Journal List > J Korean Neuropsychiatr Assoc > v.51(4) > 1017580

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



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.


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.


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.


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.

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.
Fig. 2
Summary of cognitive behavioral social skill training (12 sessions).
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.
Table 1
Socio-demographic characteristics of the sample (n=20)

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

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

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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