Authors' objectives:

This bulletin aims to summarise the available evidence on the effectiveness of psychosocial interventions used in the management of schizophrenia.

Authors' recommendations: Comprehensive care for schizophrenia involves not only drug treatments, but also the provision of ongoing support, valid information and, where appropriate, therapies or rehabilitative strategies. Individual psychoeducational interventions can decrease the risk of relapse, although the mechanism by which this is achieved is unclear. Family intervention (a supportive, educational and, perhaps, therapeutic interaction with the family of people with schizophrenia) decreases the risk of relapse. However, this decrease was most marked with early studies undertaken by pioneers of the technique. Evidence suggests that cognitive behavioural therapy may decrease relapse and readmission rates and may also improve the patient's mental state. Assertive community treatment (ACT) reduces hospital admissions and time spent in hospital by nearly 50%. ACT teams could prove particularly useful in environments where psychiatric in-patient care is at a premium. The Care Programme Approach (case management) may help health and social services keep contact with people, and may serve useful administrative functions, but ACT is required to keep severely mentally ill people out of hospital. The whole area of non-pharmacological treatments for people with schizophrenia is under researched. Well-designed, generalisable randomised controlled trials are needed. These should involve people seen in everyday practice, and measure meaningful outcomes, including adverse effects.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/ehcb.htm

Year Published: 2000

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination