PEARLS 115, October 2008 written by Brian R McAvoy
(first published in New Zealand Doctor, 3 December 2008)

Clinical question
How effective are life skills programmes for people with chronic mental health problems?

Bottom line
Currently there is no good evidence to suggest that compared with standard/ usual care or support groups, life skills programmes improve the well being of people with schizophrenia/schizoaffective disorder, or conversely that they are ineffective. Outcomes evaluated included study retention, life skills performance, symptom reduction, depression scores, quality of life scores and social performance skills.

Caveat
Only 4 studies were included in the review, involving just 318 participants. The studies lasted only 7 to 24 weeks, with most studies being too small to adequately detect potential benefits from life skills programmes.

Context
Most people with schizophrenia have a cyclical pattern of illness, characterised by remissions and relapses.This can reduce the ability of self-care and functioning, and can lead to the illness becoming chronic and disabling. Life skills programmes are designed to help during the rehabilitation process by enhancing patients' ability to live independently. The elements of such programmes include training in managing money, organising and running a home, domestic skills and personal self-care and related interpersonal skills.

Cochrane Systematic Review
Tungpunkom P and Nicol M. Life skill programmes for chronic mental illnesses. Cochrane Reviews 2008, Issue 2. Article No. CD000381. DOI: 10.1002/14651858. CD000381. pub2. This review contains 4 trials involving 318 participants.