psychiatryПСИХИАТРИЯPsychiatry (Moscow) (Psikhiatriya)1683-83192618-6667FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»10.30629/2618-6667-2019-17-3-62-74psychiatry-417Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSПсихосоциальная реабилитация и психосоциальное лечение при шизофрении: цели, этапы, оценка эффективностиPsychosocial Rehabilitation and Psychosocial Treatment in Schizophrenia: Goals, Stages, Evaluation of the Efectivenesshttps://orcid.org/0000-0003-3235-2476СолохинаТ. А.SolokhinaT. A.

Солохина Татьяна Александровна - доктор медицинских наук, заведующая отделом организации психиатрических служб.

Tatyana A. Solokhina - Dr. of Sci. (Med.), Head of Department, Department of Mental Health Services.

tsolokhina@live.ruhttps://orcid.org/0000-0003-1138-0507ЯстребоваВ. В.YastrebovaV. V.

Ястребова Валерия Владимировна - кандидат медицинских наук, научный сотрудник, отдел организации психиатрических служб.

Valeriya V. Yastrebova - PhD, MD, Сand. of Sci. (Med.), Researcher, Department of Mental Health Services.

vvyastrebova@gmail.comhttps://orcid.org/0000-0002-9502-5395МитихинВ. Г.MitikhinV. G.

Митихин Вячеслав Георгиевич - кандидат физико-математических наук, ведущий научный сотрудник, отдел организации психиатрических служб.

VyacheslavG. Mitikhin - Cand. of Sci. (Physic. and Mathema.), Leading Researcher, Department of Mental Health Services.

mvg45@mail.ruhttps://orcid.org/0000-0003-1567-2814ТюменковаГ. В.TiumenkovaG. V.

Тюменкова Галина Викторовна - кандидат медицинских наук, научный сотрудник, отдел организации психиатрических служб.

Galina V. Tiumenkova - PhD, MD, Cand. of Sci. (Med.), Researcher, Department of Mental Health Services.

tiumenkova@mail.ruФГБНУ Научный центр психического здоровьяРоссияFSBSI Mental Health Research CentreRussian Federation2019160120201736274Copyright © Солохина Т.А., Ястребова В.В., Митихин В.Г., Тюменкова Г.В., 20202020Солохина Т.А., Ястребова В.В., Митихин В.Г., Тюменкова Г.В.Solokhina T.A., Yastrebova V.V., Mitikhin V.G., Tiumenkova G.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journalpsychiatry.com/jour/article/view/417Цель

Цель: представить анализ научных публикаций по проблеме психосоциальной реабилитации и психосоциального лечения с акцентом на цели, этапы проведения, эффективность вмешательств и критерии эффективности.

Материал и метод

Материал и метод: совокупность отечественных и зарубежных публикаций по проблеме психосоциальной реабилитации и психосоциального лечения за последние два десятилетия.

Результаты

Результаты: проанализированы цели и этапы психосоциальной реабилитации, представлены результаты оценки эффективности различных видов психосоциального лечения и комплексных реабилитационных программ. Анализ научных публикаций показывает, что мишенями патогенетической психосоциальной терапии и психосоциальной реабилитации больных шизофренией являются нейрокогнитивный дефицит, нарушения социальной когниции, мотивации, эмоциональной сферы, социального функционирования, а также негативная симптоматика, социальная и психологическая уязвимость, семейная дезадаптация. Применение конкретных психосоциальных вмешательств, комплексных реабилитационных программ и модулей способствует снижению частоты рецидивов болезни и числа госпитализаций, уменьшению когнитивных и социальнокогнитивных нарушений, повышению социальной компетенции, социального функционирования и качества жизни, что может трансформироваться в более адаптивное социальное функционирование больных шизофренией.

Выводы

Выводы: программы психосоциальные вмешательства с доказанной эффективностью должны быть внедрены в практическую деятельность и доступны для большинства пациентов, страдающих шизофренией.

Purpose

Purpose: to present an analysis of scientific publications on psychosocial rehabilitation and psychosocial treatment with an emphasis on its targets, stages of implementation, effectiveness of the interventions and criteria of the effectiveness.

Material and method

Material and method: a set of domestic and foreign publications on the problem of psychosocial rehabilitation and psychosocial treatment over the past two decades.

Results

Results: the goals and stages of psychosocial rehabilitation are analyzed, the results of the evaluation of the effectiveness of different types of psychosocial treatment and comprehensive rehabilitation programs are presented. Analysis of scientific publications shows that the targets of pathogenetic psychosocial therapy and psychosocial rehabilitation of patients with schizophrenia are neurocognitive deficit, impaired social cognition, motivation, emotional sphere, social functioning, as well as negative symptoms, social and psychological vulnerability, family disadaptation. The use of specific psychosocial interventions, comprehensive rehabilitation programs and modules helps to reduce recurrence of the disease and the number of hospitalizations, reduce cognitive and socio-cognitive impairment, increase social competence, social functioning and quality of life that can transform into more adaptive social functioning in a community of schizophrenic patients.

Conclusion

Conclusion: psychosocial interventions with scientific evidence of effectiveness should be implemented in practical activities and are available to most patients with schizophrenia.

шизофренияпсихосоциальная реабилитацияпсихосоциальное лечениеоценка эффективностикритерии эффективностиschizophreniapsychosocial rehabilitationpsychosocial treatmentevaluation of the effectivenesscriteria of the effectivenessReferencesKahn I, Andrews-Hanna JR, Vincent JL, et al. Distinct cortical anatomy linked to subregions of the medial temporal lobe revealed by intrinsic connectivity. Journal Neurophysiology. 2008;100(1):129-139. DOI: https://doi.org/10.1152/jn.00077.2008.Kahn I, Andrews-Hanna JR, Vincent JL, et al. Distinct cortical anatomy linked to subregions of the medial temporal lobe revealed by intrinsic connectivity. Journal Neurophysiology. 2008;100(1):129-139. DOI: https://doi.org/10.1152/jn.00077.2008.Wible CG, Preus AP, Hashimoto R. A cognitive neuroscience view of schizophrenic symptoms: abnormal activation of a system for social perception and communication. Brain Imaging Behavior. 2009;3(1):85-110. DOI: https://doi.org/10.1007/s11682-008-9052-1.Wible CG, Preus AP, Hashimoto R. A cognitive neuroscience view of schizophrenic symptoms: abnormal activation of a system for social perception and communication. Brain Imaging Behavior. 2009;3(1):85-110. DOI: https://doi.org/10.1007/s11682-008-9052-1.Huang MX, Lee RR, Gaa KM, et al. Somatosensory system deficit in schizophrenia revealed by MEG during median-nerve oddball task. Brain Topogra-phy.2010;23(1):82-104. DOI: https://dx.doi.org/10.1007%2Fs10548-009-0122-5.Huang MX, Lee RR, Gaa KM, et al. Somatosensory system deficit in schizophrenia revealed by MEG during mediannerve oddball task. Brain Topogra-phy.2010;23(1):82-104. DOI: https://dx.doi.org/10.1007%2Fs10548-009-0122-5.Психосоциальная и когнитивная терапия и реабилитация психически больных. Практическое руководство. Под редакцией И.Я. Гуровича, А.Б. Шмуклера. М.: ИД Медпрактика-М; 2015:420.Psihosocial'naya i kognitivnaya terapiya i reabilitaci-ya psihicheski bol'nyh. Prakticheskoe rukovodstvo. Pod redakciej I.Ya. Gurovicha, A.B. Shmuklera. M.: ID Medpraktika-M; 2015:420. (In Russ.).Cattaneo L, Rizzolatti G. The Mirror Neuron System. Arch. Neurol. 2009;66 (5):557-560. DOI: https://doi.org/10.1001/archneurol.2009.41.Cattaneo L, Rizzolatti G. The Mirror Neuron System. Arch. Neurol. 2009;66 (5):557-560. DOI: https://doi.org/10.1001/archneurol.2009.41.Rizzolatti G, Fadiga L, Gallese V, Fogassi L. Premotor cortex and the recognition of motor actions. Brain Research. Cognitive Brain Research. 1996;3(2):l3l-l4l.Rizzolatti G, Fadiga L, Gallese V, Fogassi L. Premotor cortex and the recognition of motor actions. Brain Research. Cognitive Brain Research. 1996;3(2):l3l-l4l.Catmur C, Walsh V, Heyes C. Sensory-motor learning configures the human mirror system. Current Biology. 2007;17:1527-1531. DOI: https://doi.org/10.1016/]'.cub.2007.08.006.Catmur C, Walsh V, Heyes C. Sensory-motor learning configures the human mirror system. Current Biology. 2007;17:1527-1531. DOI: https://doi.org/10.1016/]'.cub.2007.08.006.Zubin J, Spring B. Vulnerability — a new view of schizophrenia. J. Abnorm Psychol. 1977;86(7):103-126.Zubin J, Spring B. Vulnerability — a new view of schizophrenia. J. Abnorm Psychol. 1977;86(7):103-126.Коцюбинский АП, Скорик АИ, Аксенова ИО и др. Шизофрения: уязвимость — диатез — стресс — заболевание. СПб.: Гиппократ плюс. 2004: 336.Kocyubinskij AP, Skorik AI, Aksenova IO i dr. Shizofreniya: uyazvimost' — diatez — stress — zabolevanie. SPb.: Gippokrat plyus. 2004:336. (In Russ.).Лиманкин ОВ. Актуальные проблемы внедрения реабилитационных технологий в практику психиатрических учреждений. Социальная и клиническая психиатрия. 2012;22(3): 99-106.Limankin OV. Actual problems of the introduction of rehabilitation technologies in the practice of psychiatric institutions. Social and Clinical Psychiatry. 2012;22(3): 99-106. (In Russ.).Незнанов НГ, Акименко МА. Холистический подход В.М. Бехтерева в современной неврологии и психиатрии. Обозрение психиатрии и медицинской психологии. 2012;1:3-6.Neznanov NG, Akimenko MA. Holistic approach V.M. Bekhtereva in modern neurology and psychiatry. Review of psychiatry and medical psychology. 2012;1:3-6. (In Russ.).Anthony WA. Psychiatric rehabilitation. W.A. Anthony, P.B. Nemec. In A.S. Bellack (Ed.). Schizophrenia:Treatment, management and rehabilitation. Orlando FL: Grune and Stratton. 1984:375-413.Anthony WA. Psychiatric rehabilitation. W.A. Anthony, P.B. Nemec. In A.S. Bellack (Ed.). Schizophre-nia:Treatment, management and rehabilitation. Orlando FL: Grune and Stratton. 1984:375-413.Bogue RL. Use S.M.A.R.T. goals to launch management by objectives plan. TechRepublic, 2005. Available at: https://www.techrepublic.com/article/use-smart-goals-to-launch-management-by-objectives-plan/.Bogue RL. Use S.M.A.R.T. goals to launch management by objectives plan. TechRepublic, 2005. Available at: https://www.techrepublic.com/article/use-smart-goals-to-launch-management-by-objectives-plan/.Исаева ЕР, Мухитова ЮВ. Критерии оценки эффективности психосоциальной реабилитации: современное состояние проблемы. Социальная и клиническая психиатрия. 2017;27(1):89-90.Isaeva ER, Muhitova YuV. Criteria for evaluating the effectiveness of psychosocial rehabilitation: the current state of the problem. Social and clinical psychiatry. 2017;27(1):89-90. (In Russ.).Wilken JP, Hollander D. Handboоk integrale rehabilitatiebenadering. Theorie en praktijk van het Systematisch Rehabilitatiegericht Handelen Amsterdam: SWP. 2018:432.Wilken JP, Hollander D. Handboоk integrale rehabilitatiebenadering. Theorie en praktijk van het Systematisch Rehabilitatiegericht Handelen Amsterdam: SWP. 2018:432.Ларина ОД, Шевцова ЕЕ. Система полипрофессионального взаимодействия специалистов как условие создания единого реабилитационного пространства специализированной службы нейрореабилитации г. Москвы. Специальное образование. 2014;4:24-39.Larina OD, Shevtsova EE. Sistema poliprofessional'nogo vzaimodejstviya spetsialistov kak uslovie sozdaniya edinogo reabilitatsionnogo prostranstva spetsializirovannoj sluzhby nejroreabilitatsii g. Moskvy. Spetsial'noe obrazovanie. 2014;4:24-39. (In Russ.).Kopelowicz A, Liberman RP, Wallae CJ. Psychiatric Rehabilitation for Schizophrenia. International Journal of Psychology and Psychological Therapy. 2003;3(2):283-298.Kopelowicz A, Liberman RP, Wallae CJ. Psychiatric Rehabilitation for Schizophrenia. International Journal of Psychology and Psychological Therapy. 2003;3(2):283-298.Wallace CJ, Lecomte TB, Wilde MS, Liberman RP. CASIG: A consumer-centered assessment for planning individualized treatment and evaluating program outcomes. Schizophrenia Research. 2001;50:105-119.Wallace CJ, Lecomte TB, Wilde MS, Liberman RP. CASIG: A consumer-centered assessment for planning individualized treatment and evaluating program outcomes. Schizophrenia Research. 2001;50:105-119.Мелехов ДЕ. Клинические основы прогноза трудоспособности при шизофрении. Москва: Мед-гиз;1963:198.Melekhov DE. Klinicheskie osnovy prognoza trudosposobnosti pri shizofrenii. Moskva: Medgiz; 1963:198. (In Russ.).Кабанов ММ. Реабилитация психически больных. 2-е изд., доп. и перераб. Л.: Медицина. 1985:216.Kabanov MM. Reabilitatsiya psikhicheski bol'nykh. 2-e izd., dop.i pererab. L.: Meditsina. 1985:216. (In Russ.).Гурович ИЯ, Шмуклер АБ, Сторожакова ЯА. Психосоциальная терапия и психосоциальная реабилитация в психиатрии. М.: Мед-практика; 2004:492.Гурович ИЯ, Шмуклер АБ, Сторожакова ЯА. Психосоциальная терапия и психосоциальная реабилитация в психиатрии. М.: Мед-практика; 2004:492. [Gurovich IYa, Shmukler АВ, Storozhakova YaA. Psi-khosotsial'naya terapiya i psikhosotsial'naya reabil-itatsiya v psikhiatrii. M.: Med-praktika; 2004: 492. (In Russ.)].Ястребов ВС, Митихин ВГ, Солохина ТА, Михайлова ИИ. Системно-ориентированная модель психосоциальной реабилитации. Журнал неврологии и психиатрии имени С.С. Корсакова. 2008;108(6):4-10. DOI: http://dx.doi.org/10.17116/jnevro2016116914-12.Yastrebov VS, Mitikhin VG, Solokhina TA, Mikhailova II. The system-oriented model of psychosocial rehabilitation. Journal of Neurology and Psychiatry ime-ni S.S. Korsakov. 2008;108(6):4-10. (In Russ.). DOI: http://dx.doi.org/10.17116/jnevro2016116914-12.Barch DM. The relationships among cognition, motivation and emotion in schizophrenia: How little we know. Schizophrenia Bulletin. 2005;31:875-881. DOI: https://doi.org/10.1093/schbul/sbi040.Barch DM. The relationships among cognition, motivation and emotion in schizophrenia: How little we know. Schizophrenia Bulletin. 2005;31:875-881. DOI: https://doi.org/10.1093/schbul/sbi040.Bell MD, Tsang HW, Greig TC, Bryson GJ. Neurocognition, social cognition, perceived social discomfort, and vocational outcomes in schizophrenia. Schizophrenia Bulletin. 2009;35:738-747. DOI: https://doi.org/10.1093/schbul/sbm169.Bell MD, Tsang HW, Greig TC, Bryson GJ. Neurocognition, social cognition, perceived social discomfort, and vocational outcomes in schizophrenia. Schizophrenia Bulletin. 2009;35:738-747. DOI: https://doi.org/10.1093/schbul/sbm169.Bora E, Eryavu A, Kayahan B, et al. Social functioning, theory of mind and neurocognition in outpatients with schizophrenia; mental state decoding may be a better predictor of social functioning than mental state reasoning. Psychiatry Research. 2006;145:95-103. DOI: https://doi.org/10.1016/]'.psychres.2005.11.003.Bora E, Eryavu A, Kayahan B, et al. Social functioning, theory of mind and neurocognition in outpatients with schizophrenia; mental state decoding may be a better predictor of social functioning than mental state reasoning. Psychiatry Research. 2006;145:95-103. DOI: https://doi.org/10.1016/]'.psychres.2005.11.003.Brune M. Emotion recognition, «theory of mind», and social behavior in schizophrenia. Psychiatry Research. 2005;133:135-147. DOI: https://doi.org/10.1016/j.psychres.2004.10.007.Brune M. Emotion recognition, «theory of mind», and social behavior in schizophrenia. Psychiatry Research. 2005;133:135-147. DOI: https://doi.org/10.1016/j.psychres.2004.10.007.Roder V, Medalia A (Eds.). Neurocognition and Social Cognition in Schizophrenia Patients. Basic Concepts and Treatment. Karger. 2010:61-84.Roder V, Medalia A (Eds.). Neurocognition and Social Cognition in Schizophrenia Patients. Basic Concepts and Treatment. Karger. 2010:61-84.Combs DR, Adams SD, Penn DL, et al. Social cognition and interaction training (SCIT) for inpatients with schizophrenia spectrum disorders: preliminary findings. Schizophrenia Research. 2007;91:112-116. DOI: https://doi.org/10.1016/j.schres.2006.12.010.Combs DR, Adams SD, Penn DL, et al. Social cognition and interaction training (SCIT) for inpatients with schizophrenia spectrum disorders: preliminary findings. Schizophrenia Research. 2007;91:112-116. DOI: https://doi.org/10.1016/j.schres.2006.12.010.Carter CS. Understanding the glass ceiling for functional outcome in schizophrenia. American Journal of Psychiatry. 2006;163:356-358. DOI: https://doi.org/10.1176/appi.ajp.163.3.356.Carter CS. Understanding the glass ceiling for functional outcome in schizophrenia. American Journal of Psychiatry. 2006;163:356-358. DOI: https://doi.org/10.1176/appi.ajp.163.3.356.Roder V, Mueller DR, Mueser KT, Brenner HD. Integrated Psychological Therapy (IPT) for Schizophrenia: Is It Effective? Schizophrenia Bull. 2006;32(1):81-93. DOI: 10.1093/schbul/sbl021.Roder V, Mueller DR, Mueser KT, Brenner HD. Integrated Psychological Therapy (IPT) for Schizophrenia: Is It Effective? Schizophrenia Bull. 2006;32(1):81-93. DOI: 10.1093/schbul/sbl021.Wampold BE, Imei ZE. The Great Psychotherapy Debate: The great psychotherapy debate: Models, methods and findings. Mahwah, NJ: Lawrence Erlbaum, Publishers; 2001: 263.Wampold BE, Imei ZE. The Great Psychotherapy Debate: The great psychotherapy debate: Models, methods and findings. Mahwah, NJ: Lawrence Erlbaum, Publishers; 2001: 263.Bitter NA, Roeg DP, van Nieuwenhuizen C, van Weeghel J. Effectiveness of the Comprehensive Approach to Rehabilitation (CARe) methodology: design of a cluster randomized controlled trial. BMC Psychiatry. 2015;15:165. DOI: https://dx.doi.org/10.1186%2Fs12888-015-0564-0.Bitter NA, Roeg DP, van Nieuwenhuizen C, van Weeghel J. Effectiveness of the Comprehensive Approach to Rehabilitation (CARe) methodology: design of a cluster randomized controlled trial. BMC Psychiatry. 2015;15:165. DOI: https://dx.doi.org/10.1186%2Fs12888-015-0564-0.Haddock G, Tarrier N, Spaulding W, et al. Individual cognitive-behavioral therapy in the treatment of hallucinations and delusions: A review. Clin. Psychol. Review. 1998;18: 821-838.Haddock G, Tarrier N, Spaulding W, et al. Individual cognitive-behavioral therapy in the treatment of hallucinations and delusions: A review. Clin. Psychol. Review. 1998;18: 821-838.Turkington D, Sensky T, Scott J, et al. A randomized controlled trial of cognitive-behavior therapy for persistent symptoms in schizophrenia: A five-year follow-up. Schizophrenia Research. 2008;98:1. DOI: https://doi.org/10.1016/j.schres. 2007.09.026.Turkington D, Sensky T, Scott J, et al. A randomized controlled trial of cognitive-behavior therapy for persistent symptoms in schizophrenia: A five-year follow-up. Schizophrenia Research. 2008;98:1. DOI: https://doi.org/10.1016/j.schres. 2007.09.026.Twamley EW, Jeste DV, Bellack AS. A review of cognitive training in schizophrenia. Schizophr. Bull. 2003;29:359-382. DOI: https://doi.org/10.1093/ox-fordjournals.schbul.a007011ers.Twamley EW, Jeste DV, Bellack AS. A review of cognitive training in schizophrenia. Schizophr. Bull. 2003;29:359-382. DOI: https://doi.org/10.1093/ox-fordjournals.schbul.a007011ers.Silverstein SM., Wilkniss SM. At issue: The future of cognitive rehabilitation of schizo-phrenia. Schizophr. Bull. 2004;30:679-692. DOI: https://doi.org/10.1093/oxfordjournals.schbul.a007122.Silverstein SM., Wilkniss SM. At issue: The future of cognitive rehabilitation of schizo-phrenia. Schizophr. Bull. 2004;30:679-692. DOI: https://doi.org/10.1093/oxfordjournals.schbul.a007122.Зайцева ЮС. Когнитивная ремедиация при шизофрении. Психосоциальная и когнитивная терапия и реабилитация психически больных. Практическое руководство. Под ред. И.Я. Гуровича, А.Б. Шмуклера. М.: Медпрактика-М; 2015:249-270.Zaytseva YS. Kognitivnaya remediatsiya pri shizofrenii. Psikhosotsial'naya i kognitivnaya terapiya i reabilitatsiya psikhicheski boL'nykh. Prakticheskoye rukovodstvo. Pod red. I.Ya. Gurovicha, A.B. Shmuk-Lera. M.: Medpraktika-M; 2015: 249-270. (In Russ.).Nakagami E, Xie B, Hoe M, Brekke JS. Intrinsic motivation, neurocognition and psychosocial functioning in schizophrenia: testing mediator and moderator effects. Schizophrenia Research. 2008;105(1-3):95-104. DOI: 10.1016/j.schres.2008.06.015.Nakagami E, Xie B, Hoe M, Brekke JS. Intrinsic motivation, neurocognition and psychosocial functioning in schizophrenia: testing mediator and moderator effects. Schizophrenia Research. 2008;105(1-3):95-104. DOI: 10.1016/j.schres.2008.06.015.Medalia A, Revheim N, Casey M. The remediation of problem-solving skills in schizophrenia. Schizophr. Bull. 2001;27:259-267. DOI: https://doi.org/10.1093/oxfordjournals.schbul.a006872.Medalia A, Revheim N, Casey M. The remediation of problem-solving skills in schizophrenia. Schizophr. Bull. 2001;27:259-267. DOI: https://doi.org/10.1093/oxfordjournals.schbul.a006872.Moritz S, Woodward TS. Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention. Current Opinion in Psychiatry. 2007;20:619-625. DOI: https://doi.org/10.1097/YCO.0b013e3282f0b8ed.Moritz S, Woodward TS. Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention. Current Opinion in Psychiatry. 2007;20:619-625. DOI: https://doi.org/10.1097/YCO.0b013e3282f0b8ed.Папсуев ОО, Мовина ЛГ, Миняйчева МВ. Метакогнитивный тренинг для больных шизофренией и расстройствами шизофренического спектра. Социальная и клиническая психиатрия. 2014; 24(3):33-36.Papsuyev OO, Movina LG, Minyaycheva MV. Metacognitive training for patients with schizophrenia and schizophrenic spectrum disorders. Social and Clinical Psychiatry. 2014;24(3):33-36. (In Russ.).McGurk SR, Twamley EW, Sitzer DI, et al. A MetaAnalysis of Cognitive Remediation in Schizophrenia. American Journal of Psychiatry. 2007;164(12):1791-1802. DOI: https://dx.doi.org/10.1176%2Fappi.ajp.2007.07060906.McGurk SR, Twamley EW, Sitzer DI, et al. A MetaAnalysis of Cognitive Remediation in Schizophrenia. American Journal of Psychiatry. 2007;164(12):1791-1802. DOI: https://dx.doi.org/10.1176%2Fappi.ajp.2007.07060906.Hofer A, Baumgartner S, Bodner T, et al. Patient outcomes in schizophrenia II: The impact of cognition. Eur. Psychiatry. 2005;20:395-402. DOI: https://doi.org/10.1016/j.eurpsy.2005.02.006.Hofer A, Baumgartner S, Bodner T, et al. Patient outcomes in schizophrenia II: The impact of cognition. Eur. Psychiatry. 2005;20:395-402. DOI: https://doi.org/10.1016/j.eurpsy.2005.02.006.Pilling S, Bebbington P, Kuipers E, et al. Psychological treatments in schizophrenia: II. Meta-analyses of randomized controlled trials of social skills training and cognitive remediation. Psychological Med. 2002;32:783.Pilling S, Bebbington P, Kuipers E, et al. Psychological treatments in schizophrenia: II. Meta-analyses of randomized controlled trials of social skills training and cognitive remediation. Psychological Med. 2002;32:783.Холмогорова АБ, Гаранян НГ, Долныкова АА, Шмуклер АБ. Программа тренинга когнитивных и социальных навыков (ТКСН) у больных шизофренией. Психосоциальная и когнитивная реабилитация психически больных: Практическое руководство под ред. И.Я. Гуровича, А.Б. Шмуклера. М.: Мед-практика-М; 2015:225-249.Kholmogorova АB, Garanyan NG, Dolnykova АА, Shmukler АB. Programma treninga kognitivnykh i sotsial'nykh navykov (TKSN) u bol'nykh shizofreniej. Psikhosotsial'naya i kognitivnaya reabilitatsiya psikhicheski bol'nykh: Prakticheskoe rukovodstvo pod red. I.Ya. Gurovicha, АА Shmuklera. M.: Med-praktika-M; 2015:225-249. (In Russ.).Zanello A, Merlo M. Le programme de rehabilitation cognitive et comportamentale IPT (Integrated Psychological Treatment) dans un contexte psychiatrique ambulatoir. Sante Mentale au Quebec. 2004;29:175-200. DOI: https://doi.org/10.7202/010836ar.Zanello A, Merlo M. Le programme de rehabilitation cognitive et comportamentale IPT (Integrated Psychological Treatment) dans un contexte psychiatrique ambulatoir. Sante Mentale au Quebec. 2004;29:175-200. DOI: https://doi.org/10.7202/010836ar.Torres A, Mendez LP, Merino H, Moran EA. Improving social functioning in schizophrenia by playing the Train Game. Psychiatric Services. 2002;53:799-801. DOI: https://doi.org/10.1176/appi.ps.53.7.799.Torres A, Mendez LP, Merino H, Moran EA. Improving social functioning in schizophrenia by playing the Train Game. Psychiatric Services. 2002;53:799-801. DOI: https://doi.org/10.1176/appi.ps.53.7.799.Kurtz MM, Richardson CL. Social cognitive training for schizophrenia: a meta-analytic investigation of controlled research. Schizophr. Bull. 2012;38(5):1092-1104. DOI: 10.1093/schbul/sbr036.Kurtz MM, Richardson CL. Social cognitive training for schizophrenia: a meta-analytic investigation of controlled research. Schizophr. Bull. 2012;38(5):1092-1104. DOI: 10.1093/schbul/sbr036.Гурович ИЯ, Семенова НД. Психосоциальные подходы в практике лечения и реабилитации шизофрении: современные тенденции. Социальная и клиническая психиатрия. 2007;4:78-85.Gurovich IYa, Semenova ND. Psychosocial approaches in the practice of treatment and rehabilitation of schizophrenia: current trends. Social and clinical psychiatry. 2007;4:78-85. (In Russ.).Pekkala E, Merinder L. Psychoeducation for schizophrenia. The Cochrane Database of Systematic Reviews. 2004:4. DOI: https://doi.org/10.1002/14651858.CD002831.Pekkala E, Merinder L. Psychoeducation for schizophrenia. The Cochrane Database of Systematic Reviews. 2004:4. DOI: https://doi.org/10.1002/14651858.CD002831.Miller WR, Rollnik S. Motivational interviewing: preparing people to change. NewYork: GuilfordPress. 3rd ed.2013:471. DOI: http://dx.doi.org/10.4236/jep.2014.5402.Miller WR, Rollnik S. Motivational interviewing: preparing people to change. NewYork: GuilfordPress. 3rd ed.2013:471. DOI: http://dx.doi.org/10.4236/jep.2014.5402.Medalia A, Brekke J. In Search of a Theoretical Structure for Understanding Motivation in Schizophrenia. Schizophr. Bull. 2010;36(5):912-918. DOI: https://doi.org/10.1093/schbul/sbq073.Medalia A, Brekke J. In Search of a Theoretical Structure for Understanding Motivation in Schizophrenia. Schizophr. Bull. 2010;36(5):912-918. DOI: https://doi.org/10.1093/schbul/sbq073.Семенова НД, Гурович ИЯ. Модуль формирования мотивации к реабилитации больных шизофренией и расстройствами шизофренического спектра. Социальная и клиническая психиатрия. 2014;24(4):31-36.Semenova ND, Gurovich IYa. A module of motivational enhancement for rehabilitation in schizophrenia and schizophrenic spectrum disorders patients. Social and clinical psychiatry. Sotsial'naya i klinicheskaya psikhiatriya. 2014;24(4):31-36. (In Russ.).Kemp R, Hayward G, Everitt B, et al. Compliance therapy in psychotic patients: randomised controlled trial. BMJ. 1996;312(7027):345-349. DOI: https://dx.doi.org/10.1136%2Fbmj.312.7027.345.Kemp R, Hayward G, Everitt B, et al. Compliance therapy in psychotic patients: randomised controlled trial. BMJ. 1996;312(7027):345-349. DOI: https://dx.doi.org/10.1136%2Fbmj.312.7027.345.Ястребова ВВ, Солохина ТА, Митихин ВГ и др. Приверженность лечению больных шизофренией и разработка мер по её повышению. Психотерапия и психосоциальная работа в психиатрии. Выпуск III. Под ред. О.В. Лиманкина, С.М. Бабина. СПб.: Изд-во «Таро», 2016: 334-341.Yastrebova VV, Solokhina TA, Mitikhin VG i dr. Priverzhennost' lecheniyu bol'nykh shizofreniyey i razrabotka mer po yeye povysheniyu. Psikhoterapiya i psikhosotsial'naya rabota v psikhiatrii. Vypusk III. Pod red. O.V. Limankina, S.M. Babina. SPb.: Izd-vo «Taro», 2016:334-341. (In Russ.).Fallon IRH, Boyd JL, McGill CW, et al. Family management in the prevention of exacerbation of schizophrenia: a controlled study. New England Journal of Medicine. 1982;306:1437-1440.Fallon IRH, Boyd JL, McGill CW, et al. Family management in the prevention of exacerbation of schizophrenia: a controlled study. New England Journal of Medicine. 1982;306:1437-1440.Glynn M, Cohen N, Dixon L, Niv N. The Potential Impact of the Recovery Movement on Family Interventions for Schizophrenia: Opportunities and Obstacles. Schizophr. Bull. 2006;32(3):451-463. DOI: https://dx.doi.org/10.1093%2Fschbul%2Fsbj066.Glynn M, Cohen N, Dixon L, Niv N. The Potential Impact of the Recovery Movement on Family Interventions for Schizophrenia: Opportunities and Obstacles. Schizophr. Bull. 2006;32(3):451-463. DOI: https://dx.doi.org/10.1093%2Fschbul%2Fsbj066.Dyck DG, Short RA, Hendryx MS, et al. Management of negative symptoms among patients with schizophrenia attending multiple-family groups. Psychiatric Servises. 2000;51:513-519. DOI: https://doi.org/10.1176/appi.ps.51.4.513.Dyck DG, Short RA, Hendryx MS, et al. Management of negative symptoms among patients with schizophrenia attending multiple-family groups. Psychiatric Servises. 2000;51:513-519. DOI: https://doi.org/10.1176/appi.ps.51.4.513.Бугорский АВ. Психиатрическое просвещение родственников пациентов, страдающих шизофренией и расстройствами шизофренического спектра. Психотерапия и психосоциальная работа в психиатрии. Выпуск IV. Под ред. О.В. Лиман-кина, С.М. Бабина. СПб.: Изд-во «Таро»; 2017:340.Bugorskij AV. Psihiatricheskoe prosveshchenie rodstvennikov pacientov,stradayushchih shizofreniej i rasstrojstvami shizofrenicheskogo spektra. Psihoterapiya i psihosocial'naya rabota v psihiatrii. Vypusk IV. Pod red. O.V. Limankina, S.M. Babina. SPb.: Izd-vo «Taro»; 2017:340. (In Russ.).Wallace Ch. Community and Interpersonal fuhction-ing in the Course of Schizophrenic Disorders. Schizophr. Bull. 1984;10(2):233-253.Wallace Ch. Community and Interpersonal fuhction-ing in the Course of Schizophrenic Disorders. Schizophr. Bull. 1984;10(2):233-253.Рихарц Б, Дворжак М. Милиотерапия (терапия средой) в психиатрии, психотерапии и реабилитации. Пер. с англ. Б. Рихарц, М. Дворжак. Оренбург. 2003:3-5.Rikharts B, Dvorzhak M. Milioter-apiya (terapiya sredoy) v psikhiatrii, psikhoterapii i reabilitatsii. Per. s angl. B. Rikharts, M. Dvorzhak. Orenburg. 2003:3-5. (In Russ.).Smith TE, Hull JW, MacKain SJ, Wallace CJ. Training hospitalized patients with schizophrenia in community reintegration skills. Psychiatric Services. 1996;47:1099-1103.Smith TE, Hull JW, MacKain SJ, Wallace CJ. Training hospitalized patients with schizophrenia in community reintegration skills. Psychiatric Services. 1996;47:1099-1103.Berhe T, Puschner B, Kilian R, Becker T. «Home treatment» fur psychische Erkrankungen. Der Nervenarzt. 2005;76:822-831. DOI: http://dx.doi.org/10.1007/s00115-004-1865-6.Berhe T, Puschner B, Kilian R, Becker T. «Home treatment» fur psychische Erkrankungen. Der Nervenarzt. 2005;76:822-831. DOI: http://dx.doi.org/10.1007/s00115-004-1865-6.Копытин АИ. Арт-терапия психических расстройств. СПб.: Речь; 2011:368. [Kopytin AI. Art-terapiya psikhicheskikh rasstrojstv. SPb.: Rech'; 2011:368. (In Russ.)].Kopytin AI. Art-terapiya psikhicheskikh rasstrojstv. SPb.: Rech'; 2011:368. (In Russ.).Бирюкова ИВ, Киселёва МВ, Солохина ТА. Танцевально-двигательная терапия при шизофрении: технология работы в открытых группах в условиях сообщества: Учебно-методическое пособие. М.: МАКС Пресс. 2016: 44.Biryukova IV, Kiselyova MV, Solokhina TA. Tantseval'no-dvigatel'naya terapiya pri shizofrenii: tekhnologiya raboty v otkrytykh gruppakh v usloviyakh soobshhestva: Uchebnometodicheskoe posobie. M.: MAKS Press. 2016:44. (In Russ.).Gold C, Heddal TO, Dahle T, Wigram T. Music therapy for schizophrenia-like illnesses. The Cochrane Database of Systematic Reviews. 2005;2. DOI: https://doi.org/10.1002/14651858.Gold C, Heddal TO, Dahle T, Wigram T. Music therapy for schizophrenia-like illnesses. The Cochrane Database of Systematic Reviews. 2005;2. DOI: https://doi.org/10.1002/14651858.Liberman RP, Glynn SM, Blair K, Ross D. In Vivo Amplified Skills Training: Promoting Generalization of Independent Living Skills for Clients with Schizophrenia. Psychiatry Interpersonal Biological Processes. 2002;65(2):137-55. DOI: http://dx.doi.org/10.1521/psyc.65.2.137.19931.Liberman RP, Glynn SM, Blair K, Ross D. In Vivo Amplified Skills Training: Promoting Generalization of Independent Living Skills for Clients with Schizophrenia. Psychiatry Interpersonal Biological Processes. 2002;65(2):137-55. DOI: http://dx.doi.org/10.1521/psyc.65.2.137.19931.Kopelowicz A, Wallace CJ, Zarate R. Teaching psychiatric patients to re-enter the community: A brief method of improving continuity of care. Psychiatric Services. 1998;49:1313-1316.Kopelowicz A, Wallace CJ, Zarate R. Teaching psychiatric patients to re-enter the community: A brief method of improving continuity of care. Psychiatric Services. 1998;49:1313-1316.Савельева ОВ, Петрова НН. Критерии оценки эффективности реабилитации больных параноидной шизофренией в амбулаторной практике. Практическая медицина. 2014;2(78): 83-87.Savel'ye-va OV, Petrova NN. Kriterii otsenki effektivnosti reabilitatsii bol'nykh paranoidnoy shizofreniyey v ambulatornoy praktike. Prakticheskaya meditsina. 2014;2(78):83-87. (In Russ.).Knapp M, Patel A, Curran C, et al. Supported employment: costeffectiveness across six European sites. World Psychiatry. 2013;12:60-68. DOI: https://doi.org/10.1002/wps.20017.Knapp M, Patel A, Curran C, et al. Supported employment: costeffectiveness across six European sites. World Psychiatry. 2013;12:60-68. DOI: https://doi.org/10.1002/wps.20017.Папсуев OO, Мовина ЛГ, Семенова НД и др. Комплексный подход к социально-когнитивным вмешательствам при работе с больными шизофренией. Социальная и клиническая психиатрия. 2015;25(1):36-44.Papsuev OO, Movina LG, Semenova ND i dr. Complex approach to social cognitive interventions in patients with schizophrenia. Social and clinical psychiatry. 2015;25(1):36-44. (In Russ.).Ястребова ВВ, Солохина ТА. Клинико-социальные и психологические аспекты реабилитационной работы в общественной организации: оценка эффективности. Психиатрия. 2018;79(03):52-61. DOI: https://doi.org/10.30629/2618-6667-2018-79-51-60.Yastrebova VV, Solokhina ТA. Clinical, social and psychological aspects of rehabilitation work in public organization: evaluation of effectiveness. Psychiatry. 2018;79(03):51-60. DOI: https://doi.org/10.30629/2618-6667-2018-79-51-60. (In Russ.).Мовина ЛГ, Папсуев OO, Голланд ЭВ и др. О работе отделения внебольничной психосоциальной реабилитации. Социальная и клиническая психиатрия. 2012;22(3):94-98.Movina LG, Papsouev OO, Gol-land EV i dr. On the work of outpatient psychosocial rehabilitation centre. Social and clinical psychiatry. 2012;22(3):94-98. (In Russ.).

The authors declare that there are no conflicts of interest present.