Verbesserung der sozialen Kompetenz als Mediator des Therapieerfolgs kognitiver Verhaltenstherapie bei Patienten mit Erkrankungen aus dem schizophrenen Formenkreis

Patients with psychotic disorder are often impaired in their social interactions. Their deficits in social competence have great negative impact on their quality of life and every-day life. The aim of the present study was to research social competence of schizophrenia patients and to analyse the change of social competence using cognitive behavioural therapy for psychosis. Additional research went into the potential correlation between the amount of social skills training during the treatment with cognitive behavioural therapy and changes in social competence as well as between changes in positive symptoms (measured by the Positive and Negative Syndrome Scale) and development in social competence. For this purpose, we compared a group of 60 patients with a control group consisting of 56 people regarding to their social competence. The group of patients was additionally split into therapy and waiting groups of equal size. The therapy group received treatment with cognitive behavioural therapy. During this time the waiting group underwent regular outpatient treatment, afterwards they were also subjected to a treatment with cognitive behavioural therapy. Social competence was measured before and after attending the different interventions (n = 40). To gather information on social competence, role plays were video recorded and evaluated using Fydrich and Bürgener’s social performance rating scale. The rating was a single blind rating conducted by the study’s author. This study clearly showed that compared to a healthy control group the group of schizophrenia patients display a lack in social competence, which proved to be statistically significant in all examined items. Treatment with cognitive behavioural therapy resulted in descriptive improvement, which appeared statistically significant for the discomfort-item during pre-posttherapy comparison. However, there was no difference in the improvement of social competence comparing the therapy group and the waiting group. The development of social competence did not correlate with an improvement in positive symptoms and did also not depend on the amount of social skills training included in the cognitive behavioural therapy treatment. Because of its negative impact on quality of life and social integration there should be further research in social competence in patients with psychotic disorders. According to this study cognitive behavioural therapy for psychosis may be a treatment option in improving social competence for these patients.