J Korean Neuropsychiatr Assoc.  2009 Nov;48(6):411-422.

The History and Achievement of Psychosocial Treatment for Patients with Schizophrenia

Affiliations
  • 1Department of Psychiatry, ChookRyoung Evangelical Hospital, Namyangju, Korea. abraxas2@hanmail.net
  • 2Department of Psychiatry, St. Andrew's Neuropsychiatry Hospital, Icheon, Korea.

Abstract


OBJECTIVES
Psychosocial treatment combined with pharmacological treatment has been established as one of the most important interventions for schizophrenia. However, it still does not show Editor's note: I was not certain whether you intended the highlighted text to convey "psychosocial treatment + pharmacological treatment is an important treatment" or "psychosocial treatment is an important treatment, and pharmacological treatment is also an important treatment." My edit reflects the former. If you actually intended the latter meaning, please change this sentence to read, "Psychosocial treatment has been established alongside pharmacological treatment as one of the most important interventions for schizophrenia." satisfactory results with regard to patients' social adjustment and independent living abilities. For this study, we reviewed the psychosocial treatment of schizophrenia: its therapeutic concepts, methods, effects of clinical application, and therapeutic limitations.
METHODS
We searched four areas of the English website Pubmed: family therapy, social skills training, cognitive remediation, and vocational rehabilitation, which are the main psychosocial treatment areas for schizophrenia.
RESULTS
Family therapy can reduce the relapse rate through psychoeducation, stress management, and behavioral intervention for family members when the therapy lasts longer than 9 months. This effect seems to last longer than 2 years. Social skills training allows patients to acquire specific skills but shows a relatively small effect on symptom improvement and relapse prevention. However, it is possible that social skills training has a lasting or generalized effect on the obtained skills if practiced long term (longer than 1 year). Basic neurocognitive function training shows a relatively small effect on social functioning, while additive and comprehensive social interventions, such as social cognition, social skill training, and context appraisal show a moderate effect on patients' social functioning. The success of vocational adjustment is related to premorbid functioning, negative symptoms, and cognitive functioning, and direct expert support can help patients' vocational functioning in the workplace.
CONCLUSION
The psychosocial treatment of schizophrenia has many important achievements during the past 30 years. However, several limitations of each type of psychosocial therapy have been ascertained during this same period. Researchers in the field of psychosocial treatment for schizophrenia have recently been trying to find more efficient treatments, by correcting distortions of social cognition, combining various treatment modules, and attempting new therapeutic approaches to psychosocial treatment.

Keyword

Schizophrenia; Psychosocial treatment; Family therapy; Social skill training; Cognitive remediation; Vocational rehabilitation

MeSH Terms

Achievement
Cognition
Family Therapy
Humans
Independent Living
Recurrence
Rehabilitation, Vocational
Schizophrenia
Social Adjustment
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