Timing of psychoeducational psychotherapeutic interventions in schizophrenic patients

Abstract

Psychoeducational interventions for schizophrenic outpatients and their key-persons have shown impressive long-term effects on the course of illness. Psychoeducation is suggested to be offered as early as possible to be most effective. This prospective randomized study examines the influence of pre-therapy duration of illness on the effects of a psychoeducative training. The controlled study covered a total of 191 schizophrenic outpatients and comprised psychoeducational training and cognitive psychotherapy. Pre-therapy duration of illness was divided at 4 and 7 years resulting in groups of short, medium, and long duration of psychosis. Study patients were examined for rehospitalization at a five year interval. In patients with long duration of illness, attendance at psychoeducation did not modify rehospitalization rate. This was true for patients with very short duration of psychosis. Only patients with medium duration of illness after psychoeducative intervention showed a reduced rehospitalization rate. In general, results do recommend psychoeducative intervention at early psychosis. However, psychoeducation was not optimally located in patients with a very short duration of illness. Psychoeducation showed a most preventive effect in patients with a medium duration of illness who already accept their illness but are not yet adhering to fatalistic assumptions often established to explain the manifestation of illness.