Chulalongkorn Medical Journal


Introduction : Relapse is common in schizophrenia. Therefore, schizophrenia patientsare vulnerable groups which require special attention. The relapsecan cause patients’ distress and result in re-admission in psychiatrichospitals. A symptom self-management program (SSMP) has beendeveloped to improve the patients’ self-management ability to decreaseearly symptoms of psychotic relapse.Objective : To evaluate the effect of SSMP on psychotic relapse in patients withchronic schizophrenia.Setting : An out-patient clinic of a psychiatric hospital.Research design : Randomized control trial.Patients : There were eligible 80 patients with chronic schizophrenia whoparticipated in this study.Methods : The samples were randomized by a computerized program, 40 ofthem were in the experimental group that received SSMP togetherwith routine care, while the other 40 were in the control group thatreceived only routine care. The experimental group underwent 4 phaseswhich were: 1) problem assessment and needs identification; 2)preparation for symptom self-management; 3) practice for symptomself-management; and, 4) evaluation for symptom self-management.The psychotic relapse was indicted by the elevation on remittedpsychotic symptom in hallucination, delusion, or disorganized thinking,up to 6 scores measured by the Brief Psychiatric Rating Scale (BPRS).Results : The findings revealed that the patients with chronic schizophreniain the experimental group 1 month after receiving the program wassignificantly lower than that of the control group at the level .05.The psychotic relapse rate of the control group was 69.2% (9 cases)as compared to 30.8% (4 cases) in the experimental group. In addition,the difference between the proportion of patients with chronicschizophrenia in the experimental group after receiving the programhad lower frequency of psychotic relapse than the control group(Kolmogorov Smirnov Z = 4.52, p-value = 0.05).Conclusion : Psychotic relapse was significantly lower in the experimental group.


Faculty of Medicine, Chulalongkorn University

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