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Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Research article

Using films as a psychoeducation tool for patients with schizophrenia: a pilot study using a quasi-experimental pre-post design

Authors: Christian von Maffei, Frauke Görges, Werner Kissling, Wolfgang Schreiber, Christine Rummel-Kluge

Published in: BMC Psychiatry | Issue 1/2015

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Abstract

Background

Relapses and, subsequently, readmissions are common in patients with schizophrenia. Psychoeducation has been shown to reduce the number and duration of readmissions. Yet, only little more than 20% of psychiatric patients in German speaking countries receive psychoeducation. Among other reasons, costs may be considered too high by hospitals. The objective of the present study was to test the feasibility of a new cost-efficient approach in the psychoeducation of patients with schizophrenia. In this study, films were used to impart knowledge about the illness to inpatients.

Methods

A total of 113 participants were initially included in the study, eleven of which were not included in the final analyses. Six films about the symptoms, diagnosis, causes, warning signs, treatment of schizophrenia and about the influence of family members and friends were shown in a group setting in the presence of nursing staff. All films combined facts, expert opinions, and personal experiences of peers. As the main outcome criterion of this feasibility pilot study, we measured the effects on knowledge. Secondary outcome measures included compliance, insight into illness, side effects, and quality of life. Data were collected directly after the intervention and about half a year afterwards. The number and the duration of readmissions to the hospital were recorded and compared to the number and duration of prior admissions. Patients were also asked to state their subjective opinion about the films. Main data analyses were done using paired t-tests and Wilcoxon signed-rank tests. Secondary analyses also involved ANOVAs and ANCOVAs.

Results

One hundred and two inpatients were included in the data analyses. Showing the films in the tested setting was shown to be feasible. Knowledge about schizophrenia (p < .001), compliance (ps < .01), insight into illness (p < .01), and quality of life (p < .001) all increased significantly after patients had watched the films and remained stable for at least half a year. A vast majority (84.9%) of the patients found the films to be interesting and informative.

Conclusions

Using films to educate inpatients about schizophrenia is a feasible method that is cost- and time-efficient and well received by the patients.
Literature
1.
go back to reference Schooler NR. Relapse and rehospitalization: comparing oral and depot antipsychotics. J Clin Psychiatry. 2003;64 Suppl 16:14–7.PubMed Schooler NR. Relapse and rehospitalization: comparing oral and depot antipsychotics. J Clin Psychiatry. 2003;64 Suppl 16:14–7.PubMed
2.
go back to reference Kissling W, Leucht S. Results of treatment of schizophrenia: is the glass half full or half empty? Int Clin Psychopharmacol. 1999;14 Suppl 3:S11–4.CrossRefPubMed Kissling W, Leucht S. Results of treatment of schizophrenia: is the glass half full or half empty? Int Clin Psychopharmacol. 1999;14 Suppl 3:S11–4.CrossRefPubMed
3.
go back to reference Lacro JP, Dunn LB, Dolder CR, Leckband SG, Jeste DV. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry. 2002;63:892–909.CrossRefPubMed Lacro JP, Dunn LB, Dolder CR, Leckband SG, Jeste DV. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry. 2002;63:892–909.CrossRefPubMed
4.
go back to reference Jeffreys SE, Harvey CA, McNaught AS, Quayle AS, King MB, Bird AS. The Hampstead Schizophrenia Survey 1991. I: Prevalence and service use comparisons in an inner London health authority, 1986–1991. Br J Psychiatry. 1997;170:301–6.CrossRefPubMed Jeffreys SE, Harvey CA, McNaught AS, Quayle AS, King MB, Bird AS. The Hampstead Schizophrenia Survey 1991. I: Prevalence and service use comparisons in an inner London health authority, 1986–1991. Br J Psychiatry. 1997;170:301–6.CrossRefPubMed
5.
go back to reference Weiden P, Glazer W. Assessment and treatment selection for "revolving door" inpatients with schizophrenia. Psychiatr Q. 1997;68:377–92.CrossRefPubMed Weiden P, Glazer W. Assessment and treatment selection for "revolving door" inpatients with schizophrenia. Psychiatr Q. 1997;68:377–92.CrossRefPubMed
6.
go back to reference Gilmer TP, Dolder CR, Lacro JP, Folsom DP, Lindamer L, Garcia P, et al. Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry. 2004;161:692–9.CrossRefPubMed Gilmer TP, Dolder CR, Lacro JP, Folsom DP, Lindamer L, Garcia P, et al. Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry. 2004;161:692–9.CrossRefPubMed
7.
go back to reference Rummel-Kluge C, Schuster T, Peters S, Kissling W. Partial compliance with antipsychotic medication is common in patients with schizophrenia. Aust N Z J Psychiatry. 2008;42:382–8.CrossRefPubMed Rummel-Kluge C, Schuster T, Peters S, Kissling W. Partial compliance with antipsychotic medication is common in patients with schizophrenia. Aust N Z J Psychiatry. 2008;42:382–8.CrossRefPubMed
8.
go back to reference Gibson S, Brand SL, Burt S, Boden ZVR, Benson O. Understanding treatment non-adherence in schizophrenia and bipolar disorder: a survey of what service users do and why. BMC Psychiatry. 2013;13:153.CrossRefPubMedPubMedCentral Gibson S, Brand SL, Burt S, Boden ZVR, Benson O. Understanding treatment non-adherence in schizophrenia and bipolar disorder: a survey of what service users do and why. BMC Psychiatry. 2013;13:153.CrossRefPubMedPubMedCentral
9.
go back to reference Rettenbacher MA, Hofer A, Eder U, Hummer M, Kemmler G, Weiss EM, et al. Compliance in schizophrenia: psychopathology, side effects, and patients' attitudes toward the illness and medication. J Clin Psychiatry. 2004;65:1211–8.CrossRefPubMed Rettenbacher MA, Hofer A, Eder U, Hummer M, Kemmler G, Weiss EM, et al. Compliance in schizophrenia: psychopathology, side effects, and patients' attitudes toward the illness and medication. J Clin Psychiatry. 2004;65:1211–8.CrossRefPubMed
10.
go back to reference Fenton WS, Blyler CR, Heinssen RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull. 1997;23:637–51.CrossRefPubMed Fenton WS, Blyler CR, Heinssen RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull. 1997;23:637–51.CrossRefPubMed
11.
go back to reference Anselmetti S, Bechi M, Bosia M, Quarticelli C, Ermoli E, Smeraldi E, et al. ‘Theory’of mind impairment in patients affected by schizophrenia and in their parents. Schizophr Res. 2009;115:278–85.CrossRefPubMed Anselmetti S, Bechi M, Bosia M, Quarticelli C, Ermoli E, Smeraldi E, et al. ‘Theory’of mind impairment in patients affected by schizophrenia and in their parents. Schizophr Res. 2009;115:278–85.CrossRefPubMed
12.
go back to reference Nuechterlein KH, Ventura J, Subotnik KL, Bartzokis G. The early longitudinal course of cognitive deficits in schizophrenia. J Clin Psychiatry. 2014;75:25.CrossRefPubMedPubMedCentral Nuechterlein KH, Ventura J, Subotnik KL, Bartzokis G. The early longitudinal course of cognitive deficits in schizophrenia. J Clin Psychiatry. 2014;75:25.CrossRefPubMedPubMedCentral
13.
go back to reference Thieda P, Beard S, Richter A, Kane J. An economic review of compliance with medication therapy in the treatment of schizophrenia. Psychiatr Serv. 2003;54:508–16.CrossRefPubMed Thieda P, Beard S, Richter A, Kane J. An economic review of compliance with medication therapy in the treatment of schizophrenia. Psychiatr Serv. 2003;54:508–16.CrossRefPubMed
14.
15.
go back to reference Nose M, Barbui C, Gray R, Tansella M. Clinical interventions for treatment non-adherence in psychosis: meta-analysis. Br J Psychiatry. 2003;183:197–206.CrossRefPubMed Nose M, Barbui C, Gray R, Tansella M. Clinical interventions for treatment non-adherence in psychosis: meta-analysis. Br J Psychiatry. 2003;183:197–206.CrossRefPubMed
16.
go back to reference Bauml J, Frobose T, Kraemer S, Rentrop M, Pitschel-Walz G. Psychoeducation: a basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophr Bull. 2006;32 Suppl 1:S1–9.CrossRefPubMedPubMedCentral Bauml J, Frobose T, Kraemer S, Rentrop M, Pitschel-Walz G. Psychoeducation: a basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophr Bull. 2006;32 Suppl 1:S1–9.CrossRefPubMedPubMedCentral
17.
go back to reference Rummel-Kluge C, Pitschel-Walz G, Kissling W. A fast, implementable psychoeducation program for schizophrenia. Psychiatr Serv. 2007;58:1226.CrossRefPubMed Rummel-Kluge C, Pitschel-Walz G, Kissling W. A fast, implementable psychoeducation program for schizophrenia. Psychiatr Serv. 2007;58:1226.CrossRefPubMed
18.
go back to reference Pekkala E, Merinder L. Psychoeducation for schizophrenia. Cochrane Database Syst Rev. 2011;15(6):CD002831. Pekkala E, Merinder L. Psychoeducation for schizophrenia. Cochrane Database Syst Rev. 2011;15(6):CD002831.
19.
go back to reference Pitschel-Walz G. Die Einbeziehung der Angehörigen in die Behandlung schizophrener Patienten und ihr Einfluss auf den Krankheitsverlauf. In: Lang P, editor. [Europäische Hochschulschriften. Reihe VI, Psychologie Publications universitaires européennes. Série VI, Psychologie European university studies. Series VI, Psychology, vol. 581], vol. 19. Frankfurt am Main, New York; 1997. p. 99–118. Pitschel-Walz G. Die Einbeziehung der Angehörigen in die Behandlung schizophrener Patienten und ihr Einfluss auf den Krankheitsverlauf. In: Lang P, editor. [Europäische Hochschulschriften. Reihe VI, Psychologie Publications universitaires européennes. Série VI, Psychologie European university studies. Series VI, Psychology, vol. 581], vol. 19. Frankfurt am Main, New York; 1997. p. 99–118.
20.
go back to reference Xia J, Merinder LB, Belgamwar MR. Psychoeducation for schizophrenia. Cochrane Database Syst Rev. 2011.15;(6):CD002831. Xia J, Merinder LB, Belgamwar MR. Psychoeducation for schizophrenia. Cochrane Database Syst Rev. 2011.15;(6):CD002831.
21.
go back to reference Pitschel-Walz G, Bauml J, Bender W, Engel RR, Wagner M, Kissling W. Psychoeducation and compliance in the treatment of schizophrenia: results of the Munich psychosis information project study. J Clin Psychiatry. 2006;67:443–52.CrossRefPubMed Pitschel-Walz G, Bauml J, Bender W, Engel RR, Wagner M, Kissling W. Psychoeducation and compliance in the treatment of schizophrenia: results of the Munich psychosis information project study. J Clin Psychiatry. 2006;67:443–52.CrossRefPubMed
22.
go back to reference Pitschel Walz G, Boerner R, Mayer CER, Peuker I, Welschehold M, Bender W, et al. Informationszentrierte gruppen für schizophrene patienten und deren angehörige: einfluß von wissen, krankheitskonzept und expressed emotions (PIP-studie). In: Bender W, Hubmann W, Mohr F, editors. Neuere entwicklungen in der behandlung schizophrener psychosen. München-Haar: VTS-Verlag; 1995. Pitschel Walz G, Boerner R, Mayer CER, Peuker I, Welschehold M, Bender W, et al. Informationszentrierte gruppen für schizophrene patienten und deren angehörige: einfluß von wissen, krankheitskonzept und expressed emotions (PIP-studie). In: Bender W, Hubmann W, Mohr F, editors. Neuere entwicklungen in der behandlung schizophrener psychosen. München-Haar: VTS-Verlag; 1995.
23.
go back to reference Rummel-Kluge C, Pitschel-Walz G, Bauml J, Kissling W. Psychoeducation in schizophrenia–results of a survey of all psychiatric institutions in Germany, Austria, and Switzerland. Schizophr Bull. 2006;32:765–75.CrossRefPubMedPubMedCentral Rummel-Kluge C, Pitschel-Walz G, Bauml J, Kissling W. Psychoeducation in schizophrenia–results of a survey of all psychiatric institutions in Germany, Austria, and Switzerland. Schizophr Bull. 2006;32:765–75.CrossRefPubMedPubMedCentral
24.
go back to reference Rummel-Kluge C, Kluge M, Kissling W. Frequency and relevance of psychoeducation in psychiatric diagnoses: results of two surveys five years apart in German-speaking European countries. BMC Psychiatry. 2013;13:170.CrossRefPubMedPubMedCentral Rummel-Kluge C, Kluge M, Kissling W. Frequency and relevance of psychoeducation in psychiatric diagnoses: results of two surveys five years apart in German-speaking European countries. BMC Psychiatry. 2013;13:170.CrossRefPubMedPubMedCentral
25.
go back to reference Rummel-Kluge C, Stiegler-Kotzor M, Schwarz C, Hansen W, Kissling W. Peer-counseling in schizophrenia: patients consult patients. Patient Educ Couns. 2008;70:357–62.CrossRefPubMed Rummel-Kluge C, Stiegler-Kotzor M, Schwarz C, Hansen W, Kissling W. Peer-counseling in schizophrenia: patients consult patients. Patient Educ Couns. 2008;70:357–62.CrossRefPubMed
26.
go back to reference McGill CW, Patterson CJ. Former patients as peer counselors on locked psychiatric inpatient units. Psychiatr Serv. 1990;41:1017–9.CrossRef McGill CW, Patterson CJ. Former patients as peer counselors on locked psychiatric inpatient units. Psychiatr Serv. 1990;41:1017–9.CrossRef
27.
go back to reference Rummel CB, Hansen W, Helbig A, Pitschel-Walz G, Kissling W. Peer-to-peer psychoeducation in schizophrenia: a new approach. J Clin Psychiatry. 2005;66:1580–5.CrossRefPubMed Rummel CB, Hansen W, Helbig A, Pitschel-Walz G, Kissling W. Peer-to-peer psychoeducation in schizophrenia: a new approach. J Clin Psychiatry. 2005;66:1580–5.CrossRefPubMed
28.
go back to reference Bäuml J, Pitschel-Walz G. Psychoedukation bei schizophrenen Erkrankungen: Konsensuspapier der Arbeitsgruppe "Psychoedukation bei schizophrenen Erkrankungen". Stuttgart, New York: Schattauer; 2003. Bäuml J, Pitschel-Walz G. Psychoedukation bei schizophrenen Erkrankungen: Konsensuspapier der Arbeitsgruppe "Psychoedukation bei schizophrenen Erkrankungen". Stuttgart, New York: Schattauer; 2003.
29.
go back to reference Froböse T, Bäuml J, Jahn T, Pohl C, Pitschel-Walz G. Knowledge gain by psychoeducation for patients with schizophrenia: associations with sociodemographic data, psychopathology, insight and global neurocognitive performance. Int J Clin Psychiatry Mental Health. 2014;2:111–21.CrossRef Froböse T, Bäuml J, Jahn T, Pohl C, Pitschel-Walz G. Knowledge gain by psychoeducation for patients with schizophrenia: associations with sociodemographic data, psychopathology, insight and global neurocognitive performance. Int J Clin Psychiatry Mental Health. 2014;2:111–21.CrossRef
30.
go back to reference Thompson K, Kulkarni J, Sergejew AA. Reliability and validity of a new medication adherence rating scale (MARS) for the psychoses. Schizophr Res. 2000;42:241–7.CrossRefPubMed Thompson K, Kulkarni J, Sergejew AA. Reliability and validity of a new medication adherence rating scale (MARS) for the psychoses. Schizophr Res. 2000;42:241–7.CrossRefPubMed
31.
go back to reference Amador XF, Strauss DH, Yale SA, Flaum MM, Endicott J, Gorman JM. Assessment of insight in psychosis. Am J Psychiatry. 1993;1:873. Amador XF, Strauss DH, Yale SA, Flaum MM, Endicott J, Gorman JM. Assessment of insight in psychosis. Am J Psychiatry. 1993;1:873.
32.
go back to reference Hays WL. Statistics for the social sciences. 2nd ed. New York: Holt, Rinehart and Winston; 1973. Hays WL. Statistics for the social sciences. 2nd ed. New York: Holt, Rinehart and Winston; 1973.
33.
go back to reference Markowitz M, Karve S, Panish J, Candrilli SD, Alphs L. Antipsychotic adherence patterns and health care utilization and costs among patients discharged after a schizophrenia-related hospitalization. BMC Psychiatry. 2013;13:246.CrossRefPubMedPubMedCentral Markowitz M, Karve S, Panish J, Candrilli SD, Alphs L. Antipsychotic adherence patterns and health care utilization and costs among patients discharged after a schizophrenia-related hospitalization. BMC Psychiatry. 2013;13:246.CrossRefPubMedPubMedCentral
34.
go back to reference McFarlane WR, Dixon L, Lukens E, Lucksted A. Family psychoeducation and schizophrenia: a review of the literature. J Marital Fam Ther. 2003;29:223–45.CrossRefPubMed McFarlane WR, Dixon L, Lukens E, Lucksted A. Family psychoeducation and schizophrenia: a review of the literature. J Marital Fam Ther. 2003;29:223–45.CrossRefPubMed
35.
go back to reference Cohen AN, Glynn SM, Murray-Swank AB, Barrio C, Fischer EP, McCutcheon SJ, et al. The family forum: directions for the implementation of family psychoeducation for severe mental illness. Psychiatr Serv. 2008;59:40–8.CrossRefPubMed Cohen AN, Glynn SM, Murray-Swank AB, Barrio C, Fischer EP, McCutcheon SJ, et al. The family forum: directions for the implementation of family psychoeducation for severe mental illness. Psychiatr Serv. 2008;59:40–8.CrossRefPubMed
36.
go back to reference Frank F, Rummel-Kluge C, Berger M, Bitzer EM, Holzel LP. Provision of group psychoeducation for relatives of persons in inpatient depression treatment–a cross-sectional survey of acute care hospitals in Germany. BMC Psychiatry. 2014;14:143.CrossRefPubMedPubMedCentral Frank F, Rummel-Kluge C, Berger M, Bitzer EM, Holzel LP. Provision of group psychoeducation for relatives of persons in inpatient depression treatment–a cross-sectional survey of acute care hospitals in Germany. BMC Psychiatry. 2014;14:143.CrossRefPubMedPubMedCentral
37.
go back to reference Farrelly S, Clement S, Gabbidon J, Jeffery D, Dockery L, Lassman F, et al. Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study. BMC Psychiatry. 2014;14:157.CrossRefPubMedPubMedCentral Farrelly S, Clement S, Gabbidon J, Jeffery D, Dockery L, Lassman F, et al. Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study. BMC Psychiatry. 2014;14:157.CrossRefPubMedPubMedCentral
38.
go back to reference Hasson-Ohayon I, Avidan-Msika M, Mashiach-Eizenberg M, Kravetz S, Rozencwaig S, Shalev H, et a. Metacognitive and social cognition approaches to understanding the impact of schizophrenia on social quality of life. Psychiatry Research 2012;200(2-3):802–806. Hasson-Ohayon I, Avidan-Msika M, Mashiach-Eizenberg M, Kravetz S, Rozencwaig S, Shalev H, et a. Metacognitive and social cognition approaches to understanding the impact of schizophrenia on social quality of life. Psychiatry Research 2012;200(2-3):802–806.
39.
go back to reference Hasson-Ohayon I, Ehrlich-Ben Or S, Vahab K, Amiaz R, Weiser M, Roe D. Insight into mental illness and self-stigma: the mediating role of shame proneness. Psychiatry Res. 2012;200:802–6.CrossRefPubMed Hasson-Ohayon I, Ehrlich-Ben Or S, Vahab K, Amiaz R, Weiser M, Roe D. Insight into mental illness and self-stigma: the mediating role of shame proneness. Psychiatry Res. 2012;200:802–6.CrossRefPubMed
40.
go back to reference Hasson-Ohayon I, Kravetz S, Roe D, David AS, Weiser M. Insight into psychosis and quality of life. Compr Psychiatry. 2006;47:265–9.CrossRefPubMed Hasson-Ohayon I, Kravetz S, Roe D, David AS, Weiser M. Insight into psychosis and quality of life. Compr Psychiatry. 2006;47:265–9.CrossRefPubMed
Metadata
Title
Using films as a psychoeducation tool for patients with schizophrenia: a pilot study using a quasi-experimental pre-post design
Authors
Christian von Maffei
Frauke Görges
Werner Kissling
Wolfgang Schreiber
Christine Rummel-Kluge
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0481-2

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