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SchizophreniaSTEMNCT01655368

Group Intervention for Improving Stigma Coping and Empowerment of People With Mental Illness (STEM)

A study testing psychotherapeutic STEM modules in people with Schizophrenia and Depression, run by Wolfgang Gaebel, Professor at 20 sites in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This multi-center, 2-arm interventional study within different mental health care settings (psychiatry: in-patient, day-unit and out-patient, as well as psychiatric rehabilitation) evaluates a psychotherapeutic group intervention to improve stigma coping and empowerment using a psychotherapeutic module embedded in a… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Schizophrenia, Depression
What is being tested?
psychotherapeutic STEM modules
Could I receive a placebo?
No, everyone receives an active treatment
How many people
486 participants
Where
20 sitesGermany
Study dates
May 2012to Jun 2015
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 - 65 years
  • ICD-10 diagnosis of F2, F31.3-31.5, F32-34, F34.2, F43.2
  • patients who would participate in a psychoeducational group therapy in their regular treatment
  • written informed consent of the patient willing to participate
  • capacity of giving consent (as diagnosed by the investigator)

Who cannot join

  • insufficient knowledge of german language (reading, understanding and speaking not sufficient, as judged by the investigator)
  • acute psychotic or dissociative condition

Trial locations and contacts

20 sites in 1 country.

20 sites in 1 country

Germany20 sites
  • Klinik für Psychiatrie und Psychotherapie der RWTH

    Aachen, 52074

  • Facharztpraxis Dr. Mönter

    Berlin, 10589

  • Facharztpraxis Gereke

    Berlin, 10589

  • Facharztpraxis Alicia Navarro Urena

    Berlin, 12203

  • MediClin Bliestal Kliniken, Fachklinik für psychosomatische Medizin

    Blieskastel, 66440

  • Mittelrhein-Klinik Bad Salzig der DRV

    Boppard-Bad Salzig, 56154

  • Klinik für Psychiatrie und Psychotherapie, Universität zu Köln

    Cologne, 50937

  • Facharztpraxis, Dr. Frosch

    Düsseldorf, 40211

  • Facharztpraxis Dr. Kuhlbusch

    Düsseldorf, 40227

  • LVR-Klinikum Düsseldorf - Kliniken der Heinrich-Heine Universität

    Düsseldorf, 40629

  • Klinik für Psychiatrie und Psychotherapie, Uniklinik Göttingen

    Göttingen, 37075

  • Klinik für Psychiatrie und Psychotherapie, UKE

    Hamburg, 20246

  • Oberhavel Kliniken Hennigsdorf

    Hennigsdorf, 16761

  • Berolina Klinik

    Löhne, 32584

  • Klinik für Psychiatrie und Psychotherapie der Uniklinik Marburg

    Marburg, 35039

  • Klinik für Psychiatrie und Psychotherapie, LMU

    Munich, 80336

  • Reha-Zentrum Seehof der DRV

    Teltow, 14513

  • Psychiatrisch-psychotherapeutisches Rehabilitationszentrum grund.stein

    Tübingen, 72072

  • Klinik für Psychiatrie und Psychotherapie

    Tübingen, 72076

  • AHG Klinik Waren

    Waren, 17192

Other trials in Germany

About this study

This multi-center, 2-arm interventional study within different mental health care settings (psychiatry: in-patient, day-unit and out-patient, as well as psychiatric rehabilitation) evaluates a psychotherapeutic group intervention to improve stigma coping and empowerment using a psychotherapeutic module embedded in a psychoeducational group therapy.

Read the detailed description

People with mental illness suffer both from the burden of disease itself and from the social stigma related to mental illness, hence impeding their treatment (Sartorius et al. 2005, Link et al. 1999). Negative attitudes towards and discriminating behavior against people with mental illness negatively affect health care utilization, the course of disease, compliance, self-esteem, and social functioning (Sirey et al. 2001, Link et al. 2001, Perlick et al. 2001). Internalizing negative social stereotypes (self-stigmatization; Ritsher et al. 2003, Watson et al. 2007) impairs the quality of life and leads to social withdrawal (Rüesch 2005). Furthermore, self stigma is associated with lower empowerment (Ritsher et al. 2004), a poorer social network (Lysaker et al. 2007), lower compliance (Fung et al. 2008) and a higher extent of symptoms (Corrigan et al. 2006). The stigma of mental illness leads to an impaired pursuance of individual life goals, as job-related ambitions or living in a relationship (Rüesch 2005).

Current approaches targeting the stigma of mental illness primarily focus on education about mental illness in different target groups (e.g. Gaebel et al. 2003, 2004) and can be successful, if appropriately implemented (Gaebel et al. 2008). Yet there is a lack of RCT-tested psychotherapeutic approaches which directly address patients with mental illness improving their skills of coping with stigma and discrimination. Therefore it is intended to develop, manualise, and to evaluate such a psychotherapeutic group intervention within a randomized clinical control group design.

In this context, group-based cognitive-behavioral psychotherapy has been proved as efficient therapeutic approach for patients with depression (cf. McDermut et al. 2006) and with schizophrenia (cf. Lawrence et al. 2006, Barrowclough et al. 2006) in different settings. Patients can serve each other as role models and will modify negative self-related cognitions, thus developing new cognitions supporting self-esteem (Corrigan et al. 2001). The following interventional effects should improve the patients' quality of life and also result in a reduction of frequency and length of inpatient stays and sickness-related absenteeism:

  • improved skills to cope with negative stigmatizing experiences,
  • a reduced burden through of self-stigmatizing cognitions,
  • a better utilization of resources for disease managing in coherence with reduced self-stigmatization, and
  • an improved coping with stigma-related conflicts at work.
Being tested
psychotherapeutic STEM modules, Interventional control of normal psychoeducational treatment
Medical subject headings
Schizophrenia, Depression

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • psychotherapeutic STEM modulesBehavioural

    psychoeducational and psychotherapeutical group intervention. 8 sessions of psychoeducation + 3 sessions + 1 booster session of STEM module for schizophrenia or depression)

  • Interventional control of normal psychoeducational treatmentBehavioural

    11 sessions + 1 booster session of psychoeducation (for schizophrenia or depression)

Study groups in NCT01655368
Study groupRoleWhat they receive
Interventional: STEM modulesExperimental8 sessions of psychoeducation + 3 sessions + 1 booster session of STEM module (for schizophrenia or depression)
Receives: Behavioral: psychotherapeutic STEM modules
Interventional ControlOther11 sessions + 1 booster session of psychoeducation for schizophrenia or depression)
Receives: Behavioral: Interventional control of normal psychoeducational treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. subjective quality of life

    subjective quality of life 12 months after intervention determined by WHOQOL-BREF total score.

    To impart coping-strategies in handling stigmatization and to develop empowerment by embedding a psychotherapeutic module in psychoeducational groups.

    Measured: 12 months after intervention

Secondary outcomes (3)
  1. self-stigma (ISMI)

    Measured: after 6 weeks, 6 months, 12 months

  2. empowerment (BUES)

    Measured: after 6 weeks, 6 months, 12 months

  3. health care utilization (CSSRI, EQ5-D, SF-36)

    Measured: after 6 weeks, 6 months, 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Aug 2012 (estimated)
  2. Study startMay 2012
  3. Primary completionJun 2015
  4. Study completionJun 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
486 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01655368
Sponsor's protocol ID
STEM
Acronym
STEM
Status last verified
Jun 2016
First submitted
14 Jun 2012
Last updated
15 Jun 2016
Results posted
No
Data monitoring committee
No

Publications

  • Barrowclough C, Haddock G, Lobban F, Jones S, Siddle R, Roberts C, Gregg L. Group cognitive-behavioural therapy for schizophrenia. Randomised controlled trial. Br J Psychiatry. 2006 Dec;189:527-32. doi: 10.1192/bjp.bp.106.021386.

    PubMed 17139037
  • Corrigan P, Lundin R. Don´t call me nuts: Coping with the stigma of mental illness. Recovery Press, Chicago 2001

  • Corrigan PW, Watson AC, Barr L (2006) The Self-Stigma of Mental Illness: Implications for Self-Esteem and Self-Efficacy. J Soc Clin Psychol 25: 875-884

  • Gaebel W, Baumann AE. Interventions to reduce the stigma associated with severe mental illness: experiences from the open the doors program in Germany. Can J Psychiatry. 2003 Nov;48(10):657-62. doi: 10.1177/070674370304801003.

    PubMed 14674047
  • Gaebel W, Zäske H, Baumann A (2004) Stigma erschwert Behandlung und Integration. Dtsch Ärztebl 101: A3253-3255

  • Gaebel W, Zaske H, Baumann AE, Klosterkotter J, Maier W, Decker P, Moller HJ. Evaluation of the German WPA "program against stigma and discrimination because of schizophrenia--Open the Doors": results from representative telephone surveys before and after three years of antistigma interventions. Schizophr Res. 2008 Jan;98(1-3):184-93. doi: 10.1016/j.schres.2007.09.013. Epub 2007 Oct 24.

    PubMed 17961985
  • Lawrence R, Bradshaw T, Mairs H. Group cognitive behavioural therapy for schizophrenia: a systematic review of the literature. J Psychiatr Ment Health Nurs. 2006 Dec;13(6):673-81. doi: 10.1111/j.1365-2850.2006.01014.x.

    PubMed 17087669
  • Link BG, Phelan JC. Labeling and stigma. In: The Handbook of the Sociology of Mental Health, Hrsg. CS Aneshensel, JC Phelan. Plenum, New York 1999

  • Link BG, Struening EL, Neese-Todd S, Asmussen S, Phelan JC. Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatr Serv. 2001 Dec;52(12):1621-6. doi: 10.1176/appi.ps.52.12.1621.

    PubMed 11726753
  • Lysaker PH, Roe D, Yanos PT. Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. Schizophr Bull. 2007 Jan;33(1):192-9. doi: 10.1093/schbul/sbl016. Epub 2006 Aug 7.

    PubMed 16894025
  • McDermut W, Miller IW, Brown RA (2006) The Efficacy of Group Psychotherapy for Depression: A Meta-analysis and Review of the Empirical Research. Clinical Psychol: Science and Practice 8: 98-116

  • Perlick DA, Rosenheck RA, Clarkin JF, Sirey JA, Salahi J, Struening EL, Link BG. Stigma as a barrier to recovery: Adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. Psychiatr Serv. 2001 Dec;52(12):1627-32. doi: 10.1176/appi.ps.52.12.1627.

    PubMed 11726754
  • Ritsher JB, Otilingam PG, Grajales M. Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res. 2003 Nov 1;121(1):31-49. doi: 10.1016/j.psychres.2003.08.008.

    PubMed 14572622
  • Ritsher JB, Phelan JC. Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Res. 2004 Dec 30;129(3):257-65. doi: 10.1016/j.psychres.2004.08.003.

    PubMed 15661319
  • Rusch N, Corrigan PW, Wassel A, Michaels P, Larson JE, Olschewski M, Wilkniss S, Batia K. Self-stigma, group identification, perceived legitimacy of discrimination and mental health service use. Br J Psychiatry. 2009 Dec;195(6):551-2. doi: 10.1192/bjp.bp.109.067157.

    PubMed 19949209

Questions about this trial

What is this clinical trial studying?

A study testing psychotherapeutic STEM modules in people with Schizophrenia and Depression, run by Wolfgang Gaebel, Professor at 20 sites in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Jun 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

subjective quality of life (time frame: 12 months after intervention). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01655368, which also lists 20 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jun 2016.

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