State of the art in the treatment of schizophrenia and law on personnel equipment in psychiatric hospitals (German Psych-PV); possibilities and limitations

Background: Comprehensive insight regarding better treatment and social rei ntegration of patients with schizophrenia has been gained over the past dec ade. Implementation of this knowledge into everyday's practice should be a major aim prior to the research on new variants of rehabilitative measures. To which extent this takes place has been poorly discussed until now. Meth od: Our comprehensive treatment program includes psychoeducation for patien ts and relatives, cognitive training, social skills training, additional ps ychoeducation for patients with dual diagnosis and a variety of traditional group therapies like work therapy. An intensive cooperation is practised w ith complementary psyche-social services. In n=89 consecutive admissions la sting at least 2 weeks we examined which patients were reached by these tre atment offers. Results: 84 %; of the patients participated in group therapi es, where they passed 6.9 hours weekly on average. Most patients were reach ed by occupation therapy (62 %), followed by physical therapy (54 %), unspe cific conversation group (54%), psychoeducation (35%), cognitive training ( 30%), work therapy (26%) and social skills training (7%). The PANSS Positiv e Scale at admission was negatively correlated with participation in group therapies. Discussion: The implementation of a variety of psychotherapeutic offers for psychotic patients adequate to the state of the art can be achi eved under conditions of standard hospital care in Germany (Psych-PV-law). Required organisational measures therefore are programs offered for patient s of several wards in union and participation of employees in education. Ho wever, even by such efforts a considerable part of patients is not reached. Strategies to improve treatment results should consider these problems.