TORONTO -- Older schizophrenic patients benefit from a combination of cognitive behavioral therapy and social skills training, according to results of a pilot project at the University of California, San Diego.

"CBT has been used a lot with younger schizophrenic patients, but not in older [patients]. In fact, we haven't had many interventions aside from medication" in this population, Fauzia Simjee McClure, Ph.D., said in a poster presentation at the annual meeting of the
Association for Advancement of Behavior Therapy.

"Having the structure that CBT provides, along with the social skills training, shows these patients exactly how to make changes in their lives," added Dr. Simjee McClure, a fellow at the Geriatric
Psychiatry Clinical Research Center in La Jolla, Calif.

Ten patients with schizophrenia, whose mean age was 62 years, showed a 33.3% decrease in scores on the Sheehan's Disability Scale (SDS) and improvements on all measures of the Rehabilitation Inventory (RI) after CBT and social skills training (SST).

"This work directly helps them in communication with health providers and family members, in their assertiveness skills, getting around the house -- even asking for help," she told this newspaper.

The therapy consisted of 12 weekly 1-hour sessions, plus homework. The sessions were later expanded to 90 minutes.

The first 4 weeks were dedicated to thought challenge skills intended to break up the pattern of negative and automatic thoughts.

The next 4 weeks were dedicated to symptom management, focusing on identifying and preventing relapses. The last 4 weeks concentrated on practicing the skills to prepare for the end of therapy.

Aside from improved posttreatment scores on the SDS and RI, patients also felt they had learned skills to help them in their everyday life.

"The next step will be to see if [the improvements are] ... retained," Dr. McClure said.