Department of Clinical and Experimental Sciences, University of Brescia.
Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy.
Curr Opin Psychiatry. 2024 May 1;37(3):131-139. doi: 10.1097/YCO.0000000000000925. Epub 2024 Feb 15.
Schizophrenia Spectrum Disorders (SSD) are severe conditions that frequently produce significant impairment in cognitive performance, social skills and psychosocial functioning. As pharmacological treatment alone often provides only limited improvements on these outcomes, several psychosocial interventions are employed in psychiatric rehabilitation practice to improve of real-world outcomes of people living with SSD: the present review aims to provide a critical overview of these treatments, focusing on those that show consistent evidence of effectiveness.
Several recent systematic reviews and meta-analyses have investigated in detail the acceptability, the effectiveness on several specific outcomes and moderators of response of different psychosocial interventions, and several individual studies have provided novel insight on their implementation and combination in rehabilitation practice.
Cognitive remediation, metacognitive training, social skills training, psychoeducation, family interventions, cognitive behavioral therapy, physical exercise and lifestyle interventions, supported employment and some other interventions can be fully considered as evidence-based treatments in SSD. Psychosocial interventions could be of particular usefulness in the context of early intervention services. Future research should focus on developing newer interventions, on better understanding the barriers and the facilitators of their implementation in clinical practice, and exploring the opportunities provided by novel technologies.
精神分裂症谱系障碍(SSD)是严重的疾病,常导致认知表现、社会技能和心理社会功能严重受损。由于单独使用药物治疗通常只能对这些结果产生有限的改善,因此在精神康复实践中采用了几种心理社会干预措施来提高 SSD 患者的现实结果:本综述旨在批判性地概述这些治疗方法,重点关注那些具有一致有效性证据的治疗方法。
最近的几项系统评价和荟萃分析详细研究了不同心理社会干预措施的可接受性、对几种特定结果的有效性以及反应的调节因素,并且一些个别研究提供了关于它们在康复实践中的实施和组合的新见解。
认知矫正、元认知训练、社交技能训练、心理教育、家庭干预、认知行为疗法、体育锻炼和生活方式干预、支持性就业和其他一些干预措施可以被完全视为 SSD 的循证治疗方法。心理社会干预措施在早期干预服务中可能特别有用。未来的研究应集中于开发新的干预措施,更好地了解在临床实践中实施这些干预措施的障碍和促进因素,并探索新技术提供的机会。