Pharmaco-psychosocial treatment (PPST) refers to a treatment paradigm combining pharmacotherapy with
psychosocial therapy. We conducted an 18-month randomized controlled tracking study
to evaluate the efficacy of social skills training (SST) in 11 individuals with
schizophrenia on risperidone monotherapy. They were randomized to either SST or
non-SST group, and Global Assessment Functioning (GAF) and Brief Psychiatric
Rating Scale (BPRS) scores in the 2 groups showed gradual improvement. In the
SST group, Digit Span Distraction Test (DSDT) at 12 and 18 months showed
significant improvement. The Subjective Deficit Syndrome Scale (SDSS) scores in
the SST group showed significant improvement after 6 months and showed a
significant difference in comparison between the groups. After the subjective
feeling of health was recovered, the items of motivation were recovered as a
direct effect of SST. Some items of the Life Assessment Scale for the Mentally
Ill (LASMI) score showed significant improvement (or significant trend) in only
the SST group after 6 months. Items of daily life, work skills, and self-recognition
were continuously improved. We report 2 cases in the SST group that had DSDT improvement
in parallel with change of action and communication as a change of social
function. This study is only exploratory due to the small number of cases.
However, we have demonstrated potential improvement in cognitive function due
to learning experiences that required working memory and attention, thus
providing improvement in social life.
Cite this paper
Shimada, E. , Anzai, N. , Ikebuchi, E. , Niwa, S. and Nishizono, M. (2013) Effects of combination pharmacotherapy and social skills training for schizophrenia: A randomized controlled trial. Open Journal of Psychiatry, 3, 273-282. doi: 10.4236/ojpsych.2013.33026.
 Nishizono, M. (2012) The role of Pyschopharmacotherapy in the whole treatment structure. Seisinka Rinsyo Service, 12, 6-10.
 Liberman, R.P. (2008) Recovery from disability: Manual of psychiatric rehabilitation. American Psychiatric Publishing, Washington, DC.
 Lehman, A.F. (2003) The Schizophrenia Patient Outcomes Research Team (PORT): Updated treatment recommendations. Schizophrenia Bulletin, 30, 193-217.
 Miyata, M., Fujii, Y., Inagaki, A., Inada, T. and Yagi, G. (1995) Reliability of the Japanese version of Brief Psychiatric Rating Scale (BPRS). Clinical Evaluation, 23, 357-367.
 Overall, J.E. and Gorham, D.R. (1988) The brief psychiatric rating scale (BPRS): Recent developments in ascertainment and scaling. Psychopharmacology Bulletin, 24, 97-99.
 Inada, T. and Yagi, G. (1996) Current topics in neuroleptic-induced extrapyramidal symptoms in Japan. The Keio Journal of Medicine, 45, 95-99. doi:10.2302/kjm.45.95
 Inada, T., Yagi, G. and Miura, S. (2002) Extrapyramidal symptom profiles in Japanese patients with schizophrenia treated with olanzapine or haloperidol. Schizophrenia Research, 57, 227-238.
 Inada, T., Beasley, C., Tanaka, Y. and Walker, D.J. (2003) Extra-pyramidal symptom profiles assessed with the Drug-Induced Extrapyramidal Symptom Scale: Comparison with western scales in the clinical double-blind studies of schizophrenic patients treated with either olanzapine or haloperidol. International Clinical Psychopharmacology, 18, 39-48.
 Iwasaki, S., et al. (1994) The invention of life assessment scale for the mentally ill and its significance. Archives of Psychiatric Diagnostic Clinical Evaluation, 5, 221-231.
 Iwasaki, S., Miyauchi, M., Oshima, I., Honda, M. and Hata, T. (1994) The development of Life Assessment Scale for the Mentally Ill: An assessment of the reliability. Clinical Psychiatry, 36, 1139-1151.
 Bowen, L., Wallace, C.J., Glynn, S.M., Nuechterlein, K.H., Lutzker, J.R. and Kuehnel, T.G. (1994) Schizophrenic individuals’ cognitive functioning and performance in interpersonal interactions and skills training procedures. Journal of Psychiatric Research, 28, 289-301.
 Perry, W. and Braff, D.L. (1994) Information-processing deficits and thought disorder in schizophrenia. The American Journal of Psychiatry, 151, 363-367.
 Fukuhara, S., Bito, S., Green, J., Hsiao, A. and Kurokawa, K. (1998) Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. Journal of Clinical Epidemiology, 51, 1037-1044.
 Fukuhara, S., Ware, J.E., Kosinski, M., Wada, S. and Gandek, B. (1998) Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. Journal of Clinical Epidemiology, 51, 1045-1053.
 Ware, J.E. and Sherbourne, C.D. (1992) The MOS 36-item short form health survey (SF-36) I. Conceptual framework and item selection. Medical Care, 30, 473-483. doi:10.1097/00005650-199206000-00002
 Bitter, I., Jaeger, J., Agdeppa, J. and Volavka, J. (1989) Subjective symptoms: Part of the negative syndrome of schizophrenia? Psychopharmacology Bulletin, 25, 180-184.
 Jaeger, J., Bitter, I., Czobor, P. and Volavka, J. (1990) The measurement of subjective experience in schizophrenia: The Subjective Deficit Syndrome Scale. Comprehensive Psychiatry, 31, 216-226.
 Kokai, M., Inada, T., Ohara, K., Shimizu, M., Iwao, H. and Morita, Y. (2003) Inter-rater and test retest reliability of the Japanese version of the subjective deficit syndrome scale. Human Psychopharmacology: Clinical and Experimental, 18, 145-149. doi:10.1002/hup.439
 Kurtz, M.M. and Mueser, K.T. (2008) A meta-analysis of controlled research on social skills training for schizophrenia. Journal of Consulting and Clinical Psychology, 76, 491-504. doi:10.1016/j.schres.2007.12.124
 Emmerson, L.C., Granholm, E., Link, P.C., McQuaid, J.R. and Jeste, D.V. (2009) Insight and treatment outcome with cognitive-behavioral social skills training for older people with schizophrenia. Journal of Rehabilitation Research and Development, 46, 1053-1058.
 Kopelowicz, A., Liberman, R.P. and Zarate, R. (2006) Recent advances in social skills training for schizophrenia. Schizophrenia Bulletin, 32, S12-S23.
 Oltmanns, T.F. and Neale, J.M. (1975) Schizophrenic performance when distracters are present: Attentional deficit or differential task difficulty? Journal of Abnormal Psychology, 84, 205-209. doi:10.1037/h0076721
 Cornblatt, B., Obuchowski, M., Roberts, S., Pollack, S. and Erlenmeyer-Kimling, L. (1999) Cognitive and behavioral precursors of schizophrenia. Development and Psychopathology, 11, 487-508.
 Gold, J.M., Carpenter, C., Randolph, C., Goldberg, T.E. and Weinberger, D.R. (1997) Auditory working memory and Wisconsin Card Sorting Test performance in schizophrenia. Archives of General Psychiatry, 54, 159-165.
 Green, M.F., et al. (1997) Does risperidone improve verbal working memory in treatment-resistant schizophrenia? American Journal of Psychiatry, 154, 799-804.
 Green, M.F. (1996) What are the functional consequences of neurocognitive deficits in schizophrenia? American Journal of Psychiatry, 153, 321-330.
 Hatashita-Wong, M. and Silverstein, S.M. (2003) Coping with voices: Selective attention training for persistent auditory hallucinations in treatment refractory schizophrenia. Psychiatry, 66, 255-261.
 Tyson, P.J., Laws, K.R., Flowers, K.A., Tyson, A. and Mortimer, A.M. (2006) Cognitive function and social abilities in patients with schizophrenia: Relationship with atypical antipsychotics. Psychiatry and Clinical Neurosciences, 60, 473-479.
 Ikebuchi, E., Suzuki, H., Andou, Y., Ando, Y., Numaguchi, R. and Kmura, M. (2007) The effect of atypical antipsychotropic to effectiveness of program to improve of deficit insight in schizophrenics. Seisinigaku, 49, 607-617.
 Granholm, E., et al. (2005) A randomized controlled trial of cognitive behavioral social skills training for middleaged and older outpatients with chronic schizophrenia. American Journal of Psychiatry, 162, 520-529.
 Osada, H., et al. (1998) Quality of life in schizophrenic patients (II). Tokyo Academy of Health Sciences, 1, 107-110.