Training patients with schizophrenia with the community re-entry module: a controlled study

Abstract

Background: There is increasing evidence indicating that the Community Re-entry Module (CRM), a brief, structured instrument, could guide an effective intervention for patients with schizophrenia. This study evaluated the effectiveness of the Chinese version of the CRM with respect to improvement in psychiatric symptoms, social functioning as well as relapse and re-hospitalization rates in comparison with a supportive counseling (SC) intervention.

Method: Ninety-six outpatients with DSM-IV schizophrenia were randomly allocated to either CRM (N=48) or an equally intensive intervention of SC (N=48). The CRM was composed of 16 one-hour sessions, which were conducted with groups of 6-8 patients on a twice-a-week schedule. The two groups received routine psychiatric outpatient care during the intervention. Participants were assessed on an intention-to-treat basis with the Positive and Negative Syndrome Scales (PANSS), with the Social Disability Screening Schedule (SDSS) by two independent raters before and immediately after intervention, and at 6-month follow-up. The number of relapse and re-hospitalization were also documented.

Results: The CRM group significantly improved in terms of psychiatric symptoms and social functioning compared with the SC group. Rates of relapse and re-hospitalization in the CRM group were lower although the difference between the two groups was not statistically significant.

Conclusions: The study supports the feasibility and effectiveness of the Chinese version of the CRM as an effective psychosocial intervention for Chinese patients with schizophrenia to improve psychopathology, social functioning and relapse and re-hospitalization rates.