Prophylaxis and prediction of relapse, rehospitalization days and thus treatment costs in schizophrenic patients
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Description
Objective:
In the present RCT study, the relapse prevention and treatment cost reduction potential were examined for 8 years after psychotherapeutic treatment in addition to standard treatment. The treatment approach used was Integrated Neurocognitive Therapy (INT), a group approach developed in our lab with interventions in 11 neuro- and social-cognitive domains, which are partly PC-supported with therapy elements from psychoeducation, CBTp and emotion regulation.
Methods:
71 outpatients with schizophrenia (ICD-10) were assigned to an INT group (30 sessions over 15 weeks) or standard treatment (TAU). Relapse rates were recorded during follow-up phases of 1 year and 5 and 8 years. A test battery was collected during treatment and the 1-year follow-up.
Results:
The relapse rates under INT and TAU did not differ significantly in the first year. 5 and 8 years after the end of treatment, the relapse rates for INT (48%/52%) were significantly lower than those for TAU (77.8%/82.8%). The rehospitalization days also differed significantly (8-year follow-up: INT=34.8 days; TAU=102.4). Extrapolated to the treatment flat rates, 47,320 Swiss francs (50,320 euros; 52,610 $) could be saved per patient over 8 years or 5915 Swiss francs (6292 euros; 6576 $) per year. Predictors: during the 1-year follow-up, there was a significant correlation between higher relapse rates and lower social-cognitive performance levels (emotional processes, schemas). The relapse rates in the first year after the end of treatment predicted the course of relapses and rehospitalization days during the 5- and 8-year follow-up. In the 5- and 8-year follow-up, lower symptoms, particularly positive symptoms, as well as a higher level of psychosocial functioning and verbal (working) memory were also shown to be predictors of reduced rehospitalization days. All other treatment and patient variables appeared to have no influence.
Conclusion:
The integrative psychological procedure (INT) used has proven to be very cost-effective over 8 years in terms of preventing recurrence and reducing rehospitalization days. Improved cognitive and social parameters and positive symptoms during the therapy phase appear to have significantly supported these very desirable results in the follow-up.
In the present RCT study, the relapse prevention and treatment cost reduction potential were examined for 8 years after psychotherapeutic treatment in addition to standard treatment. The treatment approach used was Integrated Neurocognitive Therapy (INT), a group approach developed in our lab with interventions in 11 neuro- and social-cognitive domains, which are partly PC-supported with therapy elements from psychoeducation, CBTp and emotion regulation.
Methods:
71 outpatients with schizophrenia (ICD-10) were assigned to an INT group (30 sessions over 15 weeks) or standard treatment (TAU). Relapse rates were recorded during follow-up phases of 1 year and 5 and 8 years. A test battery was collected during treatment and the 1-year follow-up.
Results:
The relapse rates under INT and TAU did not differ significantly in the first year. 5 and 8 years after the end of treatment, the relapse rates for INT (48%/52%) were significantly lower than those for TAU (77.8%/82.8%). The rehospitalization days also differed significantly (8-year follow-up: INT=34.8 days; TAU=102.4). Extrapolated to the treatment flat rates, 47,320 Swiss francs (50,320 euros; 52,610 $) could be saved per patient over 8 years or 5915 Swiss francs (6292 euros; 6576 $) per year. Predictors: during the 1-year follow-up, there was a significant correlation between higher relapse rates and lower social-cognitive performance levels (emotional processes, schemas). The relapse rates in the first year after the end of treatment predicted the course of relapses and rehospitalization days during the 5- and 8-year follow-up. In the 5- and 8-year follow-up, lower symptoms, particularly positive symptoms, as well as a higher level of psychosocial functioning and verbal (working) memory were also shown to be predictors of reduced rehospitalization days. All other treatment and patient variables appeared to have no influence.
Conclusion:
The integrative psychological procedure (INT) used has proven to be very cost-effective over 8 years in terms of preventing recurrence and reducing rehospitalization days. Improved cognitive and social parameters and positive symptoms during the therapy phase appear to have significantly supported these very desirable results in the follow-up.
Date of Publication
2025-09-12
Publication Type
Conference Item
Keyword(s)
Schizophrenia
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RCT
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Cognitive Remediation
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Costs
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Follo-up
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Rehabilitation
Language(s)
en
Contributor(s)
Title of Event
Access(Rights)
metadata.only