***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a prospect i ve , r and omized clinical trial cognitive characteristics of schizophrenic patients were examined as predictors of the efficacy of a psychoeducational psychotherapeutic intervention . The aim of this study was to select adequate cognitive predictors . The reduction of the selected cognitive deficits by means of a psychoeducational psychotherapy was measured . Additionally , the prophylactic effects of the improvement of  cognitive deficits  were examined . Predictors of the course of illness were basic cognitive deficits and metacognitive constructs of 106 schizophrenic out patients . Additionally , the modification of the cognitive skills of these patients was taken into account . Relevant factors of the course of illness representing the therapeutic effect of the intervention were investigated within a five-year follow-up . By means of logistic regression analyses thought disorders ( AMDP system ) and idiosyncratic and fatalistic assumptions ( KK-scale ) were obtained as appropriate cognitive predictors of the long-term course of illness . Thought disorders and attentional deficits could not be improved significantly . Though , there was a correlation between the therapeutic improvement of idiosyncratic and fatalistic assumptions and the rehospitalization rate within the follow-up Several studies document sex differences in premorbid and intermorbid role functioning , showing less functional deficit among females . The specific nature of sex differences in role functioning is still poorly understood . The purpose of the present study was to investigate sex differences in symptomatology and role functioning in a sample of 92 in patients hospitalized for an episode of DSM-III-diagnosed schizophrenic disorder . Patients were r and omized at hospital admission to either of two treatment conditions : ( 1 ) multimodal hospital treatment with the addition of an inpatient family intervention ( IFI ) or ( 2 ) multimodal hospital treatment without IFI . Results indicated ( 1 ) sex differences in levels of substance abuse and antisocial behavior ( worse for males both at admission and followup)--dimensions of psychopathology unrelated to the core features of schizophrenia ; ( 2 ) superior family and occupational functioning in females at followup ; and ( 3 ) superior clinical response of females to IFI . Data on family response to IFI  suggest some ameliorative effects of IFI  on critical family attitudes toward female patients as well as greater family compliance with  IFI  treatment among the families of females . Sex differences in intermorbid family and occupational functioning and response to a family-based psychosocial intervention are discussed in light of data on rejecting family attitudes toward the patient and sex differences in symptomatology . The possible influence of sex-differentiated social role dem and s on response to IFI  is also discussed Outpatient medication adherence is a major problem , especially for patients repeatedly hospitalized for psychiatric disorders . This study included 39 such patients who were receiving case management services from a community mental health center . Patients were matched and r and omly assigned to receive in a single session either ( 1 ) information regarding medication and its benefits , ( 2 ) guidelines for assuring adherence which encompassed all phases related to pill-taking including filling prescriptions , use of a pill container , transportation , self-reminders , doctor 's appointments and so forth , or ( 3 ) the same guidelines as ( 2 ) above but given in the presence of a family member who was enlisted in support . The results showed that adherence increased to about 94 % after the guidelines were given for both the individual and family guideline procedure , whereas adherence remained unchanged at 73 % after the medication information procedure . These results suggest a practical means for assuring a high level of medication adherence for patients with psychiatric disorders Within a controlled prospect i ve intervention study , schizophrenic out patients r and omly assigned to four treatment groups and one control group were assessed with regard to collaboration with drug treatment . In total , 39.3 % of 84 regular attenders of the psychoeducational training programme  and 26.6 % of 64 control patients reported having persuaded their psychiatrists to modify their medication prescriptions . A total of 8.3 % and 7.8 % , respectively , modified their medication on their own initiative , although with subsequent approval by the psychiatrist , and 20.2 % and 15.6 % , respectively , modified their medication after consulting their psychiatrist . With regard to medication management , the groups did not differ either at post‐treatment or at follow‐up . At follow‐up , regular attenders showed a reduced fear of side‐effects , increased confidence in their medication and stable confidence in their physician . Among the control subjects , confidence in the medication and in their physician declined , and fear of side‐effects increased . Psychoeducational training therefore led to an optimization of patients ' attitudes toward treatment , but not to changes in medication management Abstract The study examines long-term effects on rehospitalization rates of a psychoeducationally and cognitive-behaviorally oriented intervention for schizophrenic out patients and their key-persons . 191 patients and their key-persons were allocated by r and om into four different treatment groups and one control group . Five years after completion of treatment 126 patients were reexamined by interviews or case notes . The rate of patients experiencing psychiatric rehospitalization during the follow-up was assessed in each respective treatment group . Concerning rehospitalization rates there was no significant difference between controls ( n = 35 ) and patients of the four treatment groups ( n = 91 ) . There were , however , fewer rehospitalized patients in the group with combined psychoeducational and cognitive treatment , including key-person counselling ( 42 % ) , than in the control group ( 69 % ) . Regarding the overall functioning , the patients in this treatment group did slightly better than those in the control group . These results are in accordance with the findings of comparable studies Psychoeducational medication management training ( PMT ) , cognitive psychotherapy ( CP ) and key‐person counselling ( KC ) were carried out in various combinations in this r and omized , controlled intervention study of schizophrenic out‐ patients ( according to DSM‐III‐R ) . Special design characteristics of the study were a control group consisting of non‐specifically treated patients and a 2‐year follow‐up after completion of treatment in order to evaluate medium‐term effects . A total of 132 patients underwent a follow‐up examination 2 years after completion of treatment and were evaluated with an intention‐to‐treat approach . In the second follow‐up year , all treatment groups had lower but not significantly different relapse rates compared to the control group . The most intensive treatment ( PMT+CP+KC ) produces a clinical ly relevant reduction in rehospitalization rate ( a 26 % reduction compared to the control group ) . In comparison with the non‐specifically treated control group , whose original effect decreased , at least a medium‐term therapeutic effect was recorded in the treatment groups Schizophrenic patients were recruited into a trial of a prophylactic behavioural intervention with families . Families with at least one high Expressed Emotion ( EE ) relative were r and omly allocated to one of four intervention groups : Behavioural Intervention Enactive ; Behavioural Intervention Symbolic ; Education Only ; Routine Treatment .  Patients from low-EE families were r and omly allocated to two groups : Education Only or Routine Treatment .  Relapse rates over nine months after discharge were significantly lower for patients in the two Behavioural Intervention , compared with Education Only and Routine Treatment groups . There was little difference between the two low-EE groups . Patients returning to high-EE relatives showed significantly higher relapse rates than those returning to low-EE relatives , in groups not receiving active intervention . Changes from high to low EE occurred in the Behavioural Intervention groups , and similar although less extensive changes occurred in the Education Only and Routine Treatment groups . Changes in criticism and marked emotional over-involvement ( EOI ) occurred generally in high-EE groups but were larger in magnitude in the Enactive and Symbolic groups . Reduction of hostility only occurred in the Behavioural Intervention groups . These results give partial support for the causal role of EE in relapse . There were no significant differences between the groups with respect to contact with the psychiatric services or medication In this study we look into the question of whether , in addition to neuroleptic treatment , relapse rates among schizophrenic patients can be reduced by means of a combined psychoeducational and psychotherapeutic intervention strategy for patients and their relatives . In a r and omized controlled intervention study in an outpatient routine treatment setting , psychoeducational training for medication management , cognitive therapy and work with relatives ' groups were compared with each other and with a control group . The patients continued their st and ard treatment , including neuroleptic relapse prevention . The study comprised 191 chronic DSM-III-R schizophrenics . Data were collected before and after an 8-month intervention phase and at the 1-year follow-up . The group receiving all three treatments had the lowest relapse rates . Moreover , numerous gains recorded in subjective findings suggest that therapeutic work with schizophrenic patients and their relatives is of clinical ly significant benefit Although family intervention is practice d in most psychiatric hospitals , to our knowledge , no adequately controlled studies of its efficacy exist . This study was design ed to answer , in part , the question of the relative efficacy of  hospitalization with family intervention as compared with hospitalization without family intervention for patients ( 1 ) with major psychiatric disorders , ( 2 ) in need of hospital treatment , and ( 3 ) for whom both treatments are judged clinical ly feasible . This article compares treatment results at the time of hospital discharge for 169 patients r and omly assigned to the inpatient Family Intervention or comparison conditions . Inpatient Family Intervention had greater efficacy than the comparison treatment , mostly attributable to its effect on female patients , especially those patients ( and their families ) with affective disorder The authors estimated components of variance and intraclass correlation coefficients ( ICCs ) to aid in the design of complex surveys and community intervention studies by analyzing data from the Health Survey for Engl and 1994 . This cross-sectional survey of English adults included data on a range of lifestyle risk factors and health outcomes . For the survey , households were sample d in 720 postal code sectors nested within 177 district health authorities and 14 regional health authorities . Study subjects were adults aged 16 years or more .  ICCs and components of variance were estimated from a nested r and om-effects analysis of variance . Results are presented at the district health authority , postal code sector , and household levels . Between-cluster variation was evident at each level of clustering . In these data , ICCs were inversely related to cluster size , but design effects could be substantial when the cluster size was large . Most ICCs were below 0.01 at the district health authority level , and they were mostly below 0.05 at the postal code sector level . At the household level , many ICCs were in the range of 0.0 - 0.3 . These data may provide useful information for the design of epidemiologic studies in which the units sample d or allocated range in size from households to large administrative areas BACKGROUND We developed and evaluated a comprehensive , ongoing intervention for families of schizophrenic patients appropriate for China 's complex family relationships and unique social environment . METHOD Sixty-three DSM-III-R schizophrenic patients living with family members were enrolled when admitted to hospital and r and omly assigned to receive st and ard care or a family-based intervention that included monthly 45-minute counselling sessions focused on the management of social and occupational problems , medication management , family education , family group meetings , and crisis intervention . RESULTS At 6 , 12 , and 18-month follow-ups by blind evaluators , the proportion of subjects rehospitalised was lower , the duration of rehospitalisation was shorter , and the duration of employment was longer in the experimental group than in the control group ; these differences were statistically significant at the 12 and 18-month follow-ups and were not explained by differences in drug compliance . Family intervention was associated with significantly lower levels of family burden . CONCLUSIONS This intervention is less costly than st and ard treatment , is suitable for urban families of schizophrenic patients in China and feasible given the constraints of the Chinese mental health system Twenty-eight schizophrenic male patients , diagnosed by the Present State Examination and Catego criteria , and from families high on " expressed emotion , " were r and omly assigned to either intensive social skills training or holistic health therapy . A multidimensional evaluation was conducted before and after 9 weeks of inpatient treatment and for 24 months in the community . Patients exposed to social skills training evidence d significantly greater acquisition , generalization , and durability of social skills ; their social adjustment in the community was rated as better by significant others ; and they experienced fewer relapses and rehospitalizations This paper focuses on the follow-up results of a r and omized clinical trial of inpatient family intervention ( IFI ) that emphasized psychoeducation . Results for the sample of 169 psychiatric patients suggested that adding family treatment to st and ard hospital treatment was effective ; however , the statistical interactions indicated that this therapeutic effect was restricted to female patients with schizophrenia or major affective disorder . The effect of family treatment  on male  patients with these diagnoses was minimal or slightly negative . In a group of patients with other diagnoses , the Treatment by Sex effect was reversed : male patients did better with the family treatment BACKGROUND The paper describes a r and omized controlled trial of targeting cognitive behavioural therapy ( CBT ) during prodromal or early signs of relapse in schizophrenia . We hypothesized that CBT would result in reduced admission and relapse , reduced positive and negative symptoms , and improved social functioning . METHOD A total of 144 participants with schizophrenia or a related disorder were r and omized to receive either treatment as usual ( TAU ) ( N = 72 ) or CBT+TAU ( N = 72 ) . Participants were prospect ively followed up between entry and 12 months . RESULTS At 12 months , 11 ( 15.3 % ) participants in the CBT group were admitted to hospital compared to 19 ( 26.4 % ) of the TAU group ( haz 
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Generally , however , findings were consistent with the possibility that psychoeducation has a positive effect on a persons ' well being .
REVIEW ER 'S CONCLUSIONS Evidence from trials suggests that psychoeducational approaches are useful as a part of the treatment programme for people with schizophrenia and related illness .
The fact that the interventions are brief and inexpensive should make them attractive to managers and policy makers .