3-YEAR TRIALS OF PERSONAL THERAPY AMONG SCHIZOPHRENIC-PATIENTS LIVINGWITH OR INDEPENDENT OF FAMILY .1. DESCRIPTION OF STUDY AND EFFECTS ONRELAPSE RATES

Citation
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
Citations number
51
Categorie Soggetti
Psychiatry,Psychiatry
ISSN journal
0002953X
Volume
154
Issue
11
Year of publication
1997
Pages
1504 - 1513
Database
ISI
SICI code
0002-953X(1997)154:11<1504:3TOPTA>2.0.ZU;2-E
Abstract
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.