicosociales como el aprendizaje de habilidades psicosociales, apoyo laboral, diversos enfoques respecto al manejo de la enfermedad, la adherencia a los medicamentos, etc., c) psicoeducación, tanto al paciente como a su familia, en el manejo de la enfermedad, la prevención de recaídas, el aprendizaje de estrategias para afrontar situaciones de crisis y la resolución de conflictos en el hogar y en la comunidad y d) intervenciones cognitivas como la terapia cognitiva conductual, la rehabilitación cognitiva, o también la que intenta remediar el déficit cognitivo (cognitive remediation). Liberman, pionero de los tratamientos psicosociales y la recuperación funcional, asume que la evidencia disponible respecto a los tratamientos que buscan el manejo óptimo de los síntomas y la reintegración psicosocial del paciente, no permite aún concluir hasta qué grado dichos avances en el tratamiento y la rehabilitación presagiarán la recuperación funcional del paciente con esquizofrenia como una meta realista y alcanzable actualmente, 28 por lo que es muy importante la investigación en esta área, para lo cual propone ciertos criterios para evaluar su recuperación funcional.…”

Section: Introductionunclassified

Remisión sintomática y recuperación funcional en pacientes que padecen esquizofrenia

Valencia¹,

Caraveo²,

Colín³

et al. 2014

Salud Ment

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SUMMARYA recently proposed definition for remission and recovery in schizophrenia is receiving increased attention by clinicians and researchers. The interest on these issues is based on the recent proposed definition for symptomatic remission, and the development of operational criteria for its assessment, by the Remission in Schizophrenia Working Group (RSWG), in the United States, in 2005. Remission is assessed using eight items of the Positive and Negative Syndrome Scale (PANSS), all of which have to be scored with a symptom severity of ≤3 points (mild or better), sustained for a minimum duration of six months. In Europe, since 2006, proposed definition criteria about response and remission were introduced. Response can be assessed, with the PANSS, using a cut-off of at least 50% reduction of the baseline score for the acutely ill, and a cut-off of at least of 25% reduction for refractory patients. Remission could be assessed using a formula for calculating percentage PANSS reduction from baseline. Definition criteria have also been introduced to assess functional recovery that includes the combination of clinical and social outcomes for two consecutive years, including dimensions such as psychosocial functioning, cognition, and quality of life.The purpose of this review is to examine existing research on symptomatic remission and functional recovery in schizophrenia. We included clinical and epidemiological studies, reviews and meta-analyses published between January 1970 and July 2013. Sixty two studies on remission and recovery were included, with a total of 94 940 patients, comprising six months to 37 years follow-up. Thirty two studies on functional recovery were included, with a total of 6 483 patients with a range of six months to 42 years follow-up. Research indicates that symptomatic remission can be achieved in 20-97%, and functional recovery in 10-68% of people with schizophrenia. The use of remission and recovery criteria has been recommended for clinical practice and scientific research.Key words: Symptomatic remission, functional recovery, symtomatology, psychosocial functioning. RESUMENRecientemente los conceptos de remisión sintomática y recuperación funcional en los pacientes que padecen esquizofrenia han recibido una considerable atención por parte de los clínicos y los investigadores. El interés en estos aspectos tiene que ver con la propuesta realizada en el 2005 por el "Grupo de trabajo para evaluar la remisión en esquizofrenia", con el objetivo de proponer una definición de remisión sintomática, así como el desarrollo de criterios operacionales para su evaluación. La remisión sintomática se evalúa utilizando ocho reactivos de la escala PANSS, los cuales deben puntuar tres o menos, con una duración mínima de seis meses de remisión. En Europa, desde el 2006, también se han propuesto criterios para evaluar la respuesta al tratamiento, así como la remisión sintomática. La remisión se puede evaluar usando una fórmula para calcular el porcentaje de reducción de síntomas desde el inicio del tr...

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“…A considerable effort has been carried out in recent years to articulate the scientific basis of the treatment for people with schizophrenia. As a result evidence based treatment for schizophrenia has recommended that all persons with schizophrenia should receive the combination of: 1) optimal dose of antipsychotic medication, 2) psychosocial interventions, 3) psychoeducation for patients and carers as well as family therapy, and, 4) assertive homebased management to help prevent and resolve various issues such as: crises, relapse, medication adherence, etc, (Drake et al, 2009;Falloon et al, 2004;Fenton & Schooler, 2000;Lehman & Steinwachs, 2003;Shean, 2009;Thornicroft & Susser, 2001). In summary, scientific research indicates that the management of schizophrenia should include the following: 1) pharmacotherapy, 2) psychosocial interventions, and 3) the integration of these two approaches.…”

Section: Introductionmentioning

confidence: 99%