title: Can recovery-focused multimodal psychotherapy facilitate symptom and function improvement in people with treatment-resistant psychotic illness? A comparison study.
abstract: 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.
authors.affiliation: Buchanan Rehabilitation Centre, Auckland, New Zealand. PatteR@adhb.govt.nz
authors.forename: Patte
authors.initials: P
authors.lastname: Randal
authors.forename: Alexander I F
authors.initials: AI
authors.lastname: Simpson
authors.forename: Tannis
authors.initials: T
authors.lastname: Laidlaw
mesh_terms: 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
chemical_list: D003024:Clozapine