Integrated Psychological Rehabilitation Program on Neurocognition, Social Skill, and Functional Disability in Persons with Schizophrenia: A Pilot Study

Abstract

Abstract Introduction: Schizophrenia, a chronic and severe mental disorder, is characterized by disruptions in thinking, perception, emotions, and behavior. These disturbances are accompanied by significant cognitive and social skill deficits that affect their functional outcomes encompassing employment, independent living, social interactions, and community integration. To address these issues, the development of psychological rehabilitation programs addressing cognitive and social skill deficits becomes pivotal in schizophrenia care. Objective: The study was designed to develop modules for the integrated psychological rehabilitation program (IPRP) that focus on neurocognitive functions, social skills, and functional disability and evaluate its feasibility among schizophrenia patients. Materials and Methods: The present study made use of a pre- and posttest research design and used purposive sampling to recruit patients diagnosed with schizophrenia. Twelve participants completed the 1-month IPRP along with the pre- and posttest evaluations encompassing cognitive functions, social skills, and disability using the Bender Gestalt Test, Social Skills Assessment Screening Scale, NIMHANS neuropsychology battery, Postgraduate Institute Memory Scale, and WHO Disability Assessment Schedule II. IPRP consisted of psychoeducation, cognitive retraining, and social skills training. Results: The majority of the participants were college educated (91.7%), unemployed (83.3%), single (75%), males (75%), residing in urban areas (66.7%), and living in joint family (66.7%). Wilcoxon signed-rank test was used to compare pre- and posttest means. The results found significant improvements in various cognitive domains, including visuospatial ability (Z = 2.43, P = 0.015), remote (Z = 2.12, P = 0.034) and immediate memory (Z = 2.04, P = 0.042), verbal retention for similar (Z = 2.26, P = 0.024) and dissimilar pairs (Z = 2.82, P = 0.005), recognition (Z = 2.14, P = 0.032), total memory (Z = 3.06, P = 0.002), mental speed in terms of time taken (Z = 2.98, P = 0.003) and errors made (Z = 2.26, P = 0.024) on the digit symbol substitution test, comprehension (Z = 2.84, P = 0.004), social skills (Z = 2.807, P = 0.005), and overall disability (Z = 2.94, P = 0.003). Conclusion: The findings from the study underscore the potential of the IPRP in mitigating cognitive deficits, enhancing social skills, and reducing overall disability among schizophrenia patients.