***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 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 OBJECTIVE Despite the frequent use of the Positive and Negative Syndrome Scale ( PANSS ) for rating the symptoms of schizophrenia , the clinical meaning of its total score and of the cut-offs that are used to define treatment response ( e.g. at least 20 % or 50 % reduction of the baseline score ) are as yet unclear . We therefore compared the PANSS with simultaneous ratings of Clinical Global Impressions ( CGI ) . METHOD PANSS and CGI ratings at baseline ( n = 4091 ) , and after one , two , four and six weeks of treatment taken from a pooled data base of seven pivotal , multi-center antipsychotic drug trials on olanzapine or amisulpride in patients with exacerbations of schizophrenia were compared using equipercentile linking . RESULTS Being considered " mildly ill " according to the CGI approximately corresponded to a PANSS total score of 58 , " moderately ill " to a PANSS of 75 , " markedly ill " to a PANSS of 95 and severely ill to a PANSS of 116 . To be " minimally improved " according to the CGI score was associated with a mean percentage PANSS reduction of 19 % , 23 % , 26 % and 28 % at weeks 1 , 2 , 4 and 6 , respectively . The corresponding figures for a CGI rating " much improved " were 40 % , 45 % , 51 % and 53 % . CONCLUSIONS The results provide a better framework for underst and ing the clinical meaning of the PANSS total score in drug trials of schizophrenia patients with acute exacerbations . Such studies may ideally use at least a 50 % reduction from baseline cut-off to define response rather than lower thresholds . In treatment resistant population s , however , even a small improvement can be important , so that a 25 % cut-off might be appropriate 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 OBJECTIVE The present study examined whether psychoeducational groups for patients with schizophrenic disorders and for their families can reduce rehospitalization rates and improve compliance . METHOD 236 in patients who met DSM-III-R criteria for schizophrenia or schizoaffective disorder and who had regular contact with at least 1 relative or other key person were r and omly assigned to 1 of 2 treatment conditions . In the intervention condition , patients and their relatives were encouraged to attend psychoeducational groups over a period of 4 to 5 months . The patients ' and relatives ' psychoeducational programs were separate , and each consisted of 8 sessions . Patients in the other treatment condition received routine care . Outcomes were compared over 12-month and 24-month follow-up periods . The study was conducted from 1990 to 1994 . RESULTS It was possible to significantly reduce the rehospitalization rate after 12 and 24 months in patients who attended psychoeducational groups compared with those receiving routine care ( p < .05 ) . Patients who attended psychoeducational groups showed better compliance than patients under routine care without psycho-education . CONCLUSIONS The results suggest that a relatively brief intervention of 8 psychoeducational sessions with systematic family involvement in simultaneous groups can considerably improve the treatment of schizophrenia .  Psychoeducation should be routinely offered to all patients with schizophrenia and their families BACKGROUND A r and omised controlled trial was conducted in an acute treatment setting to examine the effectiveness of compliance therapy , a brief pragmatic intervention targeting treatment adherence in psychotic disorders , based on motivational interviewing and recent cognitive approaches to psychosis . METHOD Seventy-four patients with psychotic disorders according to DSM-III-R criteria recruited from consecutive admissions to an acute in-patient unit , received 4 - 6 sessions of either compliance therapy or non-specific counselling , and were followed-up over 18 months . The principal outcome measures were observer-rated compliance , attitudes to treatment , insight and social functioning . RESULTS Significant advantages were found for the compliance therapy group post-treatment on measures of insight , attitudes to treatment and observer-rated compliance which were retained over the follow-up period . Global social functioning improved relatively more over time in the compliance therapy group compared with the control group . Survival in the community prior to readmission was significantly longer in the compliance therapy group . CONCLUSIONS The results support the effectiveness of compliance therapy in improving functioning and community tenure after an acute psychotic episode OBJECTIVES To evaluate the effectiveness of a psychoeducation program for Chinese clients with schizophrenia and their family caregivers . METHODS A r and omized controlled trial was conducted . Seventy-three clients with a diagnosis of schizophrenia and their caregivers ( n=73 ) were recruited and r and omized into a study ( n=36 ) and control group ( n=37 ) . Ten psychoeducation sessions were provided to the study group . The outcomes were measured at the baseline , immediately after ( post-1 ) , six months ( post-2 ) , and 12 months after the intervention ( post-3 ) . RESULTS There were significant treatment effects across time for all client outcomes : adherence to medication ( p<0.01 ) , mental status ( p<0.01 ) , and insight into illness ( p<0.01 ) . However , no significant differences were found between groups at the post-3 measures for all client outcomes . For the caregivers , significant group differences were only detected in self-efficacy at the post-1 ( p=0.007 ) and post-2 ( p<0.001 ) measures , the level of satisfaction at the post-1 ( p=0.033 ) and post-2 ( p<0.021 ) measures , and the perception of family burden at the post-2 measures ( p=0.043 ) . CONCLUSION A psychoeducation intervention had positive effects on Chinese clients and their caregivers . However , these effects might not be sustained 12 months after the intervention . PRACTICE IMPLICATION S To substantiate its effects , psychoeducation should be an ongoing intervention , with its outcomes constantly evaluated BACKGROUND Family intervention in schizophrenia can reduce patient relapse and improve medication adherence , but few studies on this have involved a Chinese population . AIMS To examine the effects of a mutual support group for Chinese families of people with schizophrenia , compared with psychoeducation and st and ard care . METHOD R and omised controlled trial in Hong Kong with 96 families of out- patients with schizophrenia , of whom 32 received mutual support , 33 psychoeducation and 31 st and ard care .  The psychoeducation group included patients in all the sessions , the mutual support group did not . Intervention was provided over 6 months , and patient- and family-related psychosocial outcomes were compared over an 18-month follow-up . RESULTS Mutual support consistently produced greater improvement in patient and family functioning and caregiver burden over the intervention and follow-up periods , compared with the other two conditions . The number of readmissions did not decrease significantly , but their duration did . CONCLUSIONS Mutual support for families of Chinese people with schizophrenia can substantially benefit family and patient functioning and caregiver burden Earlier studies of family psychoeducation and clinical reports on  multiple family groups ( MFGs ) have reported substantial reductions in relapse rates for patients with schizophrenia . These groups offer an exp and ed social network and thereby may confer a margin of protection against relapse . However , to date , there has not been an empirical trial of this modality . The advent of family psychoeducational and behavioral management strategies provided the basis for an experimental , three-way comparison of psychoeducational MFGs to psychoeducation in a single-family format and to MFGs without psychoeducation , using symptomatic relapse as the outcome criterion . After 4 years , the psychoeducational MFGs were significantly more effective in extending remission than the single-family format , while the MFGs without psychoeducation approximated outcome in the psychoeducational MFGs . The respective relapse rates at 4 years were 50 % , 78 % , and 57 % ; MFGs averaged 12.5 % and 14 % per year . These results point toward an enhanced and independent , long-term therapeutic effect for multiple family groups , when combined with antipsychotic medication and psychoeducation , with especially promising cost-effectiveness Background The majority of patients with schizophrenia live with their relatives in Pakistan , thereby families experience a considerable burden . We aim ed to study the impact of psychoeducation on the burden of schizophrenia on the family in a r and omised controlled trial . Methods A total of 108 patients with schizophrenia and their family members from the outpatient department of a teaching hospital in Lahore , Pakistan were r and omised . Both groups received psychotropic drugs but one group received psychoeducation in addition . Family burden was assessed at the time of recruitment and at 6 months post intervention . Results In all , 99 patients and their relatives completed the treatment . There was significant reduction in burden at post-intervention assessment in the psychoeducation group based on intention to treat analysis . Conclusion Family psychoeducation can be an important intervention for patients with schizophrenia in Pakistan Family members of 55 patients with schizophrenia were r and omly assigned to a psychoeducational support group or to a control group . Support group participants showed greater knowledge of schizophrenia and greater satisfaction with health care services than did control group members . Psychological distress , coping behavior , and family satisfaction did not appear affected by support group participation ; nor were support groups associated with lower rehospitalization rates for patients 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 
    Output:
    
Based on mainly low to very low quality evidence from a limited number of studies , brief psychoeducation of any form appears to reduce relapse in the medium term , and promote medication compliance in the short term .