The lifetime prevalence of schizophrenia is just less than 1% with onset usually occurring during adolescence or early adulthood. People with schizophrenia have an increased risk of suicide and physical illness, as well as impaired occupational and social functioning. A large proportion experience a cyclical pattern of illness, with periods of acute psychotic episodes followed by stable periods of full or partial remission, although these are often accompanied by the presence of residual symptoms.
This Cochrane Review from February 2013 examines whether one particular aspect of psychological treatment for schizophrenia – training in the detection of early signs of relapse – might help people with schizophrenia and those who care for them to work towards a better outcome. The intention was to try to separate the effects of this training from other psychological interventions, but only one of the included studies examined this. All the studies looked at the effects of training provided to people with schizophrenia.
In total, 34 randomised trials were available for the review. These had been reported in 41 publications and included more than 3500 participants. There was a certain symmetry to these studies, with 11 from North America, 11 from Europe and 11 from the East Asia. The remaining study was from Australia. The primary outcomes for the review were relapse and rehospitalisation. The authors conducted analyses of whether or not people experienced one of these events and, where possible, they also looked at the time to the event. Almost all the trials randomised participants individually, but two of the studies used a cluster approach.