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Cited by 125Schizophrenia research and treatmentMental Health Treatment and AccessPsychotherapy Techniques and Applications

Effect of psychosocial interventions on social functioning in depression and schizophrenia: meta-analysis

Open access
De Silva, Mary J., Cooper, Sara, Li, Henry Lishi, Lund, Crick, Patel, Vikram·2013·British Journal of Psychiatry
DOI 10.1192/bjp.bp.112.118018PMC PMC3613719
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Abstract

Background: Psychosocial interventions may contribute to reducing the burden of mental disorders in low- and middle-income (LAMI) countries by improving social functioning, but the evidence has not been systematically reviewed. Aims: Systematic review and meta-analysis of the effect of psychosocial interventions on social functioning in people with depression and schizophrenia in LAMI countries. Method: Studies were identified through database searching up to March 2011. Randomised controlled trials were included if they compared the intervention group with a control group receiving placebo or treatment as usual. Random effects meta-analyses were performed separately for depressive disorders and schizophrenia and for each intervention type. Results: Of the studies that met the inclusion criteria (n=24), 21 had sufficient data to include in the meta-analysis. Eleven depression trials showed good evidence for a moderate positive effect of psychosocial interventions on social functioning (standardised mean difference (SMD)=0.46, 95% CI 0.24-0.69, n=4009) and ten schizophrenia trials showed a large positive effect on social functioning (SMD = 0.84, 95% CI 0.49-1.19, n=1671), although seven of these trials were of low quality. Excluding these did not substantially affect the size or direction of effect, although the precision of the estimate was substantially reduced (SMD = 0.89, 95% CI 0.05-1.72, n=863). Conclusions: Psychosocial interventions delivered in out-patient and primary care settings are effective at improving social functioning in people with depression and should be incorporated into efforts to scale up services. For schizophrenia there is an absence of evidence from high-quality trials and the generalisabilty of the findings is limited by the over-representation of trials conducted in populations of hospital patients in China. More high-quality trials of psychosocial interventions for schizophrenia delivered in out-patient settings are needed.

Integrity signals

Registry

Crossref · 10.1192/bjp.bp.112.118018

Cites

58 of 58 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 39 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The 24 included trials used 10 different scales to measure social functioning.

    “The 24 included trials used 10 different scales to measure social functioning, confirming the previously reported lack of consensus on its measurement.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Burns T Patrick D Social functioning as an outcome measure in schizophrenia studies. Acta Psychiatr Scand 2007; 116: 403– 18 17941964

      Not checked in the free run.

  • Findingown data

    Three trials of interpersonal therapy for depression showed a large positive impact on social functioning (SMD=0.84, 95% CI 0.40-1.29, P=0.0002, I2=67%, n=360).

    “There was evidence from three trials of a large, positive impact of IPT on social functioning (SMD = 0.84, 95% CI 0.40–1.29, P = 0.0002, I2 = 67%, n = 360).”
    Quote in the paperSubstantial claim
  • Findingown data

    Six trials of multicomponent interventions for depression showed a small improvement in social functioning (SMD=0.35, 95% CI 0.11-0.59, P≤0.001, I2=89%, n=3291).

    “There was robust evidence from the six trials evaluating multicomponent interventions for a small improvement in social functioning (SMD = 0.35, 95% CI 0.11–0.59, P≤0.001, I2 = 89%, n = 3291).”
    Quote in the paperSubstantial claim
  • Findingown data

    No schizophrenia trials were included from Sub-Saharan Africa or South Asia.

    “No trials were included from Sub-Saharan Africa or South Asia.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Only a tiny fraction of trials included in those Cochrane reviews came from low- and middle-income countries.

    “Only 17 of the 62 Cochrane reviews of psychosocial interventions to treat depression or schizophrenia include social functioning outcomes, with only a tiny fraction of the included trials from low- and middle-income (LAMI) countries”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 17
  • May combine two claims. 25

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Four depression trials were from Chile, three from China, and the remainder from India, Brazil and Uganda.

    “Four of the trials were from Chile, three from China, and the remainder from India, Brazil and Uganda.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Excluding the one depression trial with risk of bias did not affect the conclusion, and the magnitude of effect was the same for short- and long-term follow-up.

    “Excluding the one trial with a risk of bias did not affect this conclusion, and the magnitude of effect was the same for both short- and long-term follow-up.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the depression trials, the pooled standardised mean difference for all psychosocial interventions was 0.46 (95% CI 0.24-0.69, P≤0.001, I2=90%, n=4009), indicating small to moderate improvements in social functioning.

    “The combined SMD for all interventions was 0.46 (95% CI 0.24–0.69, P≤0.001, I2 = 90%, n = 4009), indicating small to moderate improvements in social functioning based on the rule of thumb interpretation of SMDs whereby 0.2 represents a small effect, 0.5 a moderate effect and 0.8 a large effect.29”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [29] Cohen J Statistical Power Analysis in the Behavioral Sciences (2nd edn). Lawrence Erlbaum Associates, 1988

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The majority of depression trials were set in out-patient, primary care or community settings.

    “The majority of trials were set in out-patient, primary care or community settings.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Five depression trials used non-mental health specialists to deliver the intervention through task-sharing.

    “Five of the trials used non-mental health specialists to deliver the intervention through task-sharing.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Three schizophrenia trials did not contain sufficient data for meta-analysis and were included in the qualitative synthesis only.

    “Three trials did not contain sufficient data to be included in the meta-analysis,30-32 and as we were unable to obtain this information from the authors, these trials are included in the qualitative synthesis of results only.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [30] Xiang M Ran M Li S A controlled evaluation of psychoeducational family intervention in a rural Chinese community. Br J Psychiatry 1994; 165: 544– 8 7804673 source

      Not checked in the free run.

    • cites [31] Cui Y Yang W Weng Y Effectiveness of social skills training in patients with chronic schizophrenia [in Chinese]. Chin Ment Health J 2004; 18: 799– 805

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [32] Xiong W Phillips MR Hu X Wang R Dai Q Kleinman J Family-based intervention for schizophrenic patients in China. A randomised controlled trial. Br J Psychiatry 1994; 165: 239– 47 7953039 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Eleven depression trials assessed interventions: six multicomponent collaborative care, three interpersonal therapy, one problem-solving therapy, and one Morita therapy.

    “In total 11 trials assessed the effect of interventions to treat depression, 6 assessed multicomponent collaborative care interventions, three interpersonal therapy (IPT), 1 problem-solving therapy, and 1 Morita therapy.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Thirteen schizophrenia trials assessed interventions: three family psychoeducation, one patient psychoeducation, one social skills training, one art therapy, four multicomponent structured psychotherapies, and three community-based care interventions.

    “Thirteen trials assessed the effect of interventions to treat schizophrenia: 3 trials assessed the effect of family psychoeducation, 1 patient psychoeducation, 1 social skills training, 1 art therapy, 4 multicomponent structured psychotherapies and 3 community-based care interventions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A total of 9592 unique records were obtained, and 24 trials met the inclusion criteria.

    “A total of 9592 unique records were obtained, of which 24 trials met the inclusion criteria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Only one depression trial was assessed as having overall risk of bias, and nine had long-term follow-up of more than six months.

    “Only one trial was assessed as having an overall risk of bias and nine had long-term follow-up of more than 6 months.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Excluding the seven schizophrenia trials with risk of bias did not substantially affect the size or direction of effect, but precision was substantially reduced (SMD=0.89, 95% CI 0.05-1.72, P≤0.001, I2=91%, n=863).

    “Excluding the seven trials with a risk of bias did not substantially affect the size or direction of effect, although the precision of the estimate was substantially reduced due to the smaller pooled sample sizes (SMD = 0.89, 95% CI 0.05–1.72, P≤0.001, I2 = 91%, n = 863).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Some included trials showed social functioning improvements only at later stages, while clinical improvements often appeared early.

    “In contrast to clinical improvements that are often observed early in the intervention, improvements in social functioning were sometimes only evident at later stages (for example Li & Arthur33 and Pang et al42).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Li & Arthur33

      Not checked in the free run.

    • cites Pang et al42

      Not checked in the free run.

  • May combine two claims.

    Findingreasoning

    The search identified a substantial body of previously largely uncited Chinese work that adds significantly to knowledge, especially on schizophrenia intervention effectiveness.

    “This resulted in the identification of a substantial body of previously largely uncited work from China that significantly adds to the body of knowledge particularly on the effectiveness of schizophrenia interventions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The depression and schizophrenia reviews found intervention effects sustained beyond 6 and 12 months, respectively.

    “Although both the depression and the schizophrenia reviews show that intervention effects were sustained over greater than a 6- or 12-month period respectively”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The social functioning outcome measures used across the included trials are sufficiently comparable to be combined in a meta-analysis.

  • May combine two claims.

    Findingown data

    Three of these four trials had low risk of bias, and a sensitivity analysis restricted to these trials did not affect the finding.

    “Three of these trials had a low risk of bias and a sensitivity analysis restricted to these trials did not affect this finding.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Eleven depression trials from five countries and thirteen schizophrenia trials from three countries were included.

    “A total of 11 depression trials from 5 countries and 13 schizophrenia trials from 3 countries were included in this review.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The combined standardised mean difference for all schizophrenia interventions was 0.84 (95% CI 0.49-1.19, P≤0.001, I2=89%, n=1671), indicating large improvements in social functioning.

    “The combined SMD for all interventions was 0.84 (95% CI 0.49–1.19, P≤0.001, I2 = 89%, n = 1671), indicating large improvements in social functioning.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The effect of schizophrenia interventions on social functioning increased over time: moderate at less than 12 months (SMD=0.71, 95% CI 0.36-1.06, P≤0.001, I2=88%, n=1718) and large at more than 12 months (SMD=0.93, 95% CI 0.37-1.49, P≤0.001, I2=95%, n=1409).

    “The effect of the interventions on social functioning increased over time, with moderate effect sizes at less than 12 months' follow-up (SMD = 0.71, 95% CI 0.36–1.06, P≤0.001, I2 = 88%, n = 1718), increasing to a large effect on social functioning at more than 12 months' follow-up (SMD = 0.93, 95% CI 0.37–1.49, P≤0.001, I2 = 95%, n = 1409).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Two high-risk trials of community-based interventions showed a small increase in social functioning (SMD=0.33, 95% CI 0.10-0.55, P=0.004, I2=88%, n=316), despite neither trial showing an effect on clinical outcomes.

    “There was weak evidence from two trials with a high risk of bias41,42 of a small increase in social functioning as a result of community-based interventions (SMD = 0.33, 95% CI 0.10–0.55, P = 0.004, I2 = 88%, n = 316), despite neither trial showing an effect on clinical outcomes.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [41] Li X Li X Ma X Ni Y Effects of social rehabilitation on late-onset schizophrenia [in Chinese]. Chin Ment Health J 2002; 16: 711– 3

      Not checked in the free run.

    • cites [42] Pang Y Huang S Li X Hu L Lin C The effect of health education on compliance of patients with paranoid schizophrenia in their follow-up therapy [in Chinese]. Chin Ment Health J 2002; 16: 348– 50

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Risk of bias was assessed at both the study level and the outcome level.

    “Risk of bias was assessed both at the study level (for example sequence generation and allocation concealment) and at the outcome level (for example losses to follow-up for the social functioning outcome).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review's methods and results are reported according to the PRISMA statement for systematic reviews.

    “The methods and results in this paper are presented according to the PRISMA statement for reporting systematic reviews.8”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Moher D Liberati A Tetzlaff J Altman DG Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: e1000097 19621072 PMC2707599 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The quality of included studies was assessed with the Cochrane risk of bias tool by two authors.

    “The quality of included studies was assessed using the Cochrane risk of bias tool14 by two authors.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Higgins JPT Green S Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, 2011

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    To control for study quality, trials with risk of bias for allocation concealment, or unassessable allocation concealment plus risk of bias for sequence generation and/or masking, were excluded from the meta-analysis.

    “To control for study quality, trials that had a risk of bias for allocation concealment, or for whom allocation concealment could not be assessed but who had a risk of bias for sequence generation and/or masking of outcome assessment, were excluded from the meta-analysis.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Data for the meta-analyses were extracted by H.L.L. and double checked by M.J.D.S.

    “Data for the meta-analyses were extracted by H.L.L. and double checked by M.J.D.S.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Funnel plots were generated to assess possible publication bias.

    “Lastly, funnel plots for the primary meta-analyses were generated to assess possible publication bias.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Data were extracted by two authors using a standard data extraction form.

    “Data were extracted by two authors using a standard data extraction form including inclusion criteria for participants, intervention and control groups, outcome measures and effect estimates.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The funnel plots were somewhat asymmetrical, but this asymmetry may have been caused by heterogeneity in intervention type rather than publication bias, as indicated by the large I2.

    “Although a visual inspection of the plots shows them to be somewhat asymmetrical, this asymmetry may have been caused by heterogeneity in intervention type rather than publication bias, as indicated by the large I2 for the combined effect estimates.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    For schizophrenia, interventions demonstrated a strong effect, but interpretation is tempered by risk of bias associated with seven of ten trials.

    “For schizophrenia, interventions demonstrated a strong effect, but the interpretation of these findings is tempered by the risk of bias associated with seven of the ten trials.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The review used a wide-ranging search with no restrictions on date, publication type, or language.

    “We used a wide-ranging search strategy with no limitations set on date, publication type or language.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Social functioning improvements tend to occur more slowly and after clinical improvements.

    “It is likely that improvements in social functioning happen more slowly and subsequently to clinical improvements”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Interventions improving patient social functioning will reduce mental disorder burden by enabling productive social roles and may be the most effective way to combat stigma.

    “Providing interventions that improve patient social functioning will not only reduce the burden of mental disorders by enabling people to fulfil a productive social role, but may also be the most effective way to combat stigma.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The results from the included trials are generalisable to LAMI countries.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The review meta-analysed similar trials with outcomes at similar time points and comparable control groups to test effect size on social functioning, and examined heterogeneity by study quality.

    “We conducted a meta-analysis of similar trials, using outcomes measured at similar time points and with comparable control groups to test the size of the effect of the interventions on social functioning, and examined heterogeneity by study quality.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The social functioning outcome measures used across the included trials are sufficiently comparable to be combined in a meta-analysis.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Some asymmetry may have been caused by the tendency for poorer quality trials to show larger effects.

    “Some asymmetry may also have been caused by the tendency in this review for the poorer quality trials to show larger effects, as documented elsewhere.44”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Schulz KF Chalmers I Hayes RJ Altman DG Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995; 273: 408– 12 7823387 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Parental functioning was measured in only two of the ten scales used by the included trials, which may underestimate intervention effects on social functioning.

    “Parental functioning was only measured in two of the ten scales used by the included trials, leading to potential underestimates of the effect of the intervention on social functioning in these trials.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    A third of included trials had short follow-up, which may have prevented detection of functioning improvements in the intervention group.

    “Additional limitations of the evidence included in this review include the short follow-up in a third of trials, potentially not allowing sufficient time to detect improvements in functioning in the intervention group.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Maternal depression has been shown to affect child health and growth.

    “but maternal depression has been shown to affect child health47 and growth.48”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [47] Rahman A Malik A Sikander S Roberts C Creed F Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. Lancet 2008; 372: 902– 9 18790313 PMC2603063 source

      Not checked in the free run.

    • cites [48] Surkan PJ Kennedy CE Hurley KM Black MM Maternal depression and early childhood growth in developing countries: systematic review and meta-analysis. Bull World Health Organ 2011; 89: 608– 15 21836759 PMC3150769 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductreasoning

    The review's methods were strong.

    “On the other hand, the methods used for this review were strong.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Four trials were assessed as having high overall risk of bias, so the level of evidence for psychoeducation is currently weak.

    “As four trials were assessed as having a high overall risk of bias (two because the risk of bias was unknown due to lack of information in the published paper), the level of evidence for psychoeducation is currently weak.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Women have a higher risk of depression.

    “as not only are they at a higher risk for depression,5”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Patel V Simon G Chowdhary N Kaaya S Araya R Packages of care for depression in low- and middle-income countries. PLoS Med 2009; 6: e1000159 19806179 PMC2747016 source

      Not checked in the free run.

39 of 39

  • The paper relies on this without support.

    Psychosocial interventions may reduce the burden of mental disorders in low- and middle-income countries by improving social functioning.

    “Psychosocial interventions may contribute to reducing the burden of mental disorders in low- and middle-income (LAMI) countries by improving social functioning”

  • The paper relies on this without support.

    Impairment of social functioning is a major reason for the high levels of stigma and disability associated with depression and schizophrenia.

    “Impairment of social functioning, defined as ‘an individual's ability to perform and fulfil normal social roles’,3 is a major reason for the high levels of stigma and disability associated with these mental disorders.”

  • The paper relies on this without support.

    The social functioning outcome measures used across the included trials are sufficiently comparable to be combined in a meta-analysis.

    “We conducted a meta-analysis of similar trials, using outcomes measured at similar time points and with comparable control groups to test the size of the effect of the interventions on social functioning”

  • The paper relies on this without support.

    The results from the included trials are generalisable to LAMI countries.

    “This review provides strong evidence for depression and weaker evidence for schizophrenia in support of the use of a range of psychosocial interventions, with or without concurrent pharmacological interventions5,6 in LAMI countries.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Most psychotherapy and pharmacotherapy trials in depression have focussed on the reduction of depressive symptoms, rather than improvement of social functioning.

    “However, most psychotherapy and pharmacotherapy trials in depression have focussed on the reduction of depressive symptoms, rather than improvement of social functioning (Silva et al., 2013).”

    From Social functioning in major depressive disorder (2016) · cites this paper as Silva et al., 2013

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • The paper both denies and identifies high-quality schizophrenia trials

    Major

    The conclusion says there is no evidence from high-quality schizophrenia trials, but the discussion identifies three such trials as providing good evidence for a treatment effect.

  • The stated count of Chinese in-patient trials exceeds the total in-patient count

    Minor

    The statement places 11 schizophrenia trials in Chinese hospital in-patient populations, whereas the table lists only seven hospital in-patient schizophrenia trials across all countries.

2 of 2

Cites

Flagged first, then by citations

1 of the 59 references couldn’t be matched to a known paper.

Research works printed but not linked: 14

  1. Chen, 2003, Efficacy of the rehabilitation strategy for inpatients with schizophrenia [in Chinese], Chin Ment Health J, 17
  2. Hu, 2007, Synthetical family treatment for depression: a randomized-controlled single-blind study among 76 cases [in Chinese], J Clin Rehabil Tissue Eng Res, 11
  3. Wei, 2005, Effect of new Morita therapy plus antipsychotic drugs in ameliorating post-schizophrenia depression [in Chinese], Zhongguo Linchuang Kangfu, 9
  4. Fritsch, 2007, A randomized trial of pharmacotherapy with telephone monitoring to improve treatment of depression in primary care in Santiago, Chile [in Spanish], Rev Med Chile, 135
  5. Higgins, 2011, Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0.
  6. Wang, 2008, The effect of regular health education on rehabilitation of outpatients with schizophrenia in rural areas [in Chinese], Chin Merit Health J, 22
  7. 2004, The Global Burden of Disease: 2004 Update
  8. Gates, 2005, In About The Cochrane Collaboration (Collaborative Review Groups (CRGs)), issue 2
  9. Meng, 2005, Group intervention for schizophrenia inpatient with art as medium [in Chinese], Acta Psychol Sinica, 37
  10. Wei, 1997, Primary application of mental education in recovery stage of schizophrenia [in Chinese], Chin Ment Health J, 11
  11. Li, 2002, Effects of social rehabilitation on late-onset schizophrenia [in Chinese], Chin Merit Health J, 16
  12. 2008, Scaling Up Care for Mental, Neurological, and Substance Use Disorders
  13. Cui, 2004, Effectiveness of social skills training in patients with chronic schizophrenia [in Chinese], Chin Ment Health J, 18, 799
  14. Pang, 2002, The effect of health education on compliance of patients with paranoid schizophrenia in their follow-up therapy [in Chinese], Chin Ment Health J, 16

Cited by

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Related

Authors
De Silva, M. J., Cooper, S., Li, H. L., Lund, C., & Patel, V.
Affiliations
  • University of Cape Town (ZA)
  • London School of Hygiene & Tropical Medicine (GB)
ORCID
Venue
British Journal of Psychiatry
Publisher
Royal College of Psychiatrists
Published
2013-04
Volume
202
Issue
4
Pages
253-260
ISSN
  • 0007-1250 (ISSN-L)
  • 1472-1465
DOI
10.1192/bjp.bp.112.118018
PMC
PMC3613719
OpenAlex
W2107904541
Semantic Scholar
e65e7f3bd43af038ab3888f1ff9076d3bc74d1c5
Cited by
125
References
59
Citations by year
2026: 2 · 2025: 10 · 2024: 10 · 2023: 8 · 2022: 8 · 2021: 23 · 2020: 13 · 2019: 11 · 2018: 9 · 2017: 4 · 2016: 10 · 2015: 9 · 2014: 5 · 2013: 2
FWCI
1.18
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified, 1737 d)
Locations
  • The British Journal of Psychiatry (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
Funders
  • Wellcome Trust (091834)
  • Department for International Development (HRPC10)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
psychosocial interventions, social functioning, depression, schizophrenia, low- and middle-income countries, outpatient mental health services, primary care, mental health service delivery
MeSH terms
Depression, Humans, Poverty, Psychotherapy, Schizophrenia, Schizophrenic Psychology, Social Behavior, Publication Bias

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