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Towards an improved access to psychiatric rehabilitation: availability and effectiveness at 1-year follow-up of psychoeducation, cognitive remediation therapy, cognitive behaviour therapy and social skills training in the FondaMental Advanced Centers of Expertise-Schizophrenia (FACE-SZ) national cohort
- Source :
- European Archives of Psychiatry and Clinical Neuroscience, European Archives of Psychiatry and Clinical Neuroscience, 2019, 269 (5), pp.599-610. ⟨10.1007/s00406-019-01001-4⟩, European Archives of Psychiatry and Clinical Neuroscience, Springer Verlag, 2019, 269 (5), pp.599-610. ⟨10.1007/s00406-019-01001-4⟩
- Publication Year :
- 2018
-
Abstract
- International audience; Psychosocial Interventions (PIs) have shown positive effects on clinical and functional outcomes of schizophrenia (SZ) in randomized controlled trials. However their effectiveness and accessibility remain unclear to date in “real world” schizophrenia. The objectives of the present study were (i) to assess the proportion of SZ outpatients who benefited from PIs between 2010 and 2015 in France after an Expert Center Intervention in a national multicentric non-selected community-dwelling sample; (ii) to assess PIs’ effectiveness at 1-year follow-up. 183 SZ outpatients were recruited from FondaMental Advanced Centers of Expertise for Schizophrenia cohort. Baseline and 1-year evaluations included sociodemographic data, current treatments, illness characteristics and standardized scales for clinical severity, adherence to treatment, quality of life, a large cognitive battery, and daily functioning assessment. Only 7 (3.8%) received a PI before the evaluation, and 64 (35%) have received at least one PI during the 1-year follow-up. Having had at least one PI during the follow-up has been associated in multivariate analyses with significantly higher improvement in positive and negative symptoms (respectively p =0.031; p = 0.011), mental flexibility (TMT B, p = 0.029; C-VF, p = 0.02) and global functioning (p =0.042). CBT and SST were associated with higher cognitive improvements, while CRT was associated with clinical improvement. These results have not been demonstrated before and suggest that the effect of each PI is larger than its initial target. The present study has confirmed the PIs’ effectiveness in a large sample of community-dwelling SZ outpatients at 1 year follow-up. Efforts to improve access to PI should be reinforced in public health policies.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
education.educational_degree
Psychological intervention
Psychiatric rehabilitation
Effectiveness
Health Services Accessibility
law.invention
Social Skills
03 medical and health sciences
Young Adult
0302 clinical medicine
Quality of life
Randomized controlled trial
Patient Education as Topic
law
Outpatients
Psychoeducation
Medicine
Humans
Pharmacology (medical)
Functioning
education
Biological Psychiatry
Cognitive Behavioral Therapy
business.industry
Rehabilitation
General Medicine
Middle Aged
Cognitive Remediation
3. Good health
030227 psychiatry
Psychiatry and Mental health
Cognitive remediation therapy
[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health
Cohort
Physical therapy
Quality of Life
Schizophrenia
Female
Schizophrenic Psychology
business
Psychosocial interventions
Psychosocial
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 14338491 and 09401334
- Volume :
- 269
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- European archives of psychiatry and clinical neuroscience
- Accession number :
- edsair.doi.dedup.....4bc05e20328eaa05e434f1f2cf2a2450