Efficacy of Community Treatments for Schizophrenia and Other Psychotic Disorders: A Literature Review

Abstract

Background: In Chile, the clinical guidelines “for the treatment of people from first episode of schizophrenia” aim to support individuals with schizophrenia to live independently, establishment occupational goals, and gain an adequate quality of life and social interaction. This requires the implementation of a treatment model that integrates psychosocial and pharmacological dimensions. Community intervention strategies ensure the achievement of these goals.Objectives: This study compiles and synthesizes available scientific evidence from the last 14 years on the effectiveness of community intervention strategies for schizophrenia and related psychotic disorders.Methodology: An electronic search was carried out using PUBMED, LILACS, and Science Direct as databases.Criteria of inclusion: (i) randomized clinical trials, (ii) Community-based interventions, (iii) diagnosis of schizophrenia or related psychotic disorder (section F2 of ICD-10). Exclusion Criteria: (i) treatments exclusively pharmacological, (ii) interventions carried out in inpatient settings, (iii) bipolar affective disorder or substance-induced psychosis (greater than 50% of sample).Results: Sixty-six articles were reviewed. Community strategies for integrated treatment from the first outbreak of schizophrenia significantly reduced negative and psychotic symptoms, days of hospitalization, and comorbidity with substance abuse and improved global functioning and adherence to treatment. In other stages, there were improved outcomes in negative and positive symptoms and general psychopathology. Psychoeducation for patients and families reduced the levels of self-stigma and domestic abuse, as well as improved knowledge of the disease and treatment adherence. Training focused on cognitive, social, and labor skills has been shown to improve yields in social functioning and employment status.Conclusion: Community-based intervention strategies are widely supported in the treatment of patients with schizophrenia.

Genetic and clinical features of social cognition in 22q11.2 deletion syndrome

“…Social knowledge, or social schema, represents the awareness of roles, rules, and goals that characterize social situations and guide social interactions (Green et al, 2008). It is the basis of an acceptable social expertise and it is among the targets for some social training programs for schizophrenia (Armijo et al, 2013;Granholm, Holden, Link, & McQuaid, 2014).…”

Social functioning and the quality of life of patients diagnosed with schizophrenia

“…Psychoeducation of patients and their families reduces the level of auto-stigmatization; similarly, an increased patient knowledge concerning the disease and treatment. Local trainings of social skills significantly improve the social functioning of patients [12]. J. S. Kwon and Jung-Soek Choi wrote about social functioning and the quality of life in the context of the measure of effectiveness in schizophrenia treatment.…”

“…At present in South Korea, clinical studies are being undertaken in order to evaluate an improvement in the social functioning of patients diagnosed with schizophrenia or schizoaffective disorder [14]. The Korean researchers draw attention to the fact that a scale for the evaluation of social functioning and QOL in clinical studies should be characterized by multidimensionality, reliable selection into a given population, and diagnosis made by clinicians, as well as capability for the examination of indistinguishable changes taking place during the course of the disease [12]. It should be added that the sense of social isolation, solitude, and the lack of interpersonal bonds which often occur among individuals suffering from schizophrenia, considerably decrease their satisfaction and quality of daily life.…”

Social Impairment and Mental Health

“…The objective is not to stigmatize the absence of social skills [65], but to recognize that human beings are the product of some social relations and his ability to manage himself and his ties with activities that give recognition [3]. Some treatments such as assertive community treatment and peer support have been developed to improve these impairments on social network for patients with severe mental illnesses [66][67][68][69]. The future is to develop new pharmacological and non-pharmacological treatments and consider as a main issue of concern all the social impairments on our clinical approach with patients with mental illness.…”