Psychosocial treatments for negative symptoms in schizophrenia: Current practices and future directions

Abstract

Schizophrenia can be a chronic and debilitating psychiatric disorder. Though advancements have been made in the psychosocial treatment of some symptoms of schizophrenia, people with schizophrenia often continue to experience some level of symptoms, particularly negative symptoms, throughout their lives. Because negative symptoms are associated with poor functioning and quality of life, the treatment of negative symptoms is a high priority for intervention development. However, current psychosocial treatments primarily focus on the reduction of positive symptoms with comparatively few studies investigating the efficacy of psychosocial treatments for negative symptoms. In this article, we review and evaluate the existing literature on three categories of psychosocial treatments – cognitive behavioral therapy (CBT), social skills training (SST), and combined treatment interventions – and their impact on the negative symptoms of schizophrenia. Of the interventions reviewed, CBT and SST appear to have the most empirical support, with some evidence suggesting that CBT is associated with maintenance of negative symptom improvement beyond six months after treatment. It remains unclear if a combined treatment approach provides improvements above and beyond those associated with each individual treatment modality. Although psychosocial treatments show promise for the treatment of negative symptoms, there are many unanswered questions about how best to intervene. We conclude with a general discussion of these unanswered questions, future directions and methodological considerations, and suggestions for the further development of negative symptom interventions.

Effectiveness of Social Skills Training Program on Social Functioning and Severity of Symptoms Among Patients with Schizophrenia

“…In relation to patients negative symptoms, there was a highly statistically significant relations between the mean scores of pre and post test as regard P<0.001 * these findings were consistent with [28] agreed on that, social skill training can decrease the negative symptoms of chronic schizophrenic patients and this result is in agreement with findings of others [43], [44] emphasized that, negative symptoms of schizophrenia could be reduced through applying the appropriate plans and practices. Psycho social activity can affect negative symptoms positively, although negative symptoms can be considered as resist ant feature against change after treatment interventions such as Pharmacotherapy and psychotherapy.…”

Negativsymptome in der Schizophrenie und ihre Differenzialdiagnose

“…Negativsymptome sind schwierig zu behandeln, moderate Behandlungseffekte wurden für einige psychosoziale Therapien wie soziales Kompetenztraining [19] und kognitive Verhaltenstherapie [20,21] …”

La terapia cognitivo conductual y los síntomas negativos en la esquizofrenia

“…64,67,68 La mayoría de los meta-análisis y revisiones al respecto 4,6,68,[71][72][73] señalan la necesidad de generar evidencia científica sólida en relación con el tratamiento de estos síntomas.…”

“…41,42 Hoy en día, debido a su efectividad, diversas investigaciones continúan adaptando y perfeccionando la técnica con el fin de tener mejores resultados; por ejemplo, con el entrenamiento virtual para combatir el problema del ausentismo del paciente al tratamiento 43 o con la combinación de este tipo de intervención psicosocial con otros tipos de terapia 44 para mejorar los resultados en pacientes con predominio de síntomas negativos, quienes generalmente se muestran refractarios al EHS debido a que el deterioro cognitivo limita su potencial de aprendizaje. 45 El hecho de que existan pocas investigaciones sobre el EHS que evalúan como principal variable de efecto los sín-tomas negativos puede deberse a que inicialmente este tipo de intervención psicosocial no fue conceptualizada para tratar los síntomas de la esquizofrenia sino para aumentar la funcionalidad e impulsar al paciente a una vida independiente.…”