79 Dyck DG, Short RA, Hendryx MS, Norell D, Myers M, Patterson T, et al. Management of negativesymptoms among patients with schizophrenia attending multiple-family groups. PsychiatrServ. 2000;51(4):513-9.80 Pharoah F, Mari J, Rathbone J, Wong W. Family intervention for schizophrenia. Cochrane DatabaseSyst Rev. 2006;(4):CD000088.81 Chien WT, Norman I, Thompson DR. A randomized controlled trial of a mutual support groupfor family caregivers of patients with schizophrenia. Int J Nurs Stud. 2004;41(6):637-49.82 Xiong H, Xiong W, Lipeng F, Wang R. Comprehensive family treatment for schizophrenic patients:a prospective, randomized, single-blind control trial of 63 patients. Chinese <strong>Mental</strong>Health Journal. 1994;1994(2):5-201.83 Shi Y, Zhao B, Xu D, Sen J. A comparative study of life quality in schizophrenic patients afterfamily intervention. Chinese <strong>Mental</strong> Health Journal. 2000;14(2):135-7.84 McFarlane WR, Lukens E, Link B, Dushay R, Deakins SA, Newmark M, et al. Multiple-familygroups and psychoeducation in the treatment of schizophrenia. Arch Gen Psychiatry.1995;52(8):679-87.85 Leff J, Berkowitz R, Shavit N, Strachan A, Glass I, Vaughn C. A trial of family therapy v. a relativesgroup for schizophrenia. Br J Psychiatry. 1989;154:58-66.86 Schooler NR, Keith SJ, Severe JB, Matthews SM, Bellack AS, Glick ID, et al. Relapse and rehospitalizationduring maintenance treatment of schizophrenia: the effects of dose reduction andfamily treatment. Arch Gen Psychiatry. 1997;54(5):453-63.87 Bressi C, Manenti S, Frongia P, Porcellana M, Invernizzi G. Systemic family therapy in schizophrenia:a randomized clinical trial of effectiveness. Psychother Psychosom. 2008;77(1):43-9.88 Montero I, Asencio A, Hernandez I, Masanet MJ, Lacruz M, Bellver F, et al. Two strategies forfamily intervention in schizophrenia: a randomized trial in a Mediterranean environment.Schizophr Bull. 2001;27(4):661-70.89 Falloon IR, Montero I, Sungur M, Mastroeni A, Malm U, Economou M, et al. Implementation ofevidence-based treatment for schizophrenic disorders: two-year outcome of an internationalfield trial of optimal treatment. World Psychiatry. 2004;3(2):104-9.90 Hogarty GE, Anderson CM, Reiss DJ, Kornblith SJ, Greenwald DP, Ulrich RF, et al. Family psychoeducation,social skills training, and maintenance chemotherapy in the aftercare treatmentof schizophrenia: II. Two-year effects of a controlled study on relapse and adjustment.Environmental-Personal Indicators in the Course of Schizophrenia (EPICS) ResearchGroup. Arch Gen Psychiatry. 1991;48(4):340-7.91 Lemos S, Vallina O, García Saiz A, Gutiérrez Pérez AM, Alonso Sánchez M, Ortega JA. Evaluaciónde la efectividad de la terapia psicológica integrada en la evolución a largo plazo depacientes con esquizofrenia. Actas Esp Psiquiatr. 2004;32(3):166-77.92 Brenner HD, Roder V, Hodel B, Kienzle N. Integrated psychological therapy for schizophrenicpatients (IPT). Seattle: Hogrefe & Huber; 1994.93 Roder V, Mueller DR, Mueser KT, Brenner HD. Integrated psychological therapy (IPT) forschizophrenia: is it effective? Schizophr Bull. 2006;32 Suppl 1:S81-93.94 Miklowitz DJ, Simoneau TL, George EL, Richards JA, Kalbag A, Sachs-Ericsson N, et al. Family-focusedtreatment of bipolar disorder: 1-year effects of a psychoeducational program inconjunction with pharmacotherapy. Biol Psychiatry. 2000;48(6):582-92.95 Miller IW, Solomon DA, Ryan CE, Keitner GI. Does adjunctive family therapy enhance recoveryfrom bipolar I mood episodes? J Affect Disord. 2004;82(3):431-6.96 Rea MM, Tompson MC, Miklowitz DJ, Goldstein MJ, Hwang S, Mintz J. Family-focused treatmentversus individual treatment for bipolar disorder: results of a randomized clinical trial. JConsult Clin Psychol. 2003;71(3):482-92.GUÍA DE PRÁCTICA CLÍNICA DE INTERVENCIONES PSICOSOCIALES EN EL TRASTORNO MENTAL GRAVE 159
97 Justo LP, Soares BG, Calil HM. Family interventions for bipolar disorder. Cochrane DatabaseSyst Rev. 2007;(4):CD005167.98 Goldstein MJ, Rea MM, Miklowitz DJ. Family factors related to the course and outcome of bipolardisorder. En: Mundt C, Goldstein MJ, Hahlweg K, editors. Interpersonal factors in affectivedisorders.London: Royal College of Psychiatrists; 1996. p. 193-203.99 Miklowitz DJ, Simoneau TL, Sachs-Ericsson N, Warner R, Suddath R. Family risk indicators inthe course of bipolar affective disorder. En: Mundt C, Goldstein MJ, Hahlweg K, Fiedler P,editors. Interpersonal factors in the origin and course of affective disorders.London: GaskellBooks; 1996. p. 204-17.100 Ryan CE, Keitner GI, Solomon DA, Kelley JE, Miller IW. Factors related to a good, poor, orfluctuating course of bipolar disorder. 156th Annual Meeting of the American Psychiatric Association,May 17-22. San Francisco CA 2003.101 Clarkin JF, Glick ID, Haas GL, Spencer JH, Lewis AB, Peyser J, et al. A randomized clinicaltrial of inpatient family intervention: V. Results for affective disorders. J Affect Disord.1990;18(1):17-28.102 van Gent EM, Zwart FM. Psychoeducation of partners of bipolar-manic patients. J AffectDisord. 1991;21(1):15-8.103 Reinares M, Vieta E, Colom F, Martinez-Aran A, Torrent C, Comes M, et al. Impact of a psychoeducationalfamily intervention on caregivers of stabilized bipolar patients. PsychotherPsychosom. 2004;73(5):312-9.104 Reinares M, Colom F, Sanchez-Moreno J, Torrent C, Martinez-Aran A, Comes M, et al. Impactof caregiver group psychoeducation on the course and outcome of bipolar patients inremission: a randomized controlled trial. Bipolar Disord. 2008;10(4):511-9.105 Goldstein MJ. Psychoeducation and relapse prevention. Int Clin Psychopharmacol. 1995;9Suppl 5:59-69.106 Pfammatter M, Junghan UM, Brenner HD. Efficacy of psychological therapy in schizophrenia:conclusions from meta-analyses. Schizophr Bull. 2006;32 Suppl 1:S64-80.107 Lincoln TM, Wilhelm K, Nestoriuc Y. Effectiveness of psychoeducation for relapse, symptoms,knowledge, adherence and functioning in psychotic disorders: a meta-analysis. SchizophrRes. 2007;96(1-3):232-45.108 Bäuml J, Pitschel-Walz G, Volz A, Engel RR, Kissling W. Psychoeducation in schizophrenia:7-year follow-up concerning rehospitalization and days in hospital in the Munich psychosisinformation project study. J Clin Psychiatry. 2007;68(6):854-61.109 Colom F, Vieta E, Martinez-Aran A, Reinares M, Goikolea JM, Benabarre A, et al. A randomizedtrial on the efficacy of group psychoeducation in the prophylaxis of recurrences inbipolar patients whose disease is in remission. Arch Gen Psychiatry. 2003;60(4):402-7.110 Colom F, Vieta E, Reinares M, Martinez-Aran A, Torrent C, Goikolea JM, et al. Psychoeducationefficacy in bipolar disorders: beyond compliance enhancement. J Clin Psychiatry.2003;64(9):1101-5.111 Perry A, Tarrier N, Morriss R, McCarthy E, Limb K. Randomised controlled trial of efficacyof teaching patients with bipolar disorder to identify early symptoms of relapse and obtaintreatment. BMJ. 1999;318(7177):149-53.112 Delahunty A, Morice R. Rehabilitation of frontal/executive impairments in schizophrenia.Aust N Z J Psychiatry. 1996;30(6):760-7.113 Medalia A, Revheim N, Casey M. The remediation of problem-solving skills in schizophrenia.Schizophr Bull. 2001;27(2):259-67.114 Hogarty GE, Flesher S, Ulrich R, Carter M, Greenwald D, Pogue-Geile M, et al. Cognitiveenhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition andbehavior. Arch Gen Psychiatry. 2004;61(9):866-76.160 GUÍAS DE PRÁCTICA CLÍNICA EN EL SNS
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Guía de Práctica Clínicade Inter
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Esta GPC ha sido fi nanciada median
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5.2.2 Programas residenciales en la
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Esperamos que esta guía promueva e
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ColaboradoresDocumentalistaIrene Mu
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Preguntas para respondera) INTERVEN
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Resumen de las recomendacionesCCCBC
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√DD√ACDBB√C5.2. INTERVENCIONE
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CCB√Cuando no haya abuso de susta
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La atención a las personas con TMG
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• Personas con trastornos de la p
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Figura 1. Estrategia de búsquedaB
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ción de la calidad de aquellos art
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4. Características de la GPC4.1. D
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los términos que utilizamos, la co
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5. Intervenciones rehabilitadorasde
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principios básicos del aprendizaje
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Los estudios de TCC incluidos en es
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El tamaño de la población es sign
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Funcionamiento socialUn estudio inf
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Sintomatología persistenteNo se pu
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• Número de ingresos (1 ECA; n =
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Resumen de evidencia1-1-1-1-1-1-1-1
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1-1-1+1-1+Sin embargo, cuando se co
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mes Research Team (PORT). El progra
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RecomendacionesCLas estrategias dir
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Terapia de apoyo vs. terapia cognit
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crisis, incluida la exacerbación s
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con tratamiento estándar. Consider
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No hay suficiente evidencia para de
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A los dos años de tratamiento, y t
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Van Gent y Zwart 102 señalan que n
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1+1-1-1-1+1+1-1+1-1-1-1-1-1-1-En re
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estudios que valorasen el impacto d
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Psicoeducación con incorporación
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más, el aprendizaje en otras inter
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El equipo elaborador de esta GPC ha
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1+1-1++El IPT es más efectivo en l
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Hipnosis para personas que sufren T
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1-1-La dramaterapia puede ayudar a
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deterioro en su autonomía personal
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33Los programas residenciales comun
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ación y re-entrenamiento que en al
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Entrenamiento prevocacional (EPV) v
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Empleo protegido (EP) vs. tratamien
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1-1+1+La incorporación de pago al
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5.2.5. Otras intervenciones terapé
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Resumen de la evidencia1-1-1-1-1-La
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El modelo ICM (Intensive case manag
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intensidad. También está la revis
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Funcionamiento SocialNo hay evidenc
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5.3.5. Hospitales de día no agudos
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- Page 159: 59 Cochran SD. Preventing medical n
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- Page 167 and 168: 218 Tsemberis SJ, Moran L, Shinn M,