A randomised controlled trial of 74 people with psychosis about to move from inpatient residence found that those receiving compliance therapy were five times more likely than those receiving non-specific counselling to take their medication without prompting, and over an 18-month follow-up period had better global functioning, insight, adherence and attitudes to their medication [ 25].
In addition, patients experiencing clearer thoughts from their medication (1.21 [1.40] 1.40]), a better quality of life (mean QLS total score: 1.64 [1.32, 2.03]), better global functioning (1.04 [1.06] 1.06]), and more daily activities (1.27 [1.52] 1.52]) had significantly greater odds of experiencing sustained favorable long-term outcome.
Higher insight at baseline was also associated with milder clinical severity (SCC between the SUMD items and the CGI score ranged from 0.29 to 0.39, p < 0.0001; Table 2) and better global functioning (SCC between the items of the SUMD and the GAF score ranged from −0.31 to −0.34, p < 0.0001; Table 2).
At follow-up 12 months after implementation, it was found that compared to the control group, prevalence of depression among women in the intervention group was lower (27% versus 59%, Adjusted Odds Ratio (AOR) 0.23, 95% CI = 0.15-0.36); and they had less disability (Adjusted Mean Difference (AMD) -2.88, 95% CI = −3.66 to −2.10) and better global functioning (AMD 8.27, 95% CI 6.23-10.31).
In addition, women showed significantly better global functioning (P <.05) at 3 of the 6 follow-ups (the 2-, 7.5-, and 10-year follow-ups).
Psychosocial intervention for caregivers can be of paramount importance in improving the quality of life of patients and their families 13, 14, especially in terms of better global functioning.
These characteristics included better quality of life, more daily activities, patient-reported clearer thinking from medication, better global functioning, being employed, not receiving individual therapy, not being a victim of a crime, and receiving less help with shopping or leisure activities.
As Harrow reported at the 2008 annual meeting of the American Psychiatric Association, "I conclude that patients with schizophrenia not on antipsychotic medication for a long period of time have significantly better global functioning than those on antipsychotics". This does not mean that antipsychotics don't have a place in psychiatry's toolbox.
The baseline predictors associated with sustained favorable long-term outcome included better quality of life, more daily activities, patient-reported clearer thinking from medication, better global functioning, being employed, not being a victim of a crime, not having received individual therapy, and not having received help with shopping and leisure activities.
Higher CFQ scores indicate more frequent cognitive problems and higher MMSE scores (0−30) indicate better global cognitive functioning, and MMSE scores of 23 or less are considered to be cognitively impaired.
