Social disability in schizophrenia: Its development and prediction over 15 years in incidence cohorts in six European centres

Wiersma, Durk; Wanderling, Joseph; Dragomirecká, Eva; Ganev, Kaloyan; Harrison, Glynn; Heiden, W. van der; Nienhuis, Fokko; Walsh, Dermot

doi:10.1016/s0920-9964(00)90721-7

Cited by 31 publications

(34 citation statements)

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“…This may take the form of increasing medication dose or psychological intervention. If successful, an intervention which reduces the number of relapses would also be an important development since there is evidence that a reduction in the number of psychotic episodes is associated with better outcomes and reduced distress to the service user and their carer [ 2 , 3 , 25 , 26 ]. There would also be the advantage of reduced treatment costs arising from reduced inpatient admissions because of a relapse.…”

Section: Discussionmentioning

confidence: 99%

Models to predict relapse in psychosis: A systematic review

et al. 2017

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BackgroundThere is little evidence on the accuracy of psychosis relapse prediction models. Our objective was to undertake a systematic review of relapse prediction models in psychosis.MethodWe conducted a literature search including studies that developed and/or validated psychosis relapse prediction models, with or without external model validation. Models had to target people with psychosis and predict relapse. The key databases searched were; Embase, Medline, Medline In-Process Citations & Daily Update, PsychINFO, BIOSIS Citation Index, CINAHL, and Science Citation Index, from inception to September 2016. Prediction modelling studies were assessed for risk of bias and applicability using the PROBAST tool.ResultsThere were two eligible studies, which included 33,088 participants. One developed a model using prodromal symptoms and illness-related variables, which explained 14% of relapse variance but was at high risk of bias. The second developed a model using administrative data which was moderately discriminative (C = 0.631) and associated with relapse (OR 1.11 95% CI 1.10, 1.12) and achieved moderately discriminative capacity when validated (C = 0.630). The risk of bias was low.ConclusionsDue to a lack of high quality evidence it is not possible to make any specific recommendations about the predictors that should be included in a prognostic model for relapse. For instance, it is unclear whether prodromal symptoms are useful for predicting relapse. The use of routine data to develop prediction models may be a more promising approach, although we could not empirically compare the two included studies.

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Section: Discussionmentioning

confidence: 99%

Models to predict relapse in psychosis: A systematic review

et al. 2017

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“…Deficits in the performance of these critical real-world functioning activities are present in many neuropsychiatric conditions but are particularly common in schizophrenia. 2 Disability in schizophrenia occurs even following successful treatment of the clinical symptoms of the illness. 3 This disability sets in immediately after the first episode 3 and persists into late life.…”

Section: Introductionmentioning

confidence: 99%

Social Disinterest Attitudes and Group Cognitive-Behavioral Social Skills Training for Functional Disability in Schizophrenia

Granholm

Ben‐Zeev

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2009

Schizophrenia Bulletin

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The majority of clinical trials of cognitive-behavioral therapy (CBT) for schizophrenia have used individual therapy to target positive symptoms. Promising results have been found, however, for group CBT interventions and other treatment targets like psychosocial functioning. CBT for functioning in schizophrenia is based on a cognitive model of functional outcome in schizophrenia that incorporates dysfunctional attitudes (eg, social disinterest, defeatist performance beliefs) as mediators between neurocognitive impairment and functional outcome. In this report, 18 clinical trials of CBT for schizophrenia that included measures of psychosocial functioning were reviewed, and two-thirds showed improvements in functioning in CBT. The cognitive model of functional outcome was also tested by examining the relationship between social disinterest attitudes and functional outcome in 79 people with schizophrenia randomized to either group cognitive-behavioral social skills training or a goal-focused supportive contact intervention. Consistent with the cognitive model, lower social disinterest attitudes at baseline and greater reduction in social disinterest during group therapy predicted better functional outcome at end of treatment for both groups. However, the groups did not differ significantly with regard to overall change in social disinterest attitudes during treatment, suggesting that nonspecific social interactions during group therapy can lead to changes in social disinterest, regardless of whether these attitudes are directly targeted by cognitive therapy interventions.

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“…There are few unselected, population-based studies about outcome and course of illness in schizophrenia [6,10,23,25,49,51,52] and, as far as we are aware, only two from a birth cohort setting [24,34]. We studied subjects with DSM-III-R schizophrenia from the population-based Northern Finland 1966 Birth Cohort that generated these reports [24,34].…”

Section: Introductionmentioning

confidence: 99%