CPG for Psychosocial Interventions in Severe Mental ... - GuÃaSalud

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Morita Therapy Morita therapy (MT) + standard treatment (ST) vs ST SR (1-) Distraction techniques (DT) There are no differences between morita therapy + ST vs. ST related to short-term improvement of negative symptoms (measured according to the SANS scale) (1 RCT, n = 50; RR = 0.89; 95% CI between 0.41 and 1.93) However, significant differences have been found in favour of MT in the medium term (1 RCT, n = 42; RR = 0.25; 95% CI between 0.08 and 0.76) 126 . Results have been obtained in favour of morita therapy + ST related to mental state, according to the BPRS scale, in medium term (1 RCT, n = 76; reduction >25% to 30% in BPRS; RR = 0.35; 95% CI: between 0.14 and 0.89; NNT = 5, 95% CI : between 4 and 25) 126 . Morita therapy + ST significantly improved the capacity to carry out daily living activities (social functioning) in the short term compared with standard treatment alone (1 RCT; n = 104; WMD = -4.1; 95% CI between -7.7 and -0.6), and in the medium term (n = 48, WMD: -10.50; 95% CI between -12.50 and -8.50) 126 . SR (1-) There are no differences between DT + standard treatment (ST) vs. health promotion + ST, related to the short term improvement of the mental state (measured through the BPRS scale) (1 RCT; n = 60; WMD = 1.60; IC 95%: between -0.49 and 3.69) 128 . Drama therapy RCT (1-) RCT (1-) RCT (1-) Dramatherapy + ST vs. group therapy + ST The results indicate that there is no significant improvement of the mental state of hospitalised people with schizophrenia who have received drama therapy as an intervention, compared with group therapy ( n = 24; RR: 0.5, 95% CI: between 0.05 and 4.81) 130 . Psychodrama + medication + hospital stay vs. medication + hospital stay In the study conducted by Zhou & Tang 131 , improved levels of self-esteem were found in favour of the psychodrama group (measured through the SES scale) than in the control group (n = 24; WMD = 4; 95% CI: between 0.80 and 7.20). Hypnosis Hypnosis vs. ST No evidence is found to indicate that hypnosis improves the mental state after a week of intervention measured with the BPRS scale (1 RCT; n =60; WMD = -3.63; 95% CI: between -12.05 and 4.79) 133 . 76 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS
Hypnosis vs. relaxation No improvement or deterioration OK of the mental state has been found between hypnosis and relaxation, assessed with the BPRS scale, after a week of intervention (1 RCT; n = 60; WMD = -3.38; 95% CI+ between -11.40 and 4.64) 133 . RCT (1-) Summary of evidence In morita therapy applied to people with schizophrenia, no significant results have been found with respect to the improvement of negative symptoms, or the improvement of 1- the mental state 134 . However, significant differences have been found in favour of morita therapy in the medium term 135 . 1- Morita therapy + standard treatment improve the mental state in the medium term 136 . 1- 1- Morita therapy improves the capacity to carry out daily living activities in people with schizophrenia in the short 137 and medium term 138 . There are differences between the distraction technique and standard treatment related to improving the mental state of people with schizophrenia 139 . 1- Drama therapy did not show any improvement in the mental state of hospitalised people with schizophrenia 140 . 1- Drama therapy can help improve the self-esteem of people with schizophrenia 131 . 1- There is no evidence to indicate that hypnosis improves the mental state in people with schizophrenia) 133 . Recommendations Sufficient evidence has not been found to make recommendations related to morita therapy, drama therapy, distraction therapy and hypnosis in the treatment of people with SMI. 5.2. Social interventions These are interventions, activities and community support structures whose aim is to facilitate social integration into the context Social interventions include different types of strategies and programmes. This CPG includes daily living programmes, residential programmes in the community and programmes directed to leisure and spare time. Question to be answered • Do social insertion programmes –daily living skills programmes, residential programmes in the community, or programmes directed to leisure and spare time- improve the evolution of the illness and the quality of life of people with SMI? CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 77
Page 1:
Clinical Practice Guidelines for Ps
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This CPG is an aid for decision mak
Page 7 and 8:
Table of Contents Presentation 7 Au
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Presentation Healthcare practice is
Page 11 and 12:
Authorship and collaborators CPG de
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José Manuel Lalana Cuenca. Special
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c) SERVICE LEVEL INTERVENTIONS •
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A B A A B B B C Psychosocial inter
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B B B C A C C 5.3. SERVICE LEV
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20 CLINICAL PRACTICE GUIDELINES IN
Page 24 and 25:
independence, quality of life, pers
Page 26 and 27:
This guideline is aimed at mental h
Page 28 and 29: Figure 1. Search Strategy Search fo
Page 30 and 31: The highest evidence level found wa
Page 33 and 34: 4. Characteristics of the CPG 4.1.
Page 35 and 36: The main focus of rehabilitation is
Page 37 and 38: 5. Psychosocial type rehabilitation
Page 39 and 40: From another point of view, social
Page 41 and 42: defined as “standard care” or
Page 43 and 44: General global state In the short r
Page 45 and 46: Specific symptoms: when CBT was com
Page 47 and 48: In the systematic review by Kurtz a
Page 49 and 50: Summary of evidence 1- 1- 1- 1- 1-
Page 51 and 52: People with SMI and a diagnosis of
Page 53 and 54: 5.1.3. Interpersonal therapy The li
Page 55 and 56: weekly or fortnightly sessions. The
Page 57 and 58: 5.1.5. Family interventions There a
Page 59 and 60: In the RCT carried out by Hogarty e
Page 61 and 62: A family intervention of more than
Page 63 and 64: After two years’ treatment, and b
Page 65 and 66: Family intervention vs. other psych
Page 67 and 68: 1- 1- 1- 1- 1- 1- 1- 1- 1+ No diffe
Page 69 and 70: Question to be answered • Are pys
Page 71 and 72: Summary of evidence Pyschoeducation
Page 73 and 74: with schizophrenia and that the tre
Page 75 and 76: With reference to the type of train
Page 77: would normally receive and which in
Page 81 and 82: Supervised fl ats are a community h
Page 83 and 84: 3 Programmes directed to leisure an
Page 85 and 86: SMI (schizophrenia, affective schiz
Page 87 and 88: When PVT is compared with standard
Page 89 and 90: Patients included in the individual
Page 91 and 92: 1+ 1+ 1++ 1+ 1+ 1+ 1+ The people in
Page 93 and 94: Music therapy Music therapy + stand
Page 95 and 96: A series of Case Management systems
Page 97 and 98: • The satisfaction data originati
Page 99 and 100: Loss of contact With respect to the
Page 101 and 102: There is not sufficient evidence, e
Page 103 and 104: 1+ 1+ 1+ 1+ Respect to ICM teams or
Page 105 and 106: Finally, in the RCT by Cheng et al
Page 107 and 108: 5.4.2. “Homeless” with SMI The
Page 109 and 110: Patients who access housing with no
Page 111: ceptive disorders. This series of c
Page 115 and 116: 7. Recommendations for Future Resea
Page 117: Appendices
Page 120 and 121: Appendix 2. Information obtained fr
Page 122 and 123: Appendix 4. Information for people
Page 124 and 125: 4. Regulatory and legal framework 1
Page 126 and 127: Several protocols have been publish
Page 128 and 129:
The coordination of these resources
Page 130 and 131:
Social protection systems Pursuant
Page 132 and 133:
Specifi c regulation • (SPANISH)
Page 134 and 135:
Service Management: The first anti-
Page 136 and 137:
on Mental Health and the future Eur
Page 138 and 139:
Spanish Society of Legal Psychiatry
Page 140 and 141:
Appendix 5. Abbreviations ACT Asser
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Appendix 6. Glossary Therapy adhere
Page 144 and 145:
Appendix 7. Declaration of interest
Page 146 and 147:
15 Rossler W. Psychiatric rehabilit
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53 Graeber DA, Moyers TB, Griffi th
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86 Schooler NR, Keith SJ, Severe JB
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117 Sohlberg MM, Mateer CA. Effecti
Page 154 and 155:
154 López M, García-Cubillana P,
Page 156 and 157:
190 Bond GR, Drake RE. Predictors o
Page 158 and 159:
225 Hurley AD. Individual psychothe
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