Effectiveness of psychosocial treatments on symptoms and functional domains in schizophrenia spectrum disorders: a prospective study in a real-world setting

Abstract

Purpose: Data of investigations suggested that psychosocial interventions are required to provide a more complete and effective treatment of schizophrenia spectrum disorders. In particular, art therapy was found an effective psychosocial intervention in SSD. Moreover, some authors reported that Befriending was as effective as cognitive behavior therapy in the treatment of schizophrenic patients. The aim of this study is to test Befriending in comparison with Group Art Therapy in patients with SSD, in order to identify differences of effects between treatments.

Materials and methods: All subjects were evaluated at baseline and after six months with the Clinical Global-Impression-Severity Scale; the 18-item Italian version of the Brief Psychiatric Rating Scale; the Coping Inventory for Stressful Situations; the Rosenberg Self-Esteem Scale; the Global Assessment of Functioning scale; and the Personal and Social Performance scale. Statistical analysis was performed with chi-square tests for categorical variables and analyses of variance for continuous variables to compare the two groups at baseline. A two-way analysis of variance for repeated measures was performed for clinical and psychosocial variables.

Results: A significant improvement over trial duration (within-group effect) was observed for both treatments in psychosocial functioning, self-esteem, and thought disturbance. Befriending was found superior to Art therapy (between-group effect) in improving psychosocial functioning. Both interventions were found efficacious in improving emotion-oriented coping strategies (within group effect), with a significant difference (between group effect) favoring Befriending.

Conclusions: Both interventions, in spite of some differences of efficacy, can be considered an important contribution to improve the patients’ real-world functioning.

Implications for rehabilitation

• Our study confirmed the need to include a set of psychosocial interventions for patients with schizophrenia spectrum disorders among usual treatment modalities.

• Techniques such as Befriending and Art therapy can be considered an important contribution to the treatment instruments required by the new community model for mental health.

• Befriending was found superior to Art therapy (between group effect) in improving psychosocial functioning.

• Both interventions were found efficacious in improving emotion-oriented coping strategies (within group effect), with a significant difference (between group effect) favoring Befriending.

Keywords:

• Schizophrenia
• group art therapy
• Befriending intervention
• real-world functioning
• integrated treatment

Acknowledgements

We wish to thank Dr. Nadja Bracale and Dr. Elisa Del Favero for the bibliography and revision of style. This study was supported by the Ministero Italiano dell’Istruzione, dell’Università e della Ricerca – MIUR projects “Dipartimenti di Eccellenza 2018–2022” assigned to the Department of Neuroscience of the University of Turin, Italy.

Disclosure statement

No potential conflict of interest was reported by the authors.