Impairment of motivation in patients with schizophrenia and the development of a program for their psychosocial treatment

Abstract

IntroductionReduced motivation in schizophrenia is expressed is as the reduction of activity and social functioning.ObjectivesAssessment of motivation in patients with schizophrenia and development to their psychosocial treatment.MethodsClinical, psychometric (URICA, PSP, PANSS), statistical. Included 100 patients diagnosed with schisophrenia F.20-29(ICD-10) with various levels of deficit.ResultsThe analysis showed the connection between the intensity of negative disorders of the patients with the level of their motivations: in the group of patients with severe deficiency (pseudoorganic), a decrease in the level of motivation was found: the score of the «Precontemplation» stage of the URICA scale (56.20 ± 9.29) was higher (P <0.001). Patients with moderate deficit (diminished schizoid) changes were distinguished by high motivation, high scores on the «Action» (49.34 ± 8.22, P <0.005) and «Maintenance» scale (52.43 ± 10.51, P <0.005). A negative correlation was established between the indicators of patient motivation and the PANSS scale: will disorders (r = -0.75, P <0.01), social withdrawal (r = -0.64, P <0.01), blunted affect (r = -0.62, P<0.005), etc. High positive correlation found between motivation rating and PSP scores in socially activity (r = 0,74, P <0,005) and social relationships (r = 0,65, P <0,01). We have developed a comprehensive program of psychosocial treatment, including compliance therapy, motivational, cognitive and social skills training, destigmatization actions and an assessment of its effectiveness.ConclusionsThe developed rehabilitation program showed high efficiency: increasing motivation, reducing self-stigmatization, developing communication skills, improving social functioning and cognitive sphere in patients with schizophrenia.