Forensic Psychiatric Patients, Schizophenia Disorder
Conditions
Keywords
Rehabilitation, Resistant Schizophrenia, Forensic
Brief summary
This study employs a quasi-experimental design to evaluate the effectiveness of a 6-month multidisciplinary rehabilitation program integrating psychodynamic group therapy, art therapy, music therapy, and cognitive stimulation compared to standard rehabilitation (physiotherapy and occupational therapy). It will be done between a group of a total of 20 patients are divided into an intervention group and a control group from the forensic psychiatric department in Al Masarra Hospital.
Detailed description
Forensic psychiatric patients with treatment-resistant psychotic symptoms often experience persistent cognitive, functional, and social deficits, posing significant challenges to rehabilitation. Traditional approaches may not adequately address these complex needs, highlighting the importance of innovative, multidisciplinary interventions. This study employs a quasi-experimental design to evaluate the effectiveness of a 6-month multidisciplinary rehabilitation program integrating psychodynamic group therapy, art therapy, music therapy, and cognitive stimulation compared to standard rehabilitation (physiotherapy and occupational therapy). A total of 20 patients are divided into an intervention group (n=10) and a control group (n=10) using convenience sampling from the forensic psychiatric department in Al Masarra Hospital. Data is collected using the Positive and Negative Syndrome Scale (PANSS) to assess psychotic symptoms and the Montreal Cognitive Assessment (MoCA) to evaluate cognitive function, administered at baseline and post-intervention. Data is analyzed using descriptive statistics (median, interquartile range) and non-parametric tests, including the Wilcoxon Signed-Rank Test for within-group comparisons and the Mann-Whitney U Test for between-group comparisons. Effect sizes are calculated using Cliff's Delta to assess the practical significance of the findings. The null hypothesis states that there will be no significant difference in PANSS and MoCA scores between the intervention and control groups post-intervention. If the null hypothesis is rejected, the findings will provide evidence for integrating creative and psychotherapeutic interventions into forensic psychiatric rehabilitation, offering a scalable model for similar settings.
Interventions
DIAGNOSTIC_TESTMoCA: Montreal Cognitive Assessment (MoCA) and Positive and Negative Syndrome Scale (PANSS)
MoCA: A 30-point screening tool assessing attention, memory, language, visuospatial and executive functions; quick and sensitive to mild cognitive deficits. PANSS: A 30-item scale rating positive, negative, and general psychopathology symptoms in psychotic disorders; widely used to track severity and change.
BEHAVIORALRehabilitation program in the form of : psychodynamic group therapy, music and art therapy , cognitive stimulation techniques
Participants received a structured 6-month program designed to address persistent psychotic symptoms and associated deficits. The intervention included: Art Therapy: Weekly sessions promoting self-expression, emotional regulation, and enhancement of social interaction. Cognitive Stimulation: Structured group exercises aimed at improving attention, memory, executive functions, and problem-solving. The program was delivered by a multidisciplinary team in a group of 10 patients, ensuring active participation, individualized support, and integration of therapeutic modalities.
Sponsors
Oman Ministry of Health
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This quasi-experimental, non-randomized parallel-group study evaluates a 6-month multidisciplinary rehabilitation program for forensic psychiatric inpatients with treatment-resistant psychotic symptoms at Al Masarra Hospital. Twenty patients will be allocated by convenience sampling to an intervention group (n=10) or control group (n=10). The intervention integrates psychodynamic group therapy, art therapy, music therapy, and cognitive stimulation (4-5 hrs/week), while controls receive standard physiotherapy and occupational therapy (3-4 hrs/week). PANSS and MoCA will be administered at baseline and post-intervention by blinded assessors. Data will be analyzed using Wilcoxon Signed-Rank and Mann-Whitney U tests, with effect sizes reported via Cliff's Delta. The null hypothesis is that there will be no significant differences in psychotic symptoms or cognition between groups post-intervention. outcomes may support rehabilitation importance in forensic settings.
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Diagnosis of chronic psychotic disorder (e.g., schizophrenia or schizoaffective disorder) confirmed by psychiatric assessment and medical records. 2. Presence of residual psychotic symptoms (positive symptoms such as hallucinations, delusions; and/or negative symptoms such as blunted affect, social withdrawal) despite ongoing psychotropic treatment. 3. Medically stable and deemed suitable for participation by the treating psychiatrist or healthcare team. 4. Patients who provide informed consent to participate in the rehabilitation program and research study.
Exclusion criteria
1. Acute medical or psychiatric conditions requiring immediate intervention. 2. Developmental or intellectual disabilities that significantly impair participation in the rehabilitation program or assessments. 3. Current substance dependence that would interfere with participation. 4. Significant risk of harm to self or others, based on clinical assessment or history of violence/aggression. 5. Contraindications to specific rehabilitation program components (e.g., physical exercise, group activities) as determined by medical evaluation. 6. Inability to comprehend study requirements or provide informed consent due to language barriers, cognitive impairment, or other factors.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Psychotic Symptoms Measured by the Positive and Negative Syndrome Scale (PANSS) | Baseline (pre-intervention) and 6 months (post-intervention). | Psychotic symptom severity will be assessed using the Positive and Negative Syndrome Scale (PANSS). Scores range from 30 to 210, with higher scores indicating greater severity. The unit of measure is score change from baseline to post-intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Cognitive Function Measured by the Montreal Cognitive Assessment (MoCA) scale | Baseline (pre-intervention) and 6 months (post intervention). | Cognitive function will be assessed using the Montreal Cognitive Assessment (MoCA) scale. Scores range from 0 to 30, with higher scores indicating better cognitive performance. The unit of measure is score change from baseline to post-intervention. |
Countries
Oman
Outcome results
None listed