Effect of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia: A randomized, 1-year study.

Effect of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia: A randomized, 1-year study.

MedLine Citation:	PMID: 20819983 Owner: NLM Status: MEDLINE
Abstract/OtherAbstract:	CONTEXT: Antipsychotic drugs are limited in their ability to improve the overall outcome of schizophrenia. Adding psychosocial treatment may produce greater improvement in functional outcome than does medication treatment alone. OBJECTIVE: To evaluate the effectiveness of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia. DESIGN: Randomized controlled trial. SETTING: Ten clinical sites in China. PARTICIPANTS: Clinical sample of 1268 patients with early-stage schizophrenia treated from January 1, 2005, through October 31, 2007. Intervention Patients were randomly assigned to receive antipsychotic medication treatment only or antipsychotic medication plus 12 months of psychosocial intervention consisting of psychoeducation, family intervention, skills training, and cognitive behavior therapy administered during 48 group sessions. MAIN OUTCOME MEASURES: The rate of treatment discontinuation or change due to any cause, relapse or remission, and assessments of insight, treatment adherence, quality of life, and social functioning. RESULTS: The rates of treatment discontinuation or change due to any cause were 32.8% in the combined treatment group and 46.8% in the medication-alone group. Comparisons with medication treatment alone showed lower risk of any-cause discontinuation with combined treatment (hazard ratio, 0.62; 95% confidence interval, 0.52-0.74; P < .001) and lower risk of relapse with combined treatment (0.57; 0.44-0.74; P < .001). The combined treatment group exhibited greater improvement in insight (P < .001), social functioning (P = .002), activities of daily living (P < .001), and 4 domains of quality of life as measured by the Medical Outcomes Study 36-Item Short Form Health Survey (all P < or = .02). Furthermore, a significantly higher proportion of patients receiving combined treatment obtained employment or accessed education (P = .001). CONCLUSION: Compared with those receiving medication only, patients with early-stage schizophrenia receiving medication and psychosocial intervention have a lower rate of treatment discontinuation or change, a lower risk of relapse, and improved insight, quality of life, and social functioning. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00654576.

Authors:	Xiaofeng Guo; Jinguo Zhai; Zhening Liu; Maosheng Fang; Bo Wang; Chuanyue Wang; Bin Hu; Xueli Sun; Luxian Lv; Zheng Lu; Cui Ma; Xiaolin He; Tiansheng Guo; Shiping Xie; Renrong Wu; Zhimin Xue; Jindong Chen; Elizabeth W Twamley; Hua Jin; Jingping Zhao
Related Documents :	12503253 - Investigation of the potential of clozapine to cause torsade de pointes. 10492863 - Malignant catatonia-induced respiratory failure with response to ect. 17288683 - An analysis of which anti-osteoporosis therapeutic regimen would improve compliance in ...
Publication Detail:	Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
Journal Detail:	Title: Archives of general psychiatry Volume: 67 ISSN: 1538-3636 ISO Abbreviation: Arch. Gen. Psychiatry Publication Date: 2010 Sep
Date Detail:	Created Date: 2010-09-07 Completed Date: 2010-09-16 Revised Date: 2011-02-17
Medline Journal Info:	Nlm Unique ID: 0372435 Medline TA: Arch Gen Psychiatry Country: United States
Other Details:	Languages: eng Pagination: 895-904 Citation Subset: AIM; IM
Affiliation:	Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Data Bank Information
Bank Name/Acc. No.:	ClinicalTrials.gov/NCT00654576
Export Citation:	APA/MLA Format Download EndNote Download BibTex
MeSH Terms
Descriptor/Qualifier:	Activities of Daily Living Adult Antipsychotic Agents / therapeutic use* Attitude to Health Awareness China Cognitive Therapy / methods* Combined Modality Therapy Female Health Status Humans Longitudinal Studies Male Patient Education as Topic Quality of Life Recurrence Schizophrenia / drug therapy, therapy* Social Adjustment Treatment Outcome
Grant Support
ID/Acronym/Agency:	R01 MH080150-04/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:	0/Antipsychotic Agents
Comments/Corrections
Comment In:	Evid Based Ment Health. 2011 Feb;14(1):24 [PMID: 21266621 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document: Neonatal vitamin d status and risk of schizophrenia: a population-based case-control study.
Next Document: Impaired intellect and memory: a missing link between genetic risk and schizophrenia?