Psychiatry/schizophrenia/rehabilitation Mental and Behavioural Disorders Schizophrenia
Conditions
Interventions
Standard Rehabilitation Programme
Both control and experimental group will receive the standard rehabilitation programme provided at the centres which is conducted by professionals. It consists of psy
Sponsors
National University of Singapore (Singapore)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: This study aims to sample the whole population at the six centres (Simei Care Centre (SCC), Hougang Care Centre (HCC), Community Rehabilitation Support & Service (CRSS) and three Occupational Therapy: Activities, Vocation and Empowerment (OcTAVE) day centres) who meets the sample inclusion criteria during one-year recruitment period. This study will include participants who are: 1. Diagnosed with schizophrenia or schizoaffective disorders by a clinical psychiatrist according to DSM-IV or ICD-10 2. In a stable condition, not in acute mental health crisis or psychotic episode, and not been admitted to hospital due to relapse of schizophrenia symptom in the past 6 months, and no change in antipsychotic dosage in the past 6 months 3. Global Assessment of Functioning score more than 50 4. English speaking 5. 21-65 years old
Exclusion criteria
Exclusion criteria: Potential participants will be excluded if they have: 1. Non-related diagnosis, or having co-morbidity of personality disorders or mental retardation 2. Exposed to other PLSMP previously 3. Incompetent to sign informed consent as assessed by psychiatrist In the event that participants are readmitted into a psychiatric hospital during the intervention period, their participation in the study will cease. If participants are readmitted to psychiatric hospital during the 12-month follow up period and be discharged before the 12-month follow up assessment, they will need re-assessment by their attending psychiatrist using Global Assessment of Functioning (GAF) to determine their competency in continuing with this study (GAF score of 50 and above). If participants are readmitted at 12-month assessment time, their participation will cease.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Compared to the control group, participants who complete the peer-led self-management program will report significantly lower psychotic symptom scores at 12 months? follow up. Outcome will be assessed at baseline, immediate after the intervention (posttest 1), six months (posttest 2) and 12 months (posttest3) after the intervention. Individual interviews will be conducted for trainers and participants 12 months after the intervention. Primary Outcome Measure: Clinician-Rated Scale Positive And Negative Syndrome Scale (PANSS). It is a 30-item rating scale that is specifically developed to assess individuals with schizophrenia. It is based upon the premises that schizophrenia has two distinct syndromes: positive and negative. The positive syndrome includes those productive features such as delusions and hallucinations, while the negative syndrome includes those features which are lacking/poorly developed in individuals with schizophrenia, such as social withdrawal and flattened or blunted affect. The Inter-class correlation coefficiency is r=0.88-0.98 in the subscales. | — |
Secondary
| Measure | Time frame |
|---|---|
| Outcome will be assessed at baseline, immediate after the intervention (posttest 1), six months (posttest 2) and 12 months (posttest3) after the intervention. Individual interviews will be conducted for trainers and participants 12 months after the intervention. Clinician-Rated Scales 1. Specific level of Functioning Scale (SLOF). It will be used to assess social functioning and daily living skills of participants. It is a 43-item behavioural rating scale designed for use in people mentally ill in the community. The internal consistency reliability of the subscales ranged from á=0.68-0.92. 2. Schizophrenia Cognition Rating Scale (SCoRS), which is a 20-item interview-based assessment. It aims to assess cognitive processes that are commonly affected in schizophrenia patients which include attention, memory, reasoning and problem solving, working memory, language production and motor skills. All items are rated on a 4-point scale. Validation in Singapore found good intra-class correlation coefficient: r=0.984. Ratings from three sources (subject, informant and interviewer) correlated significantly with each other (r = 0.684?0.846, df = 143, P < 0.001). The convergent validity of SCoRs was assessed by comparing with the Brief Assessment of Cognition in Schizophrenia (BACS) The SCoRS global rating score was significantly correlated with Brief Assessment of Cognition in Schizophrenia BACS composite score and scores on majority of the BACS sub-tests. 3. Cogstate Schizophrenia Battery will be used to assess participants? cognition level through its computerized task based assessment. It was specifically designed to assess people with schizophrenia in the domains of speed of processing, attention/vigilance, working memory, visual learning, verbal learning, reasoning/problem solving and social cognition. It was well validated with Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) (r=0.83). An introduction brochure for Cogstate Schizophrenia | — |
Countries
Singapore
Outcome results
None listed