Preventing cognitive decline in chronic schizophreniaLong-term effectiveness of integrated psychological therapy and emotional management training

  1. María Ruiz-Iriondo 1
  2. Karmele Salaberria 1
  3. Rocío Polo-López 2
  4. Alvaro Iruín 2
  5. Enrique Echeburúa 1
  1. 1 Universidad de País Vasco
  2. 2 Instituto de Investigación Sanitaria Biogipuzkoa
    info

    Instituto de Investigación Sanitaria Biogipuzkoa

    San Sebastián, España

    ROR 01a2wsa50

Revista:
Psicothema

ISSN: 0214-9915 1886-144X

Año de publicación: 2019

Volumen: 31

Número: 2

Páginas: 114-120

Tipo: Artículo

Otras publicaciones en: Psicothema

Resumen

Antecedentes: los programas de tratamiento psicológico grupal efi caces para las fases crónicas de la esquizofrenia son escasos. Este artículo describe los resultados obtenidos tras la aplicación de un programa grupal, que incluye la terapia psicológica integrada (IPT) junto con una adaptación de la terapia de manejo emocional (EMT), en una muestra de pacientes ambulatorios con esquizofrenia crónica. Método: 42 pacientes recibieron el programa durante ocho meses y se evaluaron al inicio, en el post-tratamiento y en los seguimientos de 1, 3, 6 y 12 meses. Resultados: el programa fue bien aceptado ya que únicamente hubo un abandono durante los 8 meses de tratamiento y 2 ingresos hospitalarios durante los 20 meses de duración del estudio. Se obtuvieron mejorías en la cognición, el funcionamiento social y la calidad de vida tras recibir el tratamiento, y éstas se mantuvieron en el seguimiento a largo plazo. En resumen, los pacientes estaban mejor 12 meses después de recibir el tratamiento que en la evaluación inicial. Conclusión: el tratamiento resulta efectivo, ha sido bien aceptado y podría ser útil en los servicios de salud para reducir las hospitalizaciones, prevenir el deterioro cognitivo y ayudar a los pacientes a manejar sus preocupaciones diarias

Información de financiación

This work was supported by the Ministry of Economy and Competitiveness of Spain (grant number PSI2011-27590).

Financiadores

    • PSI2011-27590

Referencias bibliográficas

  • Alonso, T., Olivares, J. M., Ciudad, A., Manresa, J. M., Casado, A., & Guilabert, I. (2008). Desarrollo y validación de la escala de funcionamiento social en la esquizofrenia para su uso en la práctica clínica [Development and validation of the social functioning scale, short version, in schizophrenia for its use in the clinical practice]. Actas Españolas de Psicología, 36, 102-110.
  • Australian Psychological Society (2018). Evidence-based psychological interventions in the treatment of mental disorders. A review of the literature, 4th edition. Retrieved from http://psychology.org.au/getmedia/23c6a11b-2600-4e19-9a1d-6ff9c2f26fae/Evidence-based-psych-interventions.pdf
  • Barlati, S., Valsecchi, P., Galluzzo, A., Turrina, C., & Vita, A. (2018). Implementing cognitive rehabilitation interventions for schizophrenia patients in mental health services: Focus on Integrated Psychological Therapy (IPT). Journal of Psychopathology, 24, 79-87.
  • Birchwood, M., Smith, J., Cochrane, R., Wetton, S., & Copestake, S. (1990). The social functioning scale: The development and validation of a new scale of social adjustment for use in family intervention programs with schizophrenic patients. British Journal of Psychiatry, 157, 853-859.
  • Bowie, C. R., McGurk, S. R., Mausbach, B., Patterson, T. L., & Harvey, P. D. (2012). Combined cognitive remediation and functional skills training for schizophrenia: Effects on cognition, functional competence, and real-world behavior. American Journal of Psychiatry, 169, 710-718. doi: 10.1176/appi.ajp.2012.11091337
  • Bowie, C. R., Reichenberg, A., McClure, M. M., Leung, W. L., & Harvey, P. D. (2008). Age-associated differences in cognitive performance in older community-dwelling schizophrenia patients: Differential sensitivity of clinical neuropsychological and experimental information processing test. Schizophrenia Research, 106, 50-58. doi: 10.1016%2Fj.schres.2007.10.026
  • Cohen, A. S., Forbes, C. B., Mann, M. C., & Blanchard, J. J. (2006). Specific cognitive deficits and differential domains of social functioning impairment in schizophrenia. Schizophrenia Research, 81, 227-238. doi: 10.1016/j.schres.2005.09.007
  • Dickerson, F. B., & Lehman, A. F. (2012). Evidence-based psychotherapy for schizophrenia, an update. Focus, 10, 217-225. doi: 10.1097/NMD.0b013e318225ee78
  • Fervaha, G., Foussias, G., Agid, O., & Remington, G. (2014). Motivational and neurocognitive deficits are central to the prediction of longitudinal functional outcome in schizophrenia. Acta Psychiatrica Scandinavica, 130, 290-299. doi: 10.1111/acps.12289
  • Fioravanti, M., Bianchi, V., & Cinti, M. E. (2012). Cognitive deficits in schizophrenia: An updated metaanalysis of the scientific evidence. BMC Psychiatry, 12, 64. doi: 10.1186/1471244x-12-64
  • Friedman, J. I., Harvey, P. D., Coleman, T., Moriarty, D. J., Bowie, C., Parrella, M., … Davis, K. L. (2001). Six-year follow-up study of cognitive and functional status across the lifespan in schizophrenia: A comparison with Alzheimer’s disease and normal aging. American Journal of Psychiatry, 158, 1441-1448.
  • Fuentes, I., Romero, M., Dasí, C., & Ruiz, J. C. (2010). Versión abreviada del WAIS III para su uso en la evaluación de pacientes con esquizofrenia [Short forms of WAIS-III for use with patients with schizophrenia]. Psicothema, 22, 202-207.
  • Fusar-Poli, P., Borgwardt, S., Bechdolf, A., Addington, J., Reicher-Rössler, A., Schultze-Lutter, F.,…Yung A. (2013). The psychosis high-risk state: A comprehensive state of the art review. JAMA Psychiatry, 70, 107-120. doi: 10.1001/jamapsychiatry.2013.269
  • Gómez-Benito, J., Guilera, G., Pino, O., Rojo, E., Tabarés-Seisdedos, R., Safont, G.,…Reja, J. (2013). The Screen for Cognitive Impairment in Psychiatry. Diagnostic-specific standardization in psychiatry in patients. BMC Psychiatry, 13, 127. doi: 10.1186/1471-244X-13-127
  • Green, M. F., & Harvey, P. D. (2014). Cognition in schizophrenia: Past, present and future. Schizophrenia Research: Cognition, 1, 9. doi: 10.1016%2Fj.scog.2014.02.001
  • Häfner, H., & an der Heiden, W. (2008). Course and outcome. In K.T. Mueser & D. V. Jester (Eds.), Clinical handbook of schizophrenia (pp. 100-113). New York: The Guilford Press.
  • Harrow, M., Jobe, T. H., & Faull, R. N. (2014). Does treatment of schizophrenia with antipsychotic medication eliminate or reduce psychosis? A 20-year multi-follow-up study. Psychology Medicine, 44, 3007-3016. doi: 10.1017/S0033291714000610
  • Harvey, P. D., & Strassnig, M. (2012). Predicting the severity of everyday functional disability in people with schizophrenia: Cognitive deficits, functional capacity, symptoms, and health status. World Psychiatry, 11, 73-79.
  • Harvey, P. D., Silverman, J. M., Mohs, R. C., Parrella, M., White, L., Powchick, P., Davidson, M., & Davis, K. L. (1999). Cognitive decline in late-life schizophrenia: A longitudinal study of geriatric chronically hospitalized patients. Biological Psychiatry, 45, 32-40.
  • Heaton, R. K., Chelune, G. J., Talley, J. L., Kay, G. G., & Curtiss, G. (1993). Wisconsin card sorting test manual (revised an expanded). Odessa, Florida: Psychological Assessment Resources, Inc.
  • Hodel, D., Brenner, H. D., Merlo, M. C., & Teuber, J. F. (1998). Emotion Management Therapy in early psychosis. British Journal of Psychiatry, 172, 128-133.
  • Hodel, D., Kern, R. S., & Brenner, H. D. (2004). Emotion Management Training (EMT) in persons with treatment-resistant schizophrenia: First results. Schizophrenia Research, 68, 107-108.
  • Holthausen, E. A. E., Wiersma, D., Sitskoorn, M. M., Hijman, R., Dingemans, P. M., Schene, A. H., & an der Bosch, R. J. (2002). Schizophrenia patients with and without neuropsychological deficits: Subgroup, disease severity or cognitive compensation. Psychiatry Research, 112, 1-11.
  • Jaramillo, P., Ruiz, J. C., & Fuentes, I. (2011). Relationships between neurocognition, emotional processing and social functioning in schizophrenia. Psychology, Society and Education, 3, 99-112.
  • Keefe, R. S., & Harvey, P. D. (2012). Cognitive impairment in schizophrenia. Handbook of Experimental Pharmacology, 213, 11-37. doi: 10.1007/978-3-642-25758-2_2
  • Kramer, I., Simons, C. J., Wigman, J. T., Collip, D., Jacobs, N., Derom, C.,… Wichers, M. (2014). Time-lagged moment-to-moment interplay between negative affect and paranoia: New insights in the affective pathway to psychosis. Schizophrenia Bulletin 40, 278-286. doi: 10.1093/schbul/sbs194
  • Lemos, S., Vallina, O., & Fernández, M. P (2013). Intervenciones psicológicas en la esquizofrenia [Psychological Interventions in Schizophrenia]. Madrid: Consejo General de la Psicología de España.
  • Lemos, S., Vallina, O., García, A., Gutiérrez, A. M., Alonso, M., & Fernández, J. (2004). Evaluación de la efectividad de la terapia psicológica integrada en la evolución a largo plazo de pacientes esquizofrénicos [Evaluation of the effectiveness of integrated psychological therapy in long-term evolution of patients with schizophrenia]. Actas Españolas de Psiquiatría, 32, 166-177.
  • Lincoln, T. M., Hartman, M., Köther, U., & Moritz, S. (2015). Dealing with feeling: Specific emotion regulation skills predict responses to stress in psychosis. Psychiatry Research, 228, 216-222. doi: 10.1016/j.psychres.2015.04.003
  • Marwaha, S., Broome, M. R., Bebbington, P. E., Kuipers, E, & Freeman, D. (2014). Mood instability and psychosis: analyses of British National Survey Data. Schizophrenia Bulletin, 40, 277-296. doi: 10.1093/schbul/sbt149
  • McGurk, S. R., Twamley, E. W., Sitzer, D. I., McHugo, G. J., & Mueser, K. T. (2007). A meta-analysis of cognitive remediation in schizophrenia. American Journal of Psychiatry, 164, 1791-1802. doi: 10.1176/appi.ajp.2007.07060906
  • McGurk, S. R., & Mueser, K. T. (2008). Response to cognitive rehabilitation in older versus younger persons with severe mental illness. American Journal of Psychiatric Rehabilitation, 11, 90-105. doi: 10.1080/15487760701853136
  • Miret, S., Fatjó-Vilas, M., Peralta, V., & Fañanás, L. (2016). Basic symptoms in schizophrenia. Their clinical study and relevance in research. Revista de Psiquiatría y Salud Mental, 9, 111-122. doi: 10.1016/j.rpsm.2015.10.007
  • Moriana, J. A., Gálvez-Lara, M., & Corpas, J. (2017). Psychological treatments for mental disorders in adults: A review of the evidence of leading international organizations. Clinical Psychology Review, 54, 29-43. doi: 10.1016/j.cpr.2017.03.008
  • Mueser, K. T., Deavers, F., Penn, D. L., & Cassisi, J. E. (2013). Psychosocial treatments for schizophrenia. Annual Review of Clinical Psychology, 9, 465-497. doi: 10.1146/annurev-clinpsy-050212-185620
  • Mueller, D. R., Schimdt, J., & Roder, V. (2013). Integrated Psychological Therapy: Effectiveness in schizophrenia inpatients settings related to patients’age. The American Journal of Geriatric Psychiatry, 21, 231-241. doi: 10.1016/j.jagp.2012
  • National Institute for Clinical Excellence for psychosis and schizophrenia (2014). Psychosis and schizophrenia in adults: Prevention and management (CG178). Retrieved from http://nice.org.uk/guidance/cg178
  • O’Driscoll, O., Laing, J., & Mason, O. (2014). Cognitive emotion regulation strategies, alexithymia and dissociation in schizophrenia, a review and meta-analysis. Clinical Psychology Review, 34, 482-495. doi: 10.1016/j.cpr.2014.07.002
  • Oliver, J. P. J., Huxley, P. J., Priebe, S., & Kaiser, W. (1997). Measuring the quality of life of severely mentally ill people using the Lancashire Quality of Life Profile. Social Psychiatry and Psychiatric Epidemiology, 32, 76-83.
  • Pathak, A., Pradas, M. K., & Chaturvedi, S. K. (2016). Recovery and Quality of life in mental illness. Journal of Psychosocial Rehabilitation in Mental Health, 3, 35-37.
  • Pino, O., Guilera, G., Rojo, E. J., Gómez-Benito, J., Bernardo, M., Crespo-Facorro, B., ... on behalf of the Spanish Working Group in Cognitive Function (2008). Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S): Psychometric properties of a brief scale for cognitive evaluation in schizophrenia. Schizophrenia Research, 99, 139-148. doi: 10.1186/1477-7525-7-28
  • Purdon, S. E. (2005). The Screen for cognitive impairment in psychiatry (SCIP): Instructions and three alternative forms. Edmonton, Alberta: PNL Inc.
  • Roder, V., Brenner, H. D., Hodel, B., Kienzle, N., & Fuentes, I. (2007). Terapia Psicológica Integrada para la esquizofrenia [Integrated Psychological Terapy for schizophrenic patients]. Granada: Alborán.
  • Roder, V., Mueller, D. R., Mueser, K. T., & Brenner, H. D. (2006) Integrated Psychological Therapy (IPT) for Schizophrenia: Is it effective? Schizophrenia Bulletin, 32, 81-93. doi: 10.1093%2Fschbul%2Fsbl021
  • Roder, V., Mueller, D. R., & Schmidt, S. (2011). Effectiveness of integrated psychological therapy (IPT) for schizophrenia patients: A research update. Schizophrenia Bulletin, 37, 71-79. doi: 10.1093%2Fschbul%2Fsbr072
  • Ruiz-Iriondo, M., Salaberria, K., & Echeburúa, E. (2013). Schizophrenia: Analysis and psychological treatment according to the clinical stage model. Actas Españolas de Psiquiatría, 41, 52-59.
  • San, L., Bernardo, M., Gómez, A., Martínez, P., González, B., & Peña, M. (2013). Sociodemographic, clinical and treatment characteristics of relapsing schizophrenia patients. Nordic Journal of Psychiatry, 67, 22-29. doi: 10.3109/08039488.2012.667150
  • Schultze-Lutter, F., Klosterkötter, J., & Rurhman, S. (2006). Can schizophrenia be predicted phenomenologically? In J. O. Johanessen, B. V. Martindale & J. Culberg (Eds.), Evolving psychosis (pp. 104-123). New York: Routledge.
  • Underwood, R., Kumari, V., & Peters, E. (2016). Cognitive and neural models of threat appraisal in psychosis: A theoretical integration. Psychiatry Research, 239, 131-138. doi: 10.1016/j.psychres.2016.03.016
  • Vallina, O., Lemos, S., Roder, V., García, A., Otero, A., Alonso, M., & Gutiérrez, A. M. (2001). Controlled study of an integrated psychological intervention in schizophrenia. European Journal of Psychiatry, 15, 167-179.
  • Vázquez-Barquero, J. L., Gaite, L., Ramírez, N., García, E., Borra, C., Sanz, O., Bobes, J., & Oliver, J. (1997). Desarrollo de la versión en castellano del perfil de calidad de vida de Lancashire [Development of the Spanish version of the Lancashire quality of life profile]. Archivos de Neurobiología, 60, 125-139.
  • Wechsler, D. (1999). WAIS-III Escala de Inteligencia de Wechsler para Adultos [Weschler Adult Intelligence Test 3rd Ed.] Madrid: TEA Ediciones.
  • World Health Organization, WHO (1992). The ICD-10 classification of mental and behavioural disorders. Geneve: World Health Organization.
  • Wunderink, L., Nieboer, R.M., Wiersma, D., Sytema, S., & Nienhuis, F. J. (2013). Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy long-term follow-up of a 2-year randomized clinical trial recovery in remitted first-episode psychosis. JAMA Psychiatry, 70, 913-920. doi: 10.1001/jamapsychiatry.2013.19