Short- and middle-term Changes in Symptomatology after visiting a group education to reduce cannabis abuse

Epidemiological studies show an increase of the prevalence rate of cannabis consumption for the last few years especially in teenagers. The same is true for those dually diagnosed with psychosis and cannabis abuse. The concept of dual diagnosis is well known since a few years, but still the etiology is not finally solved. At the same time, different treatments were developed for this group of patients, but no evaluations were done.The aim of this dissertation was to implement an adapted version of a formerly developed treatment in an inpatient setting a specialized unit for young schizophrenic patients in a psychiatric hospital - and assess the changes (short- and middleterm) of symptoms as well concerning the consumerism of drugs as the psychopathology. The treatment approach based on the basic training of Roberts, L.J., Shaner, A. & Eckman, T.A. (Overcoming addictions: Skills training for people with schizophrenia. New York: W.W. Norton & Company, 1999).For this purpose a randomized controlled treatment trial was done on a group of dually diagnosed schizophrenic patients with cannabis abuse. 31 patients received the cognitive-behavioral training (CBT), the control group (n = 27) attended a training to increase social comeptence.Both trainings span eight sessions of 45 minutes during four weeks. Cannabis consumption was measured through objective controls of urinstatus weekly. Psychopathology was assessed before and after completion of the training as well as six months later at follow-up. Motivational status, self-efficacy and craving were assessed weekly as well during the time of the training and at follow-up.The results included the fact that the training was easily installed in the integrated treatment schedule in the inpatient setting. There was evidence that significant improvement occurred following implementation of the behavioral-cognitive training. The psychopathology improved in both intervention groups even though the increase was higher in the CBT group. Same effects were found for the consumption of cannabis. Craving was strongly associated with continuing drug use. Motivational status changed during the training, where as the self-efficacy remained at a high level. Concerning these aspects no treatment-related differences were found. The strong relationship between the effect expectancy and drug use (well know for use of alcohol, nicotine) was confirmed for cannabis. The severity of symptoms had no impact on the results of the training.It was not obvious if the differences weredue to the general course of the convalescence or if the cognitive examination of the topic following the weekly assessment of drug use, craving, self-efficacy and motivation provoked the change. This should be examined in further studies as well as the benefit of subsequent outpatient assistance and medical care