Luisa Fernanda Ahunca Velásquez1, Jenny García Valencia2, Adriana Patricia Bohórquez Peñaranda3, Carlos Gómez-Restrepo4, Luis Eduardo Jaramillo González5, Carlos Palacio Acosta6. 1. Médica Psiquiatra, subespecialista en Neuropsiquiatría. Estudiante de Maestría en Ciencias Clínicas, Facultad de Medicina, Universidad de Antioquia, Delegada Asociación Colombiana de Psiquiatría. 2. Médica Psiquiatra, Magíster y Doctora en Epidemiología. Profesora Titular del Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Electronic address: jenny.garcia@udea.edu.co. 3. Médica Psiquiatra, Magíster en Epidemiología Clínica. Profesora Asistente del Departamento de Psiquiatría y Salud Mental. Pontificia Universidad Javeriana. 4. Médico Psiquiatra, Psicoanalista, Psiquiatra de Enlace, Magíster en Epidemiología Clínica. Profesor Titular y Director del Departamento de Epidemiología Clínica y Bioestadística. Pontificia Universidad Javeriana. Hospital Universitario San Ignacio. 5. Médico Psiquiatra, Master en Farmacología. Profesor Universidad Nacional de Colombia. 6. Médico Psiquiatra, Magíster en Epidemiología. Profesor Titular del Departamento de Psiquiatría, Decano de la Facultad de Medicina, Universidad de Antioquia.
Abstract
OBJECTIVES: To determine the effectiveness of the psychosocial strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of the disorder. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia. METHODS: A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. RESULTS: The psychoeducation and family intervention showed higher efficacy, compared with the usual treatment, to prevent relapses and hospital readmissions, to reduce family burden and to improve adherence to treatment. The social skill training was effective to improve symptoms, social functioning and quality of life. However, the quality of evidence was low. There was not enough evidence about the efficacy of occupational therapy, but considering patients preferences and its wide clinical utilization, the GDG suggested its inclusion. CONCLUSION: Psychoeducation, family intervention and social skill training are recommended to be offered for the treatment of schizophrenia. Furthermore, occupational therapy is suggested for inpatients and outpatients with the disorder.
OBJECTIVES: To determine the effectiveness of the psychosocial strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of the disorder. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia. METHODS: A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. RESULTS: The psychoeducation and family intervention showed higher efficacy, compared with the usual treatment, to prevent relapses and hospital readmissions, to reduce family burden and to improve adherence to treatment. The social skill training was effective to improve symptoms, social functioning and quality of life. However, the quality of evidence was low. There was not enough evidence about the efficacy of occupational therapy, but considering patients preferences and its wide clinical utilization, the GDG suggested its inclusion. CONCLUSION: Psychoeducation, family intervention and social skill training are recommended to be offered for the treatment of schizophrenia. Furthermore, occupational therapy is suggested for inpatients and outpatients with the disorder.
Authors: Felipe Botero-Rodríguez; María Camila Hernandez; José Miguel Uribe-Restrepo; Camilo Cabariqe; Catherine Fung; Stefan Priebe; Carlos Gómez-Restrepo Journal: BMC Psychiatry Date: 2021-05-06 Impact factor: 3.630