Tratamiento con intervenciones psicoterapéuticas en la fase aguda y de mantenimiento del paciente adulto con diagnóstico de esquizofrenia

OBJECTIVES: To determine the effectiveness of the psychotherapeutic strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of disease. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia.

METHODS: A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced.

RESULTS: The cognitive behavioral therapy showed higher efficacy, compared with the usual treatment, to reduce positive symptoms, prevent relapses and hospital readmissions and to improve the occupational stats. However, the quality of evidence was low. There was not enough evidence about the efficacy of adherence, psychodynamic and support therapy.

CONCLUSION: Psychotherapeutic management must be offered to the patients with schizophrenia according to their needs and clinical characteristics. Among the different psychotherapeutic modalities, cognitive behavioral therapy is recommended.