Group psychoeducation for long-term offender patients with schizophrenia: an exploratory randomised controlled trial

Abstract

Background: Psychoeducation is now commonly provided in forensic settings, but its effectiveness among long-term offender patients with schizophrenia has not yet been established in randomised controlled trials (RCTs).

Aim: To test the effects of a brief group psychoeducation programme for offenders with schizophrenia (n = 39) resident in a high-security hospital (Niuvanniemi Hospital, Finland).

Method: High-security hospital patients were randomised into either eight sessions of group psychoeducation or 'treatment as usual' (TAU). Outcome measures, made at baseline, immediately post-treatment, and 3 months after that, included knowledge about illness, insight, compliance, attitudes towards medication, psychiatric symptoms and ward behaviour, self-esteem, health-related quality of life and perceived stigma.

Results: Three months after completing treatment, or an equivalent time under TAU, patients in the intervention group showed a positive treatment effect in terms of knowledge about illness, self-esteem and insight into the illness. The only possible adverse effect was a slight increase in irritability, but this did not translate into behaviour of concern to staff.

Conclusions: Our sample size was small, and the findings must be regarded as preliminary, but the positive treatment effect of psychoeducation, and the absence of alarming side effects, suggests a full scale trial would be worthwhile. Most encouraging was that even the most severely ill patients were able to join the groups.