The Research Of Psychosocial Intervention On The Rehabilitation Of Schizophrenia

Objective: 1) To explore if the antipsychotic plus psychosocial interventionfor patients with a CCMD-Ⅲdiagnosis of schizophrenia after acute episodeis more efficient in outcomes than antipsychotic only.; 2) To analyse if therewas relation between the frequency of psychosocial intervention and theoutcomes of patients with diagnosis of schizophrenia after acute episode; 3)To evaluate the validity and feasibility of our manual,and provide evidencefor the generalization.Methods: 120 patients with the whole course less than 5 years were assignedby paired design to either antipsychotic plus psychosocialintervention(include psychoeducation, Group cognitive -behaviouraltherapy, social skills training, occupational rehabilitation)(n=60) orantipsychotic only (n=60). The Positive and Negative Syndrome Scale(PANSS), Global Assessment Scale(GAS),Montgomery-Asberg DepressionScale (MADRS), Insight and Treatment Attitude Questionnaire(ITAQ) andFamily Burden Scale of Disease(FBS) were assessed at entry,3-month,6-month ,9-month and 12 -month follow-ups by raters. Short Form 36 Health Survey Questionnaire(SF-36), Social Disability ScreeningSchedule (SDSS)and Perceived Social Support Scale(PSSS)were assessed atpretreatment, 6-month and 1 year follow-ups by raters,. At last to analyse thecorrelation between the frequency of psychosocial intervention and theoutcomes.Results: At 3-month follow-ups significant reductions were observed forPANSS-General scale (P=0.039), PANSS-thought disorder, FBS-mentalhealth of family members (P=0.041) for patients treated in psychosocialintervention plus antipsychotic than antipsychotic only. At 6-monthfollow-ups, significant reductions were observed for PANSS-General scale(P=0.03),PANSS- response falttening (P=0.018), global scores of FBS(P=0.03), FBS-physical health of family members (P=0.03), FBS-mentalhealth of family members (P=0.047), and significant increment forSF-36-Role Emotion (P=0.038) for patients treated in psychosocialintervention plus antipsychotic than antipsychotic only. At 9-monthfollow-ups, significant reductions were observed for GAS (P=0.006), PANSS(P=0.001), PANSS-General scale(P＜0.001), PANSS-responsefalttening (P=0.006), PANSS-aggression (P=0.006), Montgomery-AsbergDepression Scale (P=0.006), global scores of FBS(P＜0.001), FBS-financeburden (P＜0.001), FBS-daily activity in family (P=0.031), FBS-recreationin family (P=0.009),relation of family members(P=0.007) and FBS-mentalhealth of family members (P=0.01), significant increment for Insight andTreatment Attitude Questionnaire (P=0.003) for patients treated inpsychosocial intervention plus antipsychotic than antipsychotic only. At12-month follow-ups all global scores from PANSS but thought disorder had a significantly better in patients treated in psychosocial intervention.Significant reduction was observed for Social Disability ScreeningSchedule(P=0.003) for patients treated in psychosocial intervention plusantipsychotic than antipsychotic only. Psychosocial intervention plusantipsychotic increased Physical Functioning, Role-Physical, Role-Emotionand Mental Health in SF-36 significantly better than antipsychotic only.Reported Health Transition in SF-36 improved significantly better in group ofPsychosocial intervention plus antipsychotic.Every dimensional scores fromFBS had significant reductions in patients treated in psychosocialintervention plus antipsychotic than antipsychotic only. To analyse thecorrelation between the frequency of psychosocial intervention and thechange values in every scales,only the change value in Montgomery-AsbergDepression Scale was relative with the frequency of psychosocialintervention R=0.348(moderate correlation).To analyse the correlationbetween different frequency of psychosocial intervention with the changevalues in every scales(LSD),we found that patients who had attendedpsychosocial intervention for 6 sessions had a significantly better reductionvalue in Montgomery-Asberg Depression Scale (P=0.046) than patients whohad attended psychosocial intervention for 2 sessions, that patients who hadattended psychosocial intervention for 4, 5, 6 sessions had a significantlybetter increment values in Insight and Treatment Attitude Questionnairethan patients who had attended psychosocial intervention for 3 sessions (Pvalues were 0.006, 0.016, 0.006 respectively).Conclusion: 1) Psychosocial intervention can better improve psychosissymptoms, depression symptoms, global functions and the insight to disease;better enhance patients' social functions,so they have better socialadaption; improve the quality of patient's life;better alleviate the familyburdens.2)There is positive correlation between the frequency ofpsychosocial intervention with the reduction values of depression symptomand family burden. 3) Our manual is effective and feasible,and it is worthyof generalization.