Video as a Tool to Improve Insight in Schizophrenia
Condition: Schizophrenia; Schizoaffective Disorder
MeSH terms: Schizophrenia; Psychotic Disorders
Study type: Interventional

Summary: 
      The deficit of awareness of pathology (or insight) is a common symptom in patients with
      schizophrenia and has a negative impact on the prognosis of the disease. Current treatments
      aren't effective enough on this symptom (Pijnenbord et al., 2013).

      Previous studies have shown a positive impact of videos of patients themselves on insight but
      they lacked power. This technique needs more investigation. The study aims to improve the
      patient's awareness of pathology with a video of themselves recorded in the acute phase of
      their illness. Patients will watch this video after clinical stabilization. This is a
      randomized controlled and single blinded trial. A population of 60 patients (30 in each
      group) will be included. The impact on the insight, symptomatology, treatment adherence and
      functional remission will be evaluated.

      The video of patient is useful for a personalized clinical follow-up. Its use for therapeutic
      purposes would be innovative and could be extended to other applications in psychiatry,
      especially as this tool is readily available.
    

Detailed description: 
      In everyday practice in psychiatry, some interviews are filmed in order to follow the
      clinical course and for educational purposes. But the videos are not used as a therapeutic
      tool for patients. This research project focuses on the therapeutic potential of these videos
      and particularly on the awareness of patients of their disorder (insight). Patients
      hospitalized for decompensation of their schizophrenic pathology will be filmed during
      structured interviews. After clinical stabilization patients will be proposed to participate
      to this trial. A group of patients (G1) will watch the video recorded in the acute phase of
      their illness. A control group (G2) will have a usual care without video or specific therapy.
      48 hours after, the clinical impact et the evolution of insight of patients will be
      evaluated. Then follow-up visits will also be provided at one and four months with the same
      clinical evaluation, plus an evaluation of treatment adherence and functional remission. This
      study also includes qualitative interviews for group 1 after watching the video to explore
      the experience of patients in this situation of self-confrontation. The autobiographical
      memory will also be studied in this protocol. Tolerance of this experience will be assessed
      by a monitoring of emotions, specifically depressive affects and suicidal ideation. Adverse
      events will be reported and patients will always have the access to a psychiatrist if
      necessary.
    

Intervention name(s): Video self-observation; Non Self video observation
Intervention type(s): Other; Other
Intervention description(s): Patients will watch the video of them in acute decompensation phase then they will be asked about their emotions, their understanding and awareness of mental illness; Patients will not watch the video of them in acute decompensation phase.
Other intervention name(s): Group 1; Group 2
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: schizophrenia; awareness; insight; video; self-observation