Abstract
This study aims to evaluate a group of people with schizophrenia undergoing outpatient treatment and who participate in a mutual support intervention, compared to another group of people with the same diagnosis, but attending only the usual outpatient treatment. This is a prospective study, with two measurements between six months. The mutual support group was initially composed of 16 people and the treatment as usual group was composed of 15 people. Clinical (medication adherence and functioning) and Recovery (hope, well-being, recovery and internalized stigma) outcomes were assessed. Nonparametric tests were used to verify differences in measurements between groups and between two moments. A higher level of internalized stigma and a decrease in the adherence to drug treatment in the treatment as usual group were verified. When comparing the pre-post difference between groups, there was a greater increase in adherence to drug treatment in the mutual support group. Our data point to more favorable results in the mutual support group, showing that ongoing participation in these groups is an important tool for the recovery process and for the treatment itself.
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The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Anthony WA. Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosoc Rehabil J. 1993;16(4):11–23.
Balsanelli, ACS, Grossi, SAA, Herth, KA. Cultural adaptation and validation of the Herth Hope Index for Portuguese language: study in patients with chronic illness. Texto contexto - enferm. [Internet]. 2010 Dec [cited 2020 Nov 16]; 19(4): 754–761. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-07072010000400019&lng=en.
Bech P. Measuring the dimensions of psychological general well-being by the WHO-5. QoL Newsletter. 2004;32:15–6.
Bellamy C, Schmutte T, Davidson L. An update on the growing evidence base for peer support. Ment Health Soc Incl. 2017;21(3):161–7.
Boardman G, McCann T, Kerr D. A peer support programme for enhancing adherence to oral antipsychotic medication in consumers with schizophrenia. J Adv Nurs. 2014;70(10):2293–302.
Brissos S, Palhava F, Marques JG, Mexia S, Carmo AL, Carvalho M, Dias C, Franco JD, Mendes R, Zuzarte P, Carita AI, Molodynski A, Figueira ML. The Portuguese version of the Personal and Social Performance Scale (PSP): reliability, validity, and relationship with cognitive measures in hospitalized and community schizophrenia patients. Soc Psych Psych Epid. 2012;47(7):1077–86.
Corrigan PW, Larson JE, Michaels PJ, Buchholz BA, Del Rossi R, Fontecchio MJ, Rüsch N. Diminishing the self-stigma of mental illness by coming out proud. Psychiat Res. 2015;229(1–2):148–54.
Corrigan PW, Phelan SM. Social support and recovery in people with serious mental illnesses. Community Ment Hlt J. 2004;40(6):513–23.
Corrigan PW, Sokol KA, Rüsch N. The impact of self-stigma and mutual help programs on the quality of life of people with serious mental illnesses. Community Ment Hlt J. 2013;49(1):1–6.
Davidson L, Chinman M, Kloos B, Weingarten R, Stayner D, Tebes JK. Peer support among individuals with severe mental illness: A review of the evidence. Clin Psychol-Sci Pr. 1999;6(2):165–87.
de Souza CM, Hidalgo MPL. World Health Organization 5-item well-being index: validation of the Brazilian Portuguese version. Eur Arch Psy Clin N. 2012;262(3):239–44.
Druss BG, Zhao L, von Esenwein SA, Bona JR, Fricks L, Jenkins-Tucker S, Lorig K. The Health and Recovery Peer (HARP) Program: A peer-led intervention to improve medical self-management for persons with serious mental illness. Schizophr Res. 2010;118(1–3):264–70. https://doi.org/10.1016/j.schres.2010.01.026.
Kelly JF, Yeterian JD. Mutual-help groups. In: O’Donohue WT, Cummings NA, editors. Evidence-based adjunctive treatments: Practical Resources for the Mental Health Professional. Burlington: Academic Press; 2008. p. 61–105.
Le Boutillier C, Leamy M, Bird VJ, Davidson L, Williams J, Slade M. What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance. Psychiatr Serv. 2011;62(12):1470–6.
Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal Recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011;199(6):445–52.
Levy LH. Self-help groups. In: Rappaport J, Seidman E, editors. Handbook of community psychology. New York : Kluwer Academic; 2000. p. 591–613.
Lloyd-Evans B, Mayo-Wilson E, Harrison B, Istead H, Brown E, Pilling S, Kendall T. A systematic review and meta-analysis of randomised controlled trials of peer support for people with severe mental illness. BMC Psychiatry. 2014;14(1):39.
Magura S, Laudet AB, Mahmood D, Rosenblum A, Knight E. Adherence to medication regimens and participation in dual-focus self-help groups. Psychiat Serv. 2002;53:310–6.
Mahlke CI, Kramerb UM, Beckerc T, Bocka T. Peer support in mental health services. Curr Opin Psychiatry. 2014;27(4):276–81.
Moreira IC, Bandeira M, Pollo TC, Oliveira MS. Cross-cultural adaptation to Brazil of Medication Adherence Rating Scale for psychiatric patients. J Bras Psiquiatr. 2014;63(4):273–80.
Nasrallah H, Morosini P, Gagnon DD. Reliability, validity and ability to detect change of the Personal and Social Performance scale in patients with stable schizophrenia. Schizophr Res. 2008;161(2):213–24.
Pistrang N, Barker C, Humphreys K. Mutual help groups for mental health problems: A review of effectiveness studies. Am J CommunPsychol. 2008;42(1–2):110–21.
Pyle M, Pilling S, Machin K, Allende-Cullen G, Morrison AP. Peer support for internalised stigma experienced by people with psychosis: Rationale and recommendations. Psychosis. 2018;10(2):146–52.
Ritsher JB, Otilingam PG, Grajales M. Internalized stigma of mental illness: psychometric properties of a new measure. Schizophr Res. 2003;121(1):31–49.
Ronzani TM, Soares RG, Nery FC, Silveira PS. Adaptação transcultural brasileira da escala de estigma internalizado de transtorno mental - ismi-br. Gerais, Rev Interinst Psicol. 2017;10(1):25–34.
Rosenblum A, Matusow H, Fong C, Vogel H, Uttaro T, Moore TL, Magura S. Efficacy of dual focus mutual aid for persons with mental illness and substance misuse. Drug Alcohol Depen. 2014;135:78–87. https://doi.org/10.1016/j.drugalcdep.2013.11.012.
Silva TR, Berberian AA, Gadelha A, Villares CC, Martini LC, Bressan RA. Validação da Recovery Assessment Scale (RAS) no Brasilparaavaliar a capacidade de superação das pessoas com esquizofrenia. J Bras Psiquiatr. 2017;66(1):1–8.
Slade M, Leamy M, Bacon F, Janosik M, Le Boutillier C, Williams J, Bird V. International differences in understanding recovery: systematic review. Epidemiol Psych Sci. 2012;21(4):353–64.
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.
van Weeghel J, van Zelst C, Boertien D, Hasson-Ohayon I. Conceptualizations, assessments, and implications of personal recovery in mental illness: A scoping review of systematic reviews and meta-analyses. Psychiatr Rehabil J. 2019;42(2):169.
Worrall H, Schweizer R, Marks E, Yuan L, Lloyd C, Ramjan R. The effectiveness of support groups: a literature review. Ment Health Soc Incl. 2018;22(2):85–93.
Acknowledgements
We are grateful to Dr. Cinthia Hiroko Higuchi, for supporting the data tabulation in the database, and to nurse Eliane Cristina Almeida Costa, for the indication of patients of the treatment as usual group.
Funding
This study was financed in part by the Coordination for the Improvement of Higher Education Personnel—Brazil (CAPES)—Finance Code 001.
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The project was approved by an Ethics Committee on Human Research (protocol number: 3.225.681), with all participants providing informed consent.
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RAB has received honoraria for speaking and chairing engagements from Janssen, Torrent, Ache and Sanofi-Aventis outside this manuscript. He has also received personal fees and non-financial support from Janssen, personal fees from Pfizer, Torrent and Sanofi-Aventis outside this manuscript. The other authors declare that they have no conflict of interest.
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Orsi, J.A., Malinowski, F.R.L., Kagan, S. et al. Evaluation of Ongoing Participation of People with Schizophrenia in a Mutual Support Group as a Complementary Intervention to Outpatient Psychiatric Treatment. Psychiatr Q 92, 1283–1296 (2021). https://doi.org/10.1007/s11126-021-09893-z
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DOI: https://doi.org/10.1007/s11126-021-09893-z