Can recovery-focused multimodal psychotherapy facilitate symptom and function improvement in people with treatment-resistant psychotic illness? A comparison study.
OBJECTIVE
To assess whether recovery-focused multimodal psychotherapy can facilitate symptom and function improvement in people with treatment-resistant psychotic illness.


METHODS
Nine people with treatment-resistant schizophrenia or schizoaffective disorder whose symptoms and level of functioning necessitated inpatient care were engaged in individual multimodal psychotherapy for up to 21 months. In addition to the multimodal therapy they also received standard inpatient care. Twelve people retrospectively matched for diagnosis, age, sex, and chronicity of illness, formed a comparison group. They also received standard inpatient care. The standard inpatient care for both experimental and comparative groups consisted of custodial care, predominantly atypical antipsychotic drug therapy, and ongoing care from a key worker.


RESULTS
The treatment group showed clinically significant improvements in the overall Positive and Negative Symptom Scale (PANSS) scores which was significantly better than the changes found in the comparison group (p = 0.037). There was a 43% reduction in positive symptoms, a 30% reduction in negative symptoms, a 27.5% reduction in general psychopathology symptoms and a 30% reduction in overall scores on the PANSS. General behaviour scores on the Rehabilitation Evaluation of Hall and Baker were clinically improved, with a 32% reduction, as were deviant scores, with a 93.3% reduction. The change in the deviant scores was significantly better in the treatment group (p = 0.025).


CONCLUSIONS
Recovery-focused multimodal psychotherapy may facilitate symptom and function improvement in people with treatment-resistant psychotic illness.
Randal
Patte
P
Buchanan Rehabilitation Centre, Auckland, New Zealand. PatteR@adhb.govt.nz
Simpson
Alexander I F
AI
Laidlaw
Tannis
T
D000293:Adolescent; D000328:Adult; D003024:Clozapine / Q000008:administration & dosage / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003710:Demography; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011613:Psychotherapy / Q000379:methods*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D020127:Recovery of Function; D012932:Social Facilitation
D003024:Clozapine