3-YEAR TRIALS OF PERSONAL THERAPY AMONG SCHIZOPHRENIC-PATIENTS LIVINGWITH OR INDEPENDENT OF FAMILY .1. DESCRIPTION OF STUDY AND EFFECTS ONRELAPSE RATES
Ge. Hogarty et al., 3-YEAR TRIALS OF PERSONAL THERAPY AMONG SCHIZOPHRENIC-PATIENTS LIVINGWITH OR INDEPENDENT OF FAMILY .1. DESCRIPTION OF STUDY AND EFFECTS ONRELAPSE RATES, The American journal of psychiatry, 154(11), 1997, pp. 1504-1513
Objective: The study of individual psychotherapeutic approaches to the
treatment of schizophrenia has yielded equivocal findings, partly bec
ause of methodologic problems. Further, the ability of psychosocial tr
eatments to prevent psychotic relapse appears to lessen over time. The
authors' goal was to develop and test a demonstrably effective indivi
dual therapy for schizophrenia. Method: Using a study design that addr
essed previous methodologic issues, the authors evaluated personal the
rapy specifically designed to forestall late relapse in patients with
schizophrenia. They evaluated the effectiveness of personal therapy ov
er a period of 3 years after hospital discharge among 151 patients wit
h schizophrenia of schizoaffective disorder diagnosed according to Res
earch Diagnostic Criteria. The patients were randomly assigned to rece
ive either personal therapy or contrasting therapies in one of two con
current trials. One trial studied patients who were living with family
(N=97); the other studied patients who were living independent of fam
ily (N=54). Results: All of the patients had extensive psychiatric his
tories, but only 44 (29%) experience recurrent psychotic episodes over
the 3-year study period, and only 27 (18%) prematurely terminated the
study; most of those who left the study were in the no-personal-thera
py conditions. Among patients living with family, personal therapy was
more effective than family and supportive therapies in preventing psy
chotic and affective relapse as well as noncompliance. However, among
patients living independent of family, those who received personal the
rapy had significantly more psychotic decompensations than did those w
ho received supportive therapy. Conclusions: Personal therapy had a po
sitive effect on adverse outcomes among patients who lived with family
. However, personal therapy increased the rate of psychotic relapse fo
r patients living independent of family. The application of personal t
herapy might best be delayed until patients have achieved symptom and
residential stability.