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Lee, Ko, Choi, Kim, and Park: A Randomized Controlled Pilot Study of Cognitive Behavioral Social Skills Training (Korean version) for Middle- or Older-Aged Patients with Schizophrenia : A Pilot Study
Original Article
Journal of Korean Neuropsychiatric Association

Journal of Korean Neuropsychiatric Association 2012; 51(4): 192-201.

Published online: 30 July 2012

DOI: https://doi.org/10.4306/jknpa.2012.51.4.192

A Randomized Controlled Pilot Study of Cognitive Behavioral Social Skills Training (Korean version) for Middle- or Older-Aged Patients with Schizophrenia : A Pilot Study

Do-Hyeong Lee, MD1, Seok-Man Ko, MD2, Yong-Sung Choi, MD, PhD2, Kun-Jong Kim, MD2, Hanson Park, MD2, 3

1Department of Psychiatry, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

2Department of Psychiatry, St. Andrew's Neuropsychiatric Hospital, Icheon, Korea.

3Department of Anthropology, Seoul National University College of Social Sciences, Seoul, Korea.

Address for correspondence: Hanson Park, MD. Department of Psychiatry, St. Andrew's Neuropsychiatric Hospital, 586-2 Pyogyo-ri, Majang-myeon, Icheon 467-813, Korea. Tel +82-31-639-3836, Fax +82-31-639-3830, hansonpark@snu.ac.kr

Received 7 March 2012       Revised 14 May 2012       Accepted 31 May 2012

Copyright © 2012 Korean Neuropsychiatric Association

Abstract

Objectives

Cognitive behavioral therapy and social skills training have been proposed as a promising modality for treatment of patients with schizophrenia. The objective of this study was to evaluate the effectiveness of Cognitive Behavioral Social Skill Training (CBSST) in patients with chronic schizophrenia.

Methods

Twenty six middle- or older-aged hospitalized patients with schizophrenia were selected in a mental hospital. Eleven participants were randomly assigned to undergo treatment with CBSST and 15 participants were assigned to receive the usual treatment. CBSST was administered in a single group over 12 sessions for a period of weeks, and the participants were assessed by blinded raters at base line and end point, and end of treatment.

Results

Compared to patients who received the usual treatment, those who received treatment with CBSST showed a significant reduction of Hamilton Rating Scale for Depression score, however, scores for other psychiatric symptoms did not differ significantly. In terms of Quality of life (QoL) analysis, scores for overall quality of life showed a more significant increase in the CBSST group, compared with the group of patients who received the usual treatment. According to results of the Independent Living Skill Survey, patients receiving CBSST showed significantly greater involvement in social activities than patients receiving usual treatment group.

Conclusion

Psychosocial intervention for patients with chronic schizophrenia is very important, not only for management of primary psychiatric symptoms, but also for QoL and social rehabilitation. The results of this study, showing improvement of depressive mood, overall life quality, and social activities, suggest that CBSST could be an effective treatment for these patients. This study is a pilot study performed in an inpatient treatment setting. Further studies are required in order to clarify the advantage of CBSST in treatment of patients with chronic schizophrenia, esp. under outpatient settings.

Keywords: Schizophrenia, Social rehabilitation, Cognitive behavioral social skills training

Figures and Tables

Fig. 1
Flow of middle-aged or older patients with chronic schizophrenia through a 2-month pilot study of treatment as usual with or without cognitive behavioral social skill training. TAU : Treatment as usual, CBSST : Cognitive Behavioral Social Skil Training.
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Fig. 2
Summary of cognitive behavioral social skill training (12 sessions).
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Fig. 3
Comparison of symptoms profiles for older patients with chronic schizophrenia who received cognitive behavioral social skills training or standard treatment. * : p<0.05. BPRS : Brief Psychiatric Rating Scale, SAPS: Scale for the Assessment of Positive Symptoms, SANS : Scale for the Assessment of Negative Symptoms, HAMD : Korean version of the Hamilton Depression Rating Scale, CGI : Clinical Global Impression, CBSST : Cognitive Behavioral Social Skills Training, TAU : Treatment as usual.
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Table 1
Socio-demographic characteristics of the sample (n=20)
jkna-51-192-i001

Continuous variables : Mean±SD. * : Independent sampled t-test, † : Chi-square test. SD : Standard deviation, CBSST : Cognitive behavioral social skills training

Table 2
Comparison of each domains of QoL for older patients with chronic schizophrenia who received cognitive behavioral social skills training or treatment as usual
jkna-51-192-i002

Represented by Mean±SD. * : p<0.05, † : Wilcoxon signed rank test, ‡ : Mann Whitney test. QoL : Quality of life, SD : Standard deviation

Table 3
Comparison of ILSS for older patients with chronic schizophrenia who received cognitive behavioral social skills training or treatment as usual
jkna-51-192-i003

Represented by Mean±SD. * : p<0.05, † : Wilcoxon signed rank test, ‡ : Mann Whitney test. ILSS : Independent Living Skills Survey, SD : Standard deviation, CBSST : Cognitive Behavioral Social Skills Training

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