Approval of a comprehensive psychosocial rehabilitation program for patients with negative symptoms in schizophrenia

Abstract

The aim of the work is to develop and evaluate the effectiveness of a comprehensive program of psychosocial rehabilitation of patients with negative symptoms in schizophrenia. Materials and methods. The study involved 168 patients with negative symptoms of schizophrenia: 94 patients who underwent a comprehensive psychosocial rehabilitation program (main group) and 74 patients who underwent a course of therapy according to the traditional scheme (control group). The criteria that evaluated the effectiveness of a comprehensive program of psychosocial rehabilitation in patients with negative symptoms in schizophrenia were: clinical dynamics of negative disorders, the degree of improvement/deterioration of compliance and social functioning, and the degree of restoration of basic life functions. Psychometric (Social Avoidance and Distress Scale (SADS), Personal and Social Functioning (PSP), Level of Compliance questionnaire, and the Severity of Negative Symptoms (SANS)) and statistical research methods were used to assess effectiveness. Results. The proposed scheme of a complex program of psychosocial rehabilitation is based on the principles of a complex, individually oriented and differentiated approach, and its targets are defined as clinical manifestations of negative symptoms in schizophrenia, impaired social adaptation, communication skills, decreased motivational sphere, compliance and impaired social functioning. Rehabilitation is implemented in four stages: diagnostic, therapeutic, rehabilitation and preventive. The effectiveness of the proposed scheme of psychosocial rehabilitation of patients with negative symptoms in schizophrenia was proven, which consisted in a more pronounced reduction of clinical manifestations of abulia, anhedonia, inattention, reduction of distress and social avoidance, improvement of social functioning in the main spheres of life, and improvement of social and behavioral compliance. Conclusions. The developed comprehensive program of psychosocial rehabilitation of patients with negative symptoms in schizophrenia has shown its effectiveness and can be used in psychocorrective measures aimed at treating patients with negative symptoms in schizophrenia.