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Efficacy of Social Skill Training in the Treatment of Stabilized Outpatients with Chronic Schizophrenia
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Schizophrenia, a debilitating neuropsychiatric disorder, is considered by WHO to be one amongst the foremost ten illnesses which contribute to the global burden of disease (Murray & Lopez, 1996). Antipsychotic medicines, considered to be first-line treatment of Schizophrenia, do not meaningfully improve cognitive deficits, negative symptoms and concomitant poor social adaptive functioning. Inclusion of empirically validated psychosocial interventions can enhance the quality of life and independent life skills in persons with Schizophrenia. The study aimed at evaluating efficacy of a Social Skills Training (SST) intervention of six months duration, on adaptive behavior among stabilized outpatients of chronic schizophrenia availing day care rehabilitation services. 96 stabilized outpatients with chronic schizophrenia, diagnosed as per DSM-V criteria, availing day care rehabilitation services, were allotted either to a wait list control group receiving standard care of treatment with antipsychotic medication (n=48) or experimental (active treatment) group, receiving SST in addition to standard care (n=48), through simple random sampling. This was a centre based pretest-posttest control group study. Both the groups were assessed once at the baseline and thereafter 6 months of SST intervention, comprising of 75 sessions, using Social Adaptive Functioning Evaluation (SAFE). Statistical analysis was conducted through independent samples t test on gain score (pre-intervention or baseline assessment post-intervention assessment) of the two groups. The results revealed an overall significant effect of SST program in the form of enhancing adaptive behaviour. At post intervention, the experimental group's gain scores on SAFE were found to be significantly higher (t= 2.458, p<0.05) while compared to the wait list control group. Thus, the present study highlighted efficacy of SST intervention in improving adaptive behaviour in persons with chronic schizophrenia. Therefore, in view of these favourable effects, it can be concluded that, although not routinely recommended in treatment guidelines of schizophrenia, integration of SST can improve present standard services, and can be recommended for wider implementation in rehabilitation centres in India.
Keywords
social skills training, positive symptoms, negative symptoms, adaptive behaviour, schizophrenia
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