The efficacy of SMS text messages to compensate for the effects of cognitive impairments in schizophrenia.
OBJECTIVE
Many people with schizophrenia have severe cognitive impairments that hamper their activities. The effect of pharmacological and behavioural interventions on cognitive functioning has been demonstrated, but even after successful intervention considerable impairments can remain. Therefore, we sought for alternative ways to help patients cope with the effects of their cognitive impairments. In the present study, we have evaluated the efficacy of short message service (SMS) text messages to compensate for the effects of cognitive impairments in schizophrenia in daily life.


METHODS
A waiting list controlled trial was conducted: patients were quasi-randomly assigned to an A-B-A (baseline-intervention-follow-up) condition or an A-A-B-A condition that included an additional 7-week waiting list. The waiting list was included to control for the effect of time on relevant outcome.


METHODS
Sixty-two people with schizophrenia or related psychotic disorders were included in the study. All patients showed impaired goal-directed behaviour in daily life-situations. Patients were prompted with SMS text messages to improve their everyday functioning. The primary outcome measure was the percentage of goals achieved.


RESULTS
The overall percentage of goals achieved increased with prompting, while performance dropped to baseline level after withdrawing the prompts. Keeping appointments with mental health workers and carrying out leisure activities increased with prompting, while medication adherence and attendance at training sessions remained unchanged. A majority of the patients enjoyed receiving the SMS text messages.


CONCLUSIONS
Prompting can significantly improve achievement of a number of relevant goals. For other goals, combining prompting with interventions that enhance motivation seems indicated.
Pijnenborg
G H M
GH
Department of Psychotic Disorders, GGZ Drenthe, Assen, The Netherlands. marieke.pijnenborg@ggzdrenthe.nl
Withaar
F K
FK
Brouwer
W H
WH
Timmerman
M E
ME
van den Bosch
R J
RJ
Evans
J J
JJ
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000453:epidemiology* / Q000628:therapy*; D003142:Communication; D005260:Female; D006801:Humans; D020407:Internet / Q000295:instrumentation*; D008297:Male; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*; D012649:Self Concept; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014850:Waiting Lists
D014150:Antipsychotic Agents