The effect of psychoeducation on clinical symptoms, adherence, insight and autonomy in patients with schizophrenia.

Abstract

Objective: The aim of this study is to assess the impact of psychoeducation on patients with schizophrenia, focusing on clinical symptoms, insight, self-esteem, treatment adherence, and social autonomy.

Methods: This prospective study evaluates the effects of a 6-month psychoeducation program, the P.A.C.T. (Psychosis Aider Comprendre Traiter) program, on stabilized outpatients with schizophrenia, without the use of a control group. The program is designed to help patients understand their illness and treatment, improving adherence to care. Topics covered include the symptoms of schizophrenia, available treatment options, and coping strategies. The program also emphasizes peer support and individualized care, addressing challenges such as cognitive deficits and low motivation. Data were collected both prior to and following the psychoeducation program using a standardized questionnaire and assessment scales to evaluate the following: clinical symptoms (Positive and Negative Syndrome Scale, PANSS), therapeutic adherence (Medication Adherence Report Scale, MARS), insight (Birchwood Insight Scale), self-esteem (Rosenberg Self-Esteem Scale), and social autonomy (Social Autonomy Scale, SAS).

Results: A total of 100 patients participated in the psychoeducational sessions, with a mean age of 37.73 ± 10.51 years and a male predominance. Following the psychoeducation program, significant improvements were observed across all assessment scales: - PANSS: Clinical symptoms improved markedly, with the mean score decreasing from 83.17 ± 23.09 before psychoeducation to 43.67 ± 16.11 after psychoeducation (p < 0.0001). - MARS-5: The rate of good adherence to treatment increased from 9% to 63.7%, with a significant change (p < 0.0001). - Birchwood Insight Scale and Rosenberg Self-Esteem Scale: Insight and self-esteem scores improved significantly (p < 0.0001).

- sas: Social autonomy showed substantial improvement, with the mean SAS score decreasing from 58.81 to 20.21 (p < 0.0001).

Conclusion: The P.A.C.T. psychoeducation program has been shown to significantly improve clinical outcomes, treatment adherence, insight, self-esteem, and social autonomy in patients with schizophrenia. However, the absence of a control group prevents the generalization of these data. Subsequent comparative studies would be desirable to demonstrate the positive effect of psychoeducation in the early stages of the disease within the framework of a comprehensive approach to recovery.