Erschienen in:
13.09.2019 | Original Paper
Promoting stigma coping and empowerment in patients with schizophrenia and depression: results of a cluster-RCT
verfasst von:
Wolfgang Gaebel, Harald Zäske, Klaus Hesse, Stefan Klingberg, Christian Ohmann, Jürgen Grebe, Henrike Kolbe, Andrea Icks, Frank Schneider, Volker Backes, Claus Wolff-Menzler, Birgit Guse, Jürgen Gallinat, Thomas Bock, Maria-Christiane Jockers-Scherübl, Timo Krüger, Frank Jessen, Andreas Bechdolf, Tilo Kircher, Carsten Konrad, Peter Falkai, Annette Schaub, Matthias Rudolph, Volker Köllner, Gerhard Schmid-Ott, Michael Linden, Barbara Lieberei, Monika Stuhlinger, Sebastian Sommerfeld, Albrecht Schumacher, Sabine Krenge, Stephanie Gereke, Norbert Mönter, Alicia Navarro-Urena, Günter Frosch, Franz-Josef Kuhlbusch, Helen Cleveland, Mathias Riesbeck
Erschienen in:
European Archives of Psychiatry and Clinical Neuroscience
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Ausgabe 5/2020
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Abstract
There is a need for interventions supporting patients with mental health conditions in coping with stigma and discrimination. A psycho-educational group therapy module to promote stigma coping and empowerment (STEM) was developed and tested for efficacy in patients with schizophrenia or depression. 30 clinical centers participated in a cluster-randomized clinical trial, representing a broad spectrum of mental health care settings: in-patient (acute treatment, rehabilitation), out-patient, and day-hospitals. As randomized, patients in the intervention group clusters/centers received an illness-specific eight sessions standard psychoeducational group therapy plus three specific sessions on stigma coping and empowerment (‘STEM’). In the control group clusters the same standard psychoeducational group therapy was extended to 11 sessions followed by one booster session in both conditions. In total, N = 462 patients were included in the analysis (N = 117 with schizophrenia spectrum disorders, ICD-10 F2x; N = 345 with depression, ICD-10 F31.3–F31.5, F32–F34, and F43.2). Clinical and stigma-related measures were assessed before and directly after treatment, as well as after 6 weeks, 6 months, and 12 months (M12). Primary outcome was improvement in quality of life (QoL) assessed with the WHO-QOL-BREF between pre-assessment and M12 analyzed by mixed models and adjusted for pre-treatment differences. Overall, QoL and secondary outcome measures (symptoms, functioning, compliance, internalized stigma, self-esteem, empowerment) improved significantly, but there was no significant difference between intervention and control group. The short STEM module has proven its practicability as an add-on in different settings in routine mental health care. The overall increase in empowerment in both, schizophrenia and depression, indicates patients’ treatment benefit. However, factors contributing to improvement need to be explored.