Partizipationsverhalten schizophren erkrankter Patienten in Psychoedukationsgruppen

Background

The effectiveness of psychoeducation groups for people with schizophrenia is well documented; however, there are no studies which examined patient participation behavior although this behavior might be critical for accomplishment of the therapeutic goals. This article presents newly developed 4-point Likert scale, the participation quality rating scale (PQRS), together with initial results on practicability, validity, change sensitivity, sociodemographic and clinical correlates and on the question whether participation quality might be a significant predictor of the short and long-term outcome of psychoeducation.

Patient and methods

Within the framework of the Munich Study “Cognitive Determinants of Psychoeducation and Information in Schizophrenic Psychoses” (COGPIP) the individual participation behavior of 97 patients with schizophrenia was examined after each psychoeducational group session (4 weeks). Individual mean PQRS scores were correlated with sociodemographic, anamnestic and clinical variables. In addition to change sensitivity the ability of the scale to predict the acquisition of illness knowledge during psychoeducation was examined as well as readmission during a 9-month follow-up period and the psychopathological endpoint (positive and negative syndrome scale, PANSS).

Results

Practicability and change sensitivity of the PQRS were found to be sufficient. Significant correlations with independently rated illness insight and medication compliance indicated a construct validity of the scale. Higher age, female sex and less pronounced psychopathological symptoms (PANSS) were associated with better participation behavior. Even patients with clearly impaired participation behavior profited from psychoeducation in that they were able to catch up with the delay with regard to illness knowledge. However, the PQRS was not a predictor of readmission during the 9-month follow-up period or of psychopathological endpoints.

Conclusions

The PQRS is qualified as a new tool for the standardized assessment of participation behavior in people with schizophrenia attending psychoeducation groups. The scale can be applied in research as well as clinical contexts in order to further improve understanding of how psychoeducation works and how this kind of supplementary therapy could become even more effective.