Group psychoeducation for long-term offender patients with schizophrenia: an exploratory randomised controlled trial.

BACKGROUND

Psychoeducation is now commonly provided in forensic settings, but its effectiveness among long-term offender patients with schizophrenia has not yet been established in randomised controlled trials (RCTs).

AIM

To test the effects of a brief group psychoeducation programme for offenders with schizophrenia (n = 39) resident in a high-security hospital (Niuvanniemi Hospital, Finland).

METHOD

High-security hospital patients were randomised into either eight sessions of group psychoeducation or 'treatment as usual' (TAU). Outcome measures, made at baseline, immediately post-treatment, and 3 months after that, included knowledge about illness, insight, compliance, attitudes towards medication, psychiatric symptoms and ward behaviour, self-esteem, health-related quality of life and perceived stigma.

RESULTS

Three months after completing treatment, or an equivalent time under TAU, patients in the intervention group showed a positive treatment effect in terms of knowledge about illness, self-esteem and insight into the illness. The only possible adverse effect was a slight increase in irritability, but this did not translate into behaviour of concern to staff.

CONCLUSIONS

Our sample size was small, and the findings must be regarded as preliminary, but the positive treatment effect of psychoeducation, and the absence of alarming side effects, suggests a full scale trial would be worthwhile. Most encouraging was that even the most severely ill patients were able to join the groups.