| Abstract [eng] |
Objective. Conduct a search on and analyse the literature and clinical descriptions on psychosocial therapy aspects of adolescent schizophrenia and to draw up summaries and proposals for psychosocial treatment of adolescent schizophrenia. Methods. The literature review was conducted in “PubMed”, “ScienceDirect” and “Cochrane Library” databases from 01.12.2021 to 01.03.2022. The search was conducted using combinations of the following keywords in English: “adolescent OR early onset”, “schizophrenia”, “psychosocial”, “psychological”, “social”, “treatment OR therapy”. The period of publication was not limited and only literature published in English was selected. 25 articles were included in the literature review. The results of the articles were reviewed by sorting them into the following main categories (according to the treatment outcomes studied in the articles): neurocognitive impairment, relapse prevention, negative symptoms and employment. Results. Early-onset schizophrenia is defined as schizophrenia that occurs before the age of 18. Late adolescence is a critical period for brain development and this age group may be particularly vulnerable to schizophrenia. At present, there is a lack of evidence on the effectiveness of treatments for early schizophrenia, so existing recommendations for psychological or social interventions are based on studies in adult patient populations. Depending on the level of evidence, the most common interventions recommended in the guidelines are family therapy and cognitive behavioural therapy. Therapies with a lower level of recommendation include supported employment/supported education programmes, patient education, cognitive remediation therapy and social skills training. Cognitive remediation therapy, especially in its group format, computer-assisted interventions, auditory therapy and physical exercise were effective in treating neurocognitive impairment. Psychoeducation, especially involving the whole family or in combination with cognitive therapy, was effective in preventing relapses. Psychoeducational group, cognitive behavioural, motivational, mindfulness focused and social therapies have been useful in treating negative symptoms. Specialised, motivational, psychoeducational and cognitive interventions are the most effective in promoting employment. Conclusions. Currently, the guidelines for the psychosocial treatment of adolescent schizophrenia generally recommend only cognitive behavioural therapy and family therapy. Given the various aspects of the illness, it would be useful in the future to develop specific treatment recommendations according to the clinical presentation of the illness, considering the areas affected by different therapies. |
