Evidence-based psychosocial interventions in schizophrenia: a critical review.


Journal

Current opinion in psychiatry
ISSN: 1473-6578
Titre abrégé: Curr Opin Psychiatry
Pays: United States
ID NLM: 8809880

Informations de publication

Date de publication:
15 Feb 2024
Historique:
medline: 27 2 2024
pubmed: 27 2 2024
entrez: 27 2 2024
Statut: aheadofprint

Résumé

Schizophrenia Spectrum Disorders (SSD) are severe conditions that frequently produce significant impairment in cognitive performance, social skills and psychosocial functioning. As pharmacological treatment alone often provides only limited improvements on these outcomes, several psychosocial interventions are employed in psychiatric rehabilitation practice to improve of real-world outcomes of people living with SSD: the present review aims to provide a critical overview of these treatments, focusing on those that show consistent evidence of effectiveness. Several recent systematic reviews and meta-analyses have investigated in detail the acceptability, the effectiveness on several specific outcomes and moderators of response of different psychosocial interventions, and several individual studies have provided novel insight on their implementation and combination in rehabilitation practice. Cognitive remediation, metacognitive training, social skills training, psychoeducation, family interventions, cognitive behavioral therapy, physical exercise and lifestyle interventions, supported employment and some other interventions can be fully considered as evidence-based treatments in SSD. Psychosocial interventions could be of particular usefulness in the context of early intervention services. Future research should focus on developing newer interventions, on better understanding the barriers and the facilitators of their implementation in clinical practice, and exploring the opportunities provided by novel technologies.

Identifiants

pubmed: 38410981
doi: 10.1097/YCO.0000000000000925
pii: 00001504-990000000-00106
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

Références

Harvey PD, Bosia M, Cavallaro R, et al. Cognitive dysfunction in schizophrenia: an expert group paper on the current state of the art. Schizophr Res Cogn 2022; 29:100249.
McCutcheon RA, Keefe RSE, McGuire PK. Cognitive impairment in schizophrenia: aetiology, pathophysiology, and treatment. Mol Psychiatry 2023; 28:1902–1918.
Galderisi S, Rucci P, Mucci A, et al. The interplay among psychopathology, personal resources, context-related factors and real-life functioning in schizophrenia: stability in relationships after 4 years and differences in network structure between recovered and nonrecovered patients. World Psychiatry 2020; 19:81–91.
Harvey PD, Strassnig M. Predicting the severity of everyday functional disability in people with schizophrenia: cognitive deficits, functional capacity, symptoms, and health status. World Psychiatry 2012; 11:73–79.
Dong M, Lu L, Zhang L, et al. Quality of life in schizophrenia: a meta-analysis of comparative studies. Psychiatr Q 2019; 90:519–532.
Karow A, Wittmann L, Schöttle D, et al. The assessment of quality of life in clinical practice in patients with schizophrenia. Dialogues Clin Neurosci 2014; 16:185–195.
Barlati S, Morena D, Nibbio G, et al. Internalized stigma among people with schizophrenia: relationship with socio-demographic, clinical and medication-related features. Schizophrenia Res 2022; 243:364–371.
West ML, Yanos PT, Smith SM, et al. Prevalence of internalized stigma among persons with severe mental illness. Stigma Res Action 2011; 1:3–10.
Yanos PT, DeLuca JS, Roe D, Lysaker PH. The impact of illness identity on recovery from severe mental illness: a review of the evidence. Psychiatry Research 2020; 288: 112950.
Correll CU, Ismail Z, McIntyre RS, et al. Patient functioning, life engagement, and treatment goals in schizophrenia. J Clin Psychiatry 2022; 83:42345.
Vita A, Barlati S, Deste G, et al. Life engagement in people living with schizophrenia: predictors and correlates of patient life engagement in a large sample of people living in the community. Psychol Med 2023; 53:7943–7952.
Correll CU, Solmi M, Croatto G, et al. Mortality in people with schizophrenia: a systematic review and meta-analysis of relative risk and aggravating or attenuating factors. World Psychiatry 2022; 21:248–271.
Hjorthøj C, Stürup AE, McGrath JJ, Nordentoft M. Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis. Lancet Psychiatry 2017; 4:295–301.
Keepers GA, Fochtmann LJ, Anzia JM, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. AJP 2020; 177:868–872.
Leucht S, Schneider-Thoma J, Burschinski A, et al. Long-term efficacy of antipsychotic drugs in initially acutely ill adults with schizophrenia: systematic review and network meta-analysis. World Psychiatry 2023; 22:315–324.
Taipale H, Tanskanen A, Mehtälä J, et al. 20-year follow-up study of physical morbidity and mortality in relationship to antipsychotic treatment in a nationwide cohort of 62,250 patients with schizophrenia (FIN20). World Psychiatry 2020; 19:61–68.
Jääskeläinen E, Juola P, Hirvonen N, et al. A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull 2013; 39:1296–1306.
Maj M, van Os J, De Hert M, et al. The clinical characterization of the patient with primary psychosis aimed at personalization of management. World Psychiatry 2021; 20:4–33.
Vita A, Barlati S. Recovery from schizophrenia: is it possible? Curr Opin Psychiatry 2018; 31:246–255.
McDonagh MS, Dana T, Kopelovich SL, et al. Psychosocial interventions for adults with schizophrenia: an overview and update of systematic reviews. Psychiatr Serv 2022; 73:299–312.
Solmi M, Croatto G, Piva G, et al. Efficacy and acceptability of psychosocial interventions in schizophrenia: systematic overview and quality appraisal of the meta-analytic evidence. Mol Psychiatry 2022; 28:1–15.
Galderisi S, Kaiser S, Bitter I, et al. EPA guidance on treatment of negative symptoms in schizophrenia. Eur Psychiatry 2021; 64:e21.
Galletly C, Castle D, Dark F, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust N Z J Psychiatry 2016; 50:410–472.
Norman R, Lecomte T, Addington D, Anderson E. Canadian treatment guidelines on psychosocial treatment of schizophrenia in adults. Can J Psychiatry 2017; 62:617–623.
Vita A, Gaebel W, Mucci A, et al. European Psychiatric Association guidance on treatment of cognitive impairment in schizophrenia. Eur Psychiatry 2022; 65:e57.
Bowie CR, Bell MD, Fiszdon JM, et al. Cognitive remediation for schizophrenia: an expert working group white paper on core techniques. Schizophr Res 2020; 215:49–53.
Wykes T, Huddy V, Cellard C, et al. A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. AJP 2011; 168:472–485.
Vita A, Barlati S, Ceraso A, et al. Effectiveness, core elements, and moderators of response of cognitive remediation for schizophrenia: a systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry 2021; 78:848–858.
Lejeune JA, Northrop A, Kurtz MM. A meta-analysis of cognitive remediation for schizophrenia: efficacy and the role of participant and treatment factors. Schizophr Bull 2021; 47:997–1006.
Yeo H, Yoon S, Lee J, et al. A meta-analysis of the effects of social-cognitive training in schizophrenia: the role of treatment characteristics and study quality. Br J Clin Psychol 2022; 61:37–57.
Vita A, Barlati S, Ceraso A, et al. Acceptability of cognitive remediation for schizophrenia: a systematic review and meta-analysis of randomized controlled trials. Psychol Med 2023; 53:3661–3671.
Vita A, Kakli M, Barlati S, et al. Implementation of cognitive rehabilitation interventions for schizophrenia in low-income countries: an experience from Togo and Benin. Int J Soc Psychiatry 2023; 00207640231181526.
Cella M, Preti A, Edwards C, et al. Cognitive remediation for negative symptoms of schizophrenia: a network meta-analysis. Clin Psychol Rev 2017; 52:43–51.
Moritz S, Andreou C, Schneider BC, et al. Sowing the seeds of doubt: a narrative review on metacognitive training in schizophrenia. Clin Psychol Rev 2014; 34:358–366.
Penney D, Sauvé G, Mendelson D, et al. Immediate and sustained outcomes and moderators associated with metacognitive training for psychosis: a systematic review and meta-analysis. JAMA Psychiatry 2022; 79:417–429.
Lopez-Morinigo J-D, Ajnakina O, Martínez AS-E, et al. Can metacognitive interventions improve insight in schizophrenia spectrum disorders? A systematic review and meta-analysis. Psychol Med 2020; 50:2289–2301.
Turner DT, McGlanaghy E, Cuijpers P, et al. A meta-analysis of social skills training and related interventions for psychosis. Schizophr Bull 2018; 44:475–491.
Almerie MQ, Marhi MOA, Jawoosh M, et al. Social skills programmes for schizophrenia. Cochrane Database Syst Rev 2015; CD009006.
Kurtz MM, Mueser KT. A meta-analysis of controlled research on social skills training for schizophrenia. J Consult Clin Psychol 2008; 76:491–504. https://doi.org/10.1037/0022-006X.76.3.491
doi: 10.1037/0022-006X.76.3.491
Dubreucq J, Ycart B, Gabayet F, et al. FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) group Towards an improved access to psychiatric rehabilitation: availability and effectiveness at 1-year follow-up of psychoeducation, cognitive remediation therapy, cognitive behaviour therapy and social skills training in the FondaMental Advanced Centers of Expertise-Schizophrenia (FACE-SZ) national cohort. Eur Arch Psychiatry Clin Neurosci 2019; 269:599–610.
Rajji TK, Mamo DC, Holden J, et al. Cognitive-behavioral social skills training for patients with late-life schizophrenia and the moderating effect of executive dysfunction. Schizophr Res 2022; 239:160–167.
Granholm E, Twamley EW, Mahmood Z, et al. Integrated cognitive-behavioral social skills training and compensatory cognitive training for negative symptoms of psychosis: effects in a pilot randomized controlled trial. Schizophr Bull 2022; 48:359–370.
Lu EY, Cheng ASK, Tsang HWH, et al. Psychoeducation, motivational interviewing, cognitive remediation training, and/or social skills training in combination for psychosocial functioning of patients with schizophrenia spectrum disorders: a systematic review and meta-analysis of randomized controlled trials. Front Psychiatry 2022; 13: 899840.
Nibbio G, Barlati S, Cacciani P, et al. Evidence-based integrated intervention in patients with schizophrenia: a pilot study of feasibility and effectiveness in a real-world rehabilitation setting. Int J Environ Res Public Health 2020; 17:3352.
Xia J, Merinder LB, Belgamwar MR. Psychoeducation for schizophrenia. Cochrane Database Syst Rev 2011; CD002831.
Zhao S, Sampson S, Xia J, Jayaram MB. Psychoeducation (brief) for people with serious mental illness. Cochrane Database Syst Rev 2015; CD010823.
Bighelli I, Rodolico A, García-Mieres H, et al. Psychosocial and psychological interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis. Lancet Psychiatry 2021; 8:969–980.
Herrera SN, Sarac C, Phili A, et al. Psychoeducation for individuals at clinical high risk for psychosis: a scoping review. Schizophr Res 2023; 252:148–158.
Ma CF, Chan SKW, Chung YL, et al. The predictive power of expressed emotion and its components in relapse of schizophrenia: a meta-analysis and meta-regression. Psychol Med 2021; 51:365–375.
Wuerker AK. The Family and Schizophrenia. Issues Ment Health Nurs 2000; 21:127–141.
McFarlane WR, Dixon L, Lukens E, Lucksted A. Family psychoeducation and schizophrenia: a review of the literature. J Marital Fam Ther 2003; 29:223–245.
Rodolico A, Bighelli I, Avanzato C, et al. Family interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis. Lancet Psychiatry 2022; 9:211–221.
Kim S-H, Park S. Effectiveness of family interventions for patients with schizophrenia: a systematic review and meta-analysis. Int J Ment Health Nurs 2023; 32:1598–1615.
Bighelli I, Salanti G, Huhn M, et al. Psychological interventions to reduce positive symptoms in schizophrenia: systematic review and network meta-analysis. World Psychiatry 2018; 17:316–329.
Bighelli I, Huhn M, Schneider-Thoma J, et al. Response rates in patients with schizophrenia and positive symptoms receiving cognitive behavioural therapy: a systematic review and single-group meta-analysis. BMC Psychiatry 2018; 18:1–10.
Berendsen S, Berendse S, van der Torren J, et al. Cognitive behavioural therapy for the treatment of schizophrenia spectrum disorders: an umbrella review of meta-analyses of randomised controlled trials. eClinicalMedicine 2024; 67:102392.
Guaiana G, Abbatecola M, Aali G, et al. Cognitive behavioural therapy (group) for schizophrenia. Cochrane Database Syst Rev 2022; CD009608.
Zheng Y, Xu T, Zhu Y, et al. Cognitive behavioral therapy for prodromal stage of psychosis—outcomes for transition, functioning, distress, and quality of life: a systematic review and meta-analysis. Schizophr Bull 2022; 48:8–19.
Firth J, Cotter J, Elliott R, et al. A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychol Med 2015; 45:1343–1361.
Dauwan M, Begemann MJH, Heringa SM, et al. Exercise improves clinical symptoms, quality of life, global functioning, and depression in schizophrenia: a systematic review and meta-analysis. Schizophr Bull 2016; 42:588–599.
Fernández-Abascal B, Suárez-Pinilla P, Cobo-Corrales C, et al. In- and outpatient lifestyle interventions on diet and exercise and their effect on physical and psychological health: a systematic review and meta-analysis of randomised controlled trials in patients with schizophrenia spectrum disorders and first episode of psychosis. Neurosci Biobehav Rev 2021; 125:535–568.
Firth J, Stubbs B, Rosenbaum S, et al. Aerobic exercise improves cognitive functioning in people with schizophrenia: a systematic review and meta-analysis. Schizophr Bull 2017; 43:546–556.
Shimada T, Ito S, Makabe A, et al. Aerobic exercise and cognitive functioning in schizophrenia: an updated systematic review and meta-analysis. Psychiatry Res 2022; 314:114656.
Deste G, Corbo D, Nibbio G, et al. Impact of physical exercise alone or in combination with cognitive remediation on cognitive functions in people with schizophrenia: a qualitative critical review. Brain Sci 2023; 13:320.
Nuechterlein KH, McEwen SC, Ventura J, et al. Aerobic exercise enhances cognitive training effects in first-episode schizophrenia: randomized clinical trial demonstrates cognitive and functional gains. Psychol Med 2022; 53:1–11.
Korman N, Stanton R, Vecchio A, et al. The effect of exercise on global, social, daily living and occupational functioning in people living with schizophrenia: a systematic review and meta-analysis. Schizophr Res 2023; 256:98–111.
Carmona VR, Gómez-Benito J, Huedo-Medina TB, Rojo JE. Employment outcomes for people with schizophrenia spectrum disorder: a meta-analysis of randomized controlled trials. Int J Occup Med Environ Health 2017; 30:345–366.
de Winter L, Couwenbergh C, van Weeghel J, et al. Who benefits from individual placement and support? A meta-analysis. Epidemiol Psychiatric Sci 2022; 31:e50.
Sauvé G, Buck G, Lepage M, Corbière M. Minds@Work: a new manualized intervention to improve job tenure in psychosis based on scoping review and logic model. J Occup Rehabil 2022; 32:515–528.
Bond GR, Drake RE, Mueser KT, Latimer E. Assertive community treatment for people with severe mental illness. Dis-Manage-Health-Outcomes 2001; 9:141–159.
Munch Nielsen C, Hjorthøj C, Arnfred BT, Nordentoft M. Patient outcomes of flexible assertive community treatment compared with assertive community treatment. Psychiatr Serv 2023; 74:695–701.
Allott K, van-der-EL K, Bryce S, et al. Compensatory interventions for cognitive impairments in psychosis: a systematic review and meta-analysis. Schizophr Bull 2020; 46:869–883.
Lean M, Fornells-Ambrojo M, Milton A, et al. Self-management interventions for people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry 2019; 214:260–268.
Zou H, Li Z, Nolan MT, et al. Self-management education interventions for persons with schizophrenia: a meta-analysis. Int J Ment Health Nurs 2013; 22:256–271.
Wang W, Chau AKC, Kong P, et al. Efficacy of motivational interviewing in treating co-occurring psychosis and substance use disorder: a systematic review and meta-analysis. J Clin Psychiatry 2021; 83:13916.
Vanderwaal FM. Impact of motivational interviewing on medication adherence in schizophrenia. Issues Ment Health Nurs 2015; 36:900–904.
Khoury B, Lecomte T, Gaudiano BA, Paquin K. Mindfulness interventions for psychosis: a meta-analysis. Schizophr Res 2013; 150:176–184.
Hodann-Caudevilla RM, Díaz-Silveira C, Burgos-Julián FA, Santed MA. Mindfulness-based interventions for people with schizophrenia: a systematic review and meta-analysis. Int J Environ Res Public Health 2020; 17:4690.
Correll CU, Galling B, Pawar A, et al. Comparison of early intervention services vs treatment as usual for early-phase psychosis. JAMA Psychiatry 2018; 75:555–565.
Wright A, Browne J, Mueser KT, Cather C. Evidence-based psychosocial treatment for individuals with early psychosis. Child Adolesc Psychiatr Clin N Am 2020; 29:211–223.
Vita A, Barlati S. The implementation of evidence-based psychiatric rehabilitation: challenges and opportunities for mental health services. Front Psychiatry 2019; 10:147.
Burschinski A, Schneider-Thoma J, Chiocchia V, et al. Metabolic side effects in persons with schizophrenia during mid- to long-term treatment with antipsychotics: a network meta-analysis of randomized controlled trials. World Psychiatry 2023; 22:116–128.
Galderisi S, De Hert M, Del Prato S, et al. Identification and management of cardiometabolic risk in subjects with schizophrenia spectrum disorders: a Delphi expert consensus study. Eur Psychiatry 2021; 64:e7.
Higgins A, Murphy R, Downes C, et al. Factors impacting the implementation of a psychoeducation intervention within the mental health system: a multisite study using the consolidation framework for implementation research. BMC Health Serv Res 2020; 20:1023.
Drolet BC, Lorenzi NM. Translational research: understanding the continuum from bench to bedside. Transl Res 2011; 157:1–5.
Schroeder AH, Bogie BJM, Rahman TT, et al. Feasibility and efficacy of virtual reality interventions to improve psychosocial functioning in psychosis: systematic review. JMIR Ment Health 2022; 9:e28502.
Holopainen R, Tiihonen J, Lähteenvuo M. Efficacy of immersive extended reality (XR) interventions on different symptom domains of schizophrenia spectrum disorders. A systematic review. Front Psychiatry 2023; 14:1208287.
Tan B-L, Shi J, Yang S, et al. The use of virtual reality and augmented reality in psychosocial rehabilitation for adults with neurodevelopmental disorders: a systematic review. Front Psychiatry 2022; 13:1055204.
Arnold C, Farhall J, Villagonzalo K-A, et al. Engagement with online psychosocial interventions for psychosis: a review and synthesis of relevant factors. Internet Interv 2021; 25:100411.

Auteurs

Stefano Barlati (S)

Department of Clinical and Experimental Sciences, University of Brescia.
Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy.

Gabriele Nibbio (G)

Department of Clinical and Experimental Sciences, University of Brescia.

Antonio Vita (A)

Department of Clinical and Experimental Sciences, University of Brescia.
Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy.

Classifications MeSH