A Self-Management Program for Adults With Both Schizophrenia and a Co-occurring Medical Condition

Schizophrenia is a life-long brain disorder affecting approximately 1 percent of Americans
each year. Schizophrenia can be extremely disabling, causing people to hear voices,
experience paranoia or hallucinations, and believe that others are controlling their
thoughts. People with schizophrenia also experience increased rates of concurrent medical
conditions, such as diabetes, respiratory illness, and heart disease. This can make holding
a job or even caring for oneself very difficult. The purpose of this study is to develop and
evaluate a self-management program for adults living with both schizophrenia and a
concurrent medical condition.

Participants in this open-label study will attend 10 to 16 group sessions led by two group
leaders. Group sessions will meet each week for an hour during which participants will learn
new skills to help them take responsibility for the daily management of chronic medical
conditions. In addition to learning how to communicate more effectively with medical
providers, participants will learn about healthy eating, the importance of physical
activity, addictive behaviors that can worsen health conditions, and proper use of
medications. Homework will be assigned weekly for participants to review skills learned in
each session. After each session, participants will complete a survey to evaluate the
session's effectiveness. At the end of the study, participants will attend one additional
group meeting and an individual interview to discuss the overall effectiveness of the
intervention and their experiences in the group sessions. The results of this study will be
used to evaluate and improve the self-management program for future use.

Inclusion Criteria:

- Meets DSM-IV criteria for schizophrenia or schizoaffective disorder

- Current documented chart diagnosis of at least one chronic medical condition

- Received clinic services for a minimum of 3 months prior to study entry

- English-speaking

- Willing to use an effective form of birth control throughout the study if sexually
active

Exclusion Criteria:

- History of a serious neurological disorder or head trauma with loss of consciousness

- Diagnosed with mental retardation or dementia

- Diagnosed with end stage organ disease

- Currently receiving chemotherapy and/or radiation treatment for cancer

- Received psychiatric hospitalization less than 3 months prior to study entry date

- Blind and/or deaf

- Pregnant

- Infected with HIV with a CD4 count under 350

- Diagnosis of AIDS

- Diagnosis of anorexia

- Problematic substance use, as defined by a mental health provider

- Psychiatric instability, as defined by a mental health provider