 |
|
A Program for Relapse Prevention in Schizophrenia
A Controlled Study
Marvin I. Herz, MD;
J. Steven Lamberti, MD;
Jim Mintz, PhD;
Ruth Scott, MS, RN, CS;
Susan P. O'Dell, MS, RN, CS;
Lisa McCartan, MA;
Glen Nix, PhD
Arch Gen Psychiatry. 2000;57:277-283.
Background This study examined whether a program for relapse prevention (PRP) is more effective than treatment as usual (TAU) in reducing relapse and rehospitalization rates among outpatients with schizophrenia.
Methods Eighty-two outpatients with DSM-III-R schizophrenia or schizoaffective disorder were randomly assigned to receive either PRP (experimental group, n = 41) or TAU (control group, n = 41) and were followed up for an 18-month prospective controlled study. Patients in both groups were prescribed standard doses of maintenance antipsychotic medication. Treatment with PRP consisted of a combination of psychoeducation, active monitoring for prodromal symptoms with clinical intervention when such symptoms occurred, weekly group therapy for patients, and multifamily groups. The TAU consisted of biweekly individual supportive therapy and medication management.
Results Outcome rates over 18 months were 17% for relapse (7 patients) and 22% for rehospitalization (9 patients) in the PRP group, compared with 34% for relapse (14 patients) and 39% for rehospitalization (16 patients) in the TAU group (P = .01 and P = .03, respectively). Addition of age, sex, baseline Global Assessment Scale score, Positive and Negative Syndrome Scale scores (3 measures), and substance abuse to the proportional hazards regression models all yielded nonsignificant effects. The PRP teams were much more likely than the TAU psychiatrists to identify prodromal episodes before patients met objective relapse criteria or needed hospitalization.
Conclusions The PRP was effective in detecting prodromal symptoms of relapse early in an episode. Crisis intervention including increased antipsychotic medication use during the prodromal phase reduced relapse and rehospitalization rates.
From the Departments of Psychiatry, University of Rochester Medical Center, Rochester, NY (Drs Herz, Lamberti and Nix and Mss Scott, O'Dell, and McCartan), and University of California, Los Angeles (Dr Mintz).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Science and Recovery in Schizophrenia
Lieberman et al.
Psychiatr. Serv. 2008;59:487-496.
ABSTRACT
| FULL TEXT
Efficacy of Psychological Therapy in Schizophrenia: Conclusions From Meta-analyses
Pfammatter et al.
Schizophr Bull 2006;32:S64-S80.
ABSTRACT
| FULL TEXT
Psychoeducation to Increase Psychotherapy Entry for Older African Americans
Alvidrez et al.
AJGP 2005;13:554-561.
ABSTRACT
| FULL TEXT
Relapse in schizophrenia: costs, clinical outcomes and quality of life
ALMOND et al.
Br. J. Psychiatry 2004;184:346-351.
ABSTRACT
| FULL TEXT
Illness Management and Recovery: A Review of the Research
Mueser et al.
Focus 2004;2:34-47.
ABSTRACT
| FULL TEXT
The early warning symptom intervention for patients with bipolar affective disorder
Morriss
Adv. Psychiatr. Treat. 2004;10:18-26.
ABSTRACT
| FULL TEXT
Interventions Reduce Risk Of Schizophrenia Relapse
Moran
Psychiatr. News 2003;38:16-16.
FULL TEXT
Illness Management and Recovery: A Review of the Research
Mueser et al.
Psychiatr. Serv. 2002;53:1272-1284.
ABSTRACT
| FULL TEXT
A 23-Year-Old Man With Schizophrenia
Goff
JAMA 2002;287:3249-3257.
FULL TEXT
A Comparison of Risperidone and Haloperidol for the Prevention of Relapse in Patients with Schizophrenia
Csernansky et al.
NEJM 2002;346:16-22.
ABSTRACT
| FULL TEXT
Requirements for Multidisciplinary Teamwork in Psychiatric Rehabilitation
Liberman et al.
Psychiatr. Serv. 2001;52:1331-1342.
ABSTRACT
| FULL TEXT
A programme for relapse prevention was effective for patients with schizophrenia or schizoaffective disorder
Bradshaw
Evid. Based Ment. Health 2000;3:110-110.
FULL TEXT
|
