Authors

Piedad Pérez Marín1, Mª Paz Hernández Jiménez2, Ignacio García Cabeza3

Position

1 Enfermera especialista en Salud Mental. Servicio de Psiquiatría B. Hospital General Universitario Gregorio Marañón. Madrid2 Enfermera. Servicio de Psiquiatría B. Hospital General Universitario Gregorio Marañón. Madrid3Psiquiatra. Servicio de Psiquiatría B. Hospital General Universitario Gregorio Marañón. Madrid 

Contact address

Piedad Pérez Marín. Servicio de Psiquiatría B. Hospital General Universitario Gregorio Marañón. C/ Ibiza, 43. 28009 Madrid.

Contact email: piperezm@yahoo.es

Abstract

Objective: to evaluate the efficacy of this therapeutic program for patients with psychosis (ATIICO) in the improvement of: adherence to treatment, attitude towards the disease, clinical impression, negative and positive symptoms, level of insight, degree of disability, and level of quality of life.
Method: a quasi-experimental before-and-after study was conducted, without any control arm. The population of this study was formed by all patients included in the ATIICO program.
Said patients were evaluated when entering the program and at one year, with scales for adherence (CRS, DAI-10); psychopathology (PANSS); clinical scales (ICG, GAF); disability (DAS/WHO); insight (Birchwood) and quality of life (EuroQol5D).
The intervention consisted in a therapeutic program conducted by a multidisciplinary team who was in charge of preparing an individualized treatment, adapted to the needs of each patient, and based on the following criteria: accessibility, immediacy and continuity, intervention in a crisis, comprehensive intervention, specific care for families, and chronic care.
For data analysis, Wilcoxon signed-rank test was used in order to compare medians between the associated samples, and McNemar Test was used for qualitative variables.
Results: significant improvements were found in the adherence measured, at psychopathological and clinical level, in the sub-scales for positive symptoms and overall psychopathology, in total disability and all its sub-scales. No improvements were found in the attitude towards treatment measured, or in the sub-scale for negative symptoms, insight or quality of life.
Conclusions: intensive and integrating interventions can be effective even in those patients with psychosis who are more reluctant to treatment.

Keywords:

schizophrenia; Treatment adherence; integrating interventions; psychosis

Versión en Español

Título:

Eficacia de un programa terapéutico para pacientes con psicosis (ATIICO) en la mejora de la adherencia al tratamiento