A randomized controlled trial of a private-sector inpatient-initiated psychoeducation program for schizophrenia

Objectives: Psychoeducation programs have been demonstrated to reduce relapse and be cost-effective for schizophrenia in academic settings, although this has not been examined in private care inpatient settings. Methods: A total of 57 consecutive patients hospitalized for an exacerbation of schizophrenia symptoms were randomly assigned to receive treatment as usual or Schizophrenia Treatment and Education Programs (STEPS), an intensive inpatient-initiated psychoeducation program in a private-sector treatment setting. At six months, 54% of the original sample was reassessed. Results: Rehospitalization over six months was significantly less frequent among STEPS participants than among usual care participants (20% versus 56%, p=.038, Hedge's g effect size=.76). Conclusions: This controlled study demonstrated subsequent reduction of costly rehospitalization among patients randomly assigned to STEPS, although study attrition of 46% over six months may diminish the confidence in the findings. This is the first study to demonstrate effectiveness of inpatient-initiated psychoeducation in private-sector care. Larger, more comprehensive studies are needed to replicate these findings and identify the active components of the intervention yielding these apparent gains.