Document Detail


Two-year outcome of social skills training and group psychotherapy for outpatients with schizophrenia.
MedLine Citation:
PMID:  8942455     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The authors evaluated the effectiveness of behaviorally oriented social skills training and supportive group therapy for improving the social adjustment of schizophrenic patients living in the community and for protecting them against psychotic relapse. METHOD: Eighty male outpatients with schizophrenia were stabilized with a low dose of fluphenazine decanoate (5 to 10 mg every 14 days), which was supplemented with oral fluphenazine (5 mg twice daily) or a placebo when they first met criteria for a prodromal period. (Half of the patients did so at some time during the study.) Patients were randomly assigned to receive either social skills training or supportive group therapy twice weekly for 6 months and then weekly for the next 18 months. Rates of psychotic exacerbation were monitored, as were scores on the Social Adjustment Scale II. RESULTS: There were significant main effects favoring social skills training over supportive group therapy on two of the six Social Adjustment Scale II cluster totals examined (personal well-being and total) and significant interactions between psychosocial treatment and drug treatment for three items (external family, social and leisure activities, and total). In each case, these interactions indicated that the advantage of social skills training over supportive group therapy was greatest when it was combined with active drug supplementation. Social skills training did not significantly decrease the risk of psychotic exacerbation in the full group, but an advantage was observed (post hoc) among patients who received placebo supplementation. CONCLUSIONS: These findings suggest that social skills training resulted in greater improvement in certain measures of social adjustment than supportive group therapy. The greatest improvement in social outcomes occurred when social skills training was combined with a pharmacological strategy of active drug supplementation at the time prodromal worsening of psychotic symptoms was first observed. However, these improvements were modest in absolute terms and confined to certain subgroups of patients.
Authors:
S R Marder; W C Wirshing; J Mintz; J McKenzie; K Johnston; T A Eckman; M Lebell; K Zimmerman; R P Liberman
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of psychiatry     Volume:  153     ISSN:  0002-953X     ISO Abbreviation:  Am J Psychiatry     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-01-08     Completed Date:  1997-01-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370512     Medline TA:  Am J Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1585-92     Citation Subset:  AIM; IM    
Affiliation:
West Los Angeles VA Medical Center, CA 90073, USA. marder@ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Age of Onset
Ambulatory Care*
Behavior Therapy*
Combined Modality Therapy
Fluphenazine / analogs & derivatives,  therapeutic use
Humans
Male
Psychiatric Status Rating Scales
Psychotherapy, Group*
Reinforcement, Social
Role Playing
Schizophrenia / diagnosis,  drug therapy,  therapy*
Social Adjustment
Social Support
Treatment Outcome
Grant Support
ID/Acronym/Agency:
MH-41573/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
5002-47-1/fluphenazine depot; 69-23-8/Fluphenazine

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


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