Functional Skills Training For Late Life Schizophrenia

描述(由申请人提供)：尽管药理作用有所改善 精神分裂症的治疗，患者继续有困难 在现实世界中发挥作用(例如，药物管理、交流 需求、建立社交网络、管理财务)。这些困难是 可能合并为精神分裂症年龄的人(例如，身体 限制、认知障碍)，从而使其更难生活 社区。事实上，美国老年人的比例 老年人精神分裂症的比例也会呈爆炸式增长， 造成精神健康和社会服务系统的流失 为他们服务。目前，关于这类药物的有效性的研究还很少。 为精神分裂症患者设计的康复方案还没有设计出来 并在老年患者中进行了测试。因此，显然有必要发展 对老年人的缺陷敏感的有效康复方案 患有精神分裂症。有效地促进更好的心理社会干预 症状管理、药物管理、日常生活技能，以及 心理社会功能尤其重要，因为它们可能会降低 老年精神分裂症患者需要住院和 长期护理，同时将医疗保健系统的负担降至最低。 拟议项目的目标是测试技能培训的效果 议定书，题为功能适应技能培训(FAST)，旨在 提高老年精神分裂症患者的日常功能。我们将招收 将200名60岁以上社区居住的患者随机分成两组， 多个后测控制组设计研究。受试者将参加以下其中一项 两种时间相等的干预措施：实验治疗，24次组 针对6个功能技能领域的针对老年人的干预措施 (即财务管理、社交技能、沟通技能、 运输、组织和计划以及药物管理)；或 心理社会安慰剂(一个友好的支持小组)。治疗之后将会有 六次每月一次的维护会议。评估在6点、12点和12点进行 基线后18个月。拟议研究的一个独特之处是使用了 以绩效为基础的成果衡量标准，减少与缺乏相关的问题 精神分裂症患者中常见的洞察力。数据将使我们能够确定短期内 我们干预的效果，维护会议的有效性，以及 干预后持续时间的治疗效果。

DESCRIPTION (provided by applicant): Despite improved pharmacological treatments for schizophrenia, patients continue to have difficulties functioning in the real world (e.g., medication management, communicating needs, establishing social networks, managing finances). These difficulties are likely compounded as persons with schizophrenia age (e.g., physical limitations, cognitive impairment), thus, making it more difficult to live in the community. As the proportion of older persons in the U. S. virtually explodes, so too will the proportion of older persons with schizophrenia, creating a drain on mental health and social service systems ill-equipped to serve them. There is a current paucity of studies on the effectiveness of rehabilitation programs for schizophrenia patients and none has been designed and tested with older patients. Thus, there is a clear need to develop effective rehabilitation programs sensitive to the deficits of older persons with schizophrenia. Psychosocial interventions which efficiently promote better symptom management, medication management, every day living skills, and psychosocial functioning are of particular importance in that they may reduce the chance that older patients with schizophrenia require hospitalization and long-term care while minimizing burden on health care systems. The goal of the proposed project is to test the efficacy of a skills training protocol, entitled Functional Adaptation Skills Training (FAST), designed to enhance daily functioning of older patients with schizophrenia. We will enroll 200 community dwelling patients over age 60 into a randomized, pretest, multiple posttest control group design study. Subjects will enroll in one of two time-equivalent interventions: Experimental treatment, a 24-session group intervention designed for older adults targeting 6 functional skill domains (i.e., financial management, social skills, communication skills, transportation, organization and planning, and medication management); or psychosocial placebo (a friendly support group). Treatment will be followed by six one-monthly maintenance sessions. Assessments are conducted at 6-, 12-, and 18-months post-baseline. A unique feature of the proposed study is the use of performance-based outcome measures which reduce problems associated with lack of insight common in schizophrenia. Data will allow us to determine short-term effects of our intervention, effectiveness of maintenance sessions, and post-intervention duration of treatment effects.