Psychological Medicine

Original Article

A psychosocial skills training approach in Mexican out-patients with schizophrenia


a1 Division of Epidemiology and Psychosocial Research, National Institute of Psychiatry, Mexico City, Mexico

a2 Division of Clinical Services, National Institute of Psychiatry, Mexico City, Mexico


Background The effectiveness of a psychosocial skills training (PSST) approach applied to chronic out-patients with schizophrenia was examined. We hypothesized that the PSST programme, which included treatment as usual (TAU), PSST and family therapy (FT), would reduce positive and negative symptoms, prevent relapse and rehospitalization, and improve psychosocial functioning (PSF), global functioning and treatment adherence.

Method Eighty-two patients were randomly assigned to receive either TAU [antipsychotic medication (AP); n=39] or the PSST approach (TAU+PSST+FT; n=43). The two groups were assessed at intake and after completion of 1 year of treatment.

Results There were statistically significant differences between the two groups. Patients in the PSST group improved their symptomatology, psychosocial and global functioning (symptoms and psychological, social and occupational functioning), showed lower relapse, rehospitalization and drop-out rates, a higher level of compliance with AP medication, and a high level of therapeutic adherence in comparison with TAU patients, whose symptoms also improved although they showed no improvement in any of the clinical or psychosocial variables. A comparison of the standardized effect sizes showed a medium and a large effect size of PSF and global functioning for the PSST group and a non-effect size for the TAU group.

Conclusions A higher level of effectiveness was demonstrated when combining TAU, PSST and FT in comparison with AP medication alone. The PSST approach should be recommended for clinical practice.

(Online publication May 02 2007)


c1 Address for correspondence: Dr Marcelo Valencia, Psychosocial Treatment Research Programme for Patients with Schizophrenia, Instituto Nacional de Psiquiatría Ramón de la Fuente, Calzada Mexico-Xochimilco 101, Colonia San Lorenzo Huipulco, Tlalpan, Mexico City, Mexico. (Email: