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Integrated Treatment to Achieve Functional Recovery for First-Episode Psychosis

DOI: 10.1155/2012/962371

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Abstract:

This study describes an integrated treatment approach that was implemented to enhance functional recovery in first-episode psychotic patients. Patients were randomized to two treatment conditions: either to an integrated treatment approach: pharmacotherapy, psychosocial treatment, and psychoeducation (experimental group: ) or to medication alone (control group: ). Patients were evaluated at baseline and after one year of treatment. Functional recovery was assessed according to symptomatic and functional remission. At the end of treatment, experimental patients showed a 94.9% of symptomatic remission compared to 58.8% of the control group. Functional remission was 56.4% for the experimental group and 3.6% for the control group, while 56.4% of the experimental group met both symptomatic and functional remission criteria and were considered recovered compared to 2.9% of the control group. 1. Introduction Schizophrenia-spectrum disorders are characterized by the presence of psychotic symptoms, cognitive deficits, poor quality of life, and psychosocial deterioration [1–4]. Of all illnesses that afflict humans, schizophrenia is considered the 7th most disabling [5]. While perhaps only 1% of the population has schizophrenia, 30% experience an onset of psychotic symptoms by age 18 [6, 7]. Most patients are likely to experience multiple episodes of acute symptomatology, causing severe long-term functional impairment [8]. Relapse can be expected in 70% of patients after the first episode [9]. Intervention strategies for first-episode psychosis include implementation of pharmacological treatment and managing side effects. Psychoeducation is relevant for optimizing the management of side effects and promoting compliance with medication. Once the acute episode has been resolved, emphasis should focus on relapse prevention. The next stage would include implementation of psychosocial intervention facilitating compliance with medication, learning the warning signs of relapse, managing stressors, solving family problems, plus preparing to reestablish social relations and work or school activities that were interrupted [10, 11]. Pharmacological and psychosocial treatment strategies offer hope of preventing progression to long-term psychosis and moving toward a new recovery model for early psychosis. It is aimed at improving psychosocial functioning and promoting independent living in the community. Two key elements have been considered in the recovery model: symptomatic remission and functional recovery. Antipsychotic medication normally is prescribed for first-episode

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