title: [MODen: Psychoeducationnal therapeutic group program for schizophrenic patients, based on nutritional balance and pleasure, using cognitive functions: A pilot study].
abstract: BACKGROUND
  Schizophrenia causes psychological difficulties (with positive and/or negative symptoms) as well as cognitive disabilities (attention, memory, executive functions and social cognition). Moreover, 40 to 60% of patients suffer from an excess of weight or obesity (due to bad eating habits, eating disorders or medication). All these difficulties impair their autonomy and their insertion into the society. In this context, setting-up a therapeutic tool, which may have cognitive benefits seems relevant. Thus, MODen is a therapeutic educational tool whose aim is to improve cognitive functions and the symptoms by using "nutritional balance" as an aid.
  
  
  METHODS
  In this treatment program, two therapists lead a group of 5 to 8 patients which group meets once a week during two to four hours for 16 weeks, divided in 4 cycles. The first three weeks of each cycle consists of theoretical instruction: patients talk about their eating habits, information is given about nutritional balance and preparation of meals. In the different cycles, flexibility, planning, memory and attention are trained. For instance, the work on categorisation of foods and nutritional balance allow enhancing flexibility abilities. Writing down the lists of different ingredients needed for one week's meals and preparation of meals train planning abilities. MODen also takes into account ecological issues such as the limited budget of patients to do their shopping (this budget is around 4 euros per meal in France). The budget is also linked to planning abilities and reasoning. Finally, during the last session of each cycle the group prepares a meal (from the shopping to cooking). This last session is all about sharing and social cognition abilities. By the end of the program, patients will have prepared four meals together. Also "homework" has to be done each week in order to facilitate memorisation of what has been learned during the last session and to prepare the beginning of the next session.
  
  
  RESULTS
  In a pilot study with 8 patients with schizophrenia (DSM-IV), improvements in PANSS negative symptoms and disorganization (respectively P<0.02; P<0.02) were observed. An underlying improvement at BECS scores was also observed (P<0.08). Regarding those preliminary results as well as the ecological qualities of this program, this therapeutic tool could be relevant in the treatment of patients with schizophrenia.
authors.affiliation: Unité Crisalid, pôle FJ5, CHI Clermont-de-l'Oise, 2, rue des Finets, 60600 Clermont, France; GDR 3557, groupe de recherche en psychiatrie, 7, rue Cabanis, 75014 Paris, France. Electronic address: sarahlise.farhat@gmail.com.
authors.forename: S L
authors.initials: SL
authors.lastname: Farhat
authors.affiliation: Unité Crisalid, pôle FJ5, CHI Clermont-de-l'Oise, 2, rue des Finets, 60600 Clermont, France.
authors.forename: C
authors.initials: C
authors.lastname: Hochard
authors.affiliation: Unité Crisalid, pôle FJ5, CHI Clermont-de-l'Oise, 2, rue des Finets, 60600 Clermont, France.
authors.forename: S
authors.initials: S
authors.lastname: Orens
authors.affiliation: Unité Crisalid, pôle FJ5, CHI Clermont-de-l'Oise, 2, rue des Finets, 60600 Clermont, France.
authors.forename: C
authors.initials: C
authors.lastname: Gautier
authors.affiliation: Unité Crisalid, pôle FJ5, CHI Clermont-de-l'Oise, 2, rue des Finets, 60600 Clermont, France.
authors.forename: T
authors.initials: T
authors.lastname: Lambert
authors.affiliation: Unité Crisalid, pôle FJ5, CHI Clermont-de-l'Oise, 2, rue des Finets, 60600 Clermont, France.
authors.forename: L
authors.initials: L
authors.lastname: Geret
authors.affiliation: Unité Crisalid, pôle FJ5, CHI Clermont-de-l'Oise, 2, rue des Finets, 60600 Clermont, France; GDR 3557, groupe de recherche en psychiatrie, 7, rue Cabanis, 75014 Paris, France; Unité Inserm U669, Psigiam, universités Paris 5-11, 9, boulevard de Port-Royal, 75014 Paris, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Bralet
mesh_terms: D000328:Adult; D003071:Cognition; D005260:Female; D005502:Food; D006801:Humans; D008297:Male; D062407:Meals; D009752:Nutritional Status; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D057181:Pleasure; D011615:Psychotherapy, Group / Q000379:methods*; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Balance; Cognitive remediation; Ecological qualities; Milieu écologique; Nutrition; Plaisir; Pleasure; Remédiation cognitive; Therapeutic educational tool; Éducation thérapeutique; Équilibre