Background The established mental health care system does not have the resources to meet the extensive need for care of those with anxiety and depressive disorders. Paraprofessionals partially replacing professionals may be cost-effective. Objectives To investigate the effectiveness of any kind of psychological treatment for anxiety and depressive disorders performed by paraprofessionals. To examine whether the results apply to clinically significant disorders. Search methods CCDANCTR-Studies, EMBASE (ExerptaMedica), MEDLINE, PsycINFO, all years published using the key words: para-/paraprofessional, non-/nonprofessional, rand*, psy*; peer; volunt*; citation lists of articles reviewing the subject and included studies; correspondence with authors of controlled studies, and review reports on the subject. Selection criteria Randomised controlled trials that used symptom measures, and compared the effects of treatments given by paraprofessionals (paid or voluntary, unqualified with respect to the psychological treatment) with treatments given by professionals, and with waiting list or placebo condition. Data collection and analysis The standard mean difference was used to pool continuous data, and odds ratios were used to pool dichotomous data, using a random effects model. The generic inverse variance method was used for combining continuous and dichotomous data. The effect of low quality studies and the use of self-rated versus observer-rated measures were tested. Subgroup analyses were performed for differences between depression and anxiety diagnosis, paraprofessionals with/without professional background, group/individual intervention, length of follow-up and gender (post-hoc subgroup analysis).
Impaired social functioning is one of the diagnostic features of schizophrenia. Cognitive functioning is also often impaired in several domains. Meta-analysis has shown a predictive value of cognition for a variety of domains related to social functioning (Green, Kern, Braff, & Mintz, 2000). The significance of these findings for clinical practice has remained largely uninvestigated, however, and is therefore taken up here. We investigated verbal memory, attention and executive functioning in 52 schizophrenia patients. Social functioning was assessed for different types of social roles. The percentages of cognitive and social impairments in our group were assessed according to clinical principles, normally used to judge an individual patient. A possible predictive relationship between cognition and social functioning was studied on the basis of these clinical criteria. A large proportion of patients showed impairments in both cognitive functioning and social functioning. However, the clinical method resulted in a successful prediction of social functioning in only 21-69% of the cases. Social functioning and cognitive functioning were impaired in a large proportion of patients, but were largely independent from each other. Since relationships between cognition and social functioning are weak, assessment procedures are inconsistent and possibly not optimally adjusted to the psychiatric population, the clinical relevance of cognitive testing in order to predict social functioning is as yet questionable.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.