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VADO approach efficacy in psychiatric rehabilitation: a controlled study

  • Michela Vittorielli (a1), Rosaria Pioli (a1), Luisa Brambilla (a1), Luigina Archiati (a1), Giuseppe Rossi (a1), Charlotte Sleijpen (a1), Lorenza Magliano (a2), Franco Veltro (a3), Pierluigi Morosini (a4) and Gruppo Di Lavoro (a5)...


Aims – Assessment of the efficacy of the rehabilitation approach that is recommended by the manual VADO (AAOS in English: Abilities Assessment and Objectives Setting) in schizophrenic syndromes. Methods – Controlled trial, partly with individual randomisation. Centres were invited to recruit 10 patients who in most centres were randomly allocated either to the VADO approach or to usual rehabilitation practice. At least two professionals for each centre attended a brief intensive training course. Patients were assessed at baseline and six months later with a) the FPS scale, which is an improvement on the DSMIV SOFAS; b) the BPRS 4.0; c) AR, a clinical tool that is contained in VADO. Results – 55 patients received the experimental interventions and 40 the control one. Six months later greater significant improvements were observed in the experimental group, both in social functioning and in psychopathology. Conclusions – The dissemination of structured rehabilitation approaches that are based on personalized definition of objective, intensive progress monitoring, patient's therapeutic education and validated strategies and do not imply additional costs, may be warranted. A longer follow–up is under way.

Declaration of Interest: this work was partly funded by the National Mental Health Project (PNSM) of the Istituto Superiore della Sanita.


Corresponding author

Address for correspondence: Dr.ssa M. Vittorielli, IRCCS Centro S. Giovanni di Dio, FBF-Brescia, Via Piastroni 4, 25125 Brescia. Fax: +39-030-353.3513 E-mail:


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American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorder (4th ed.). American Psychiatric Association: Washington DC.
Amaddeo, F., Bacigalupi, M., de Girolamo, G., Di Munzio, W., Lora, A. & Semisa, D. (1998). Attività, interventi e strutture del Dipartimento di Salute Mentale. Epidemiologia e Psichiatria Sociale, Suppl. al n. 2, 936
Anthony, W.A., Cohen, M. & Farkas, M. (1990). Psychiatric Rehabilitaion. Centre for Psychiatric Rehabilitation, Boston University: Boston.
Bradshaw, W. (2000). Integrating cognitive-behavioural psychotherapy for person with schizophrenia into a psychiatric rehabilitation program: Results of a three year trial. Community Mental Health Journal 36(5), 491500.
Brambilla, L., Archiati, L., David, A., Rossi, G., Tura, G.B. & Pioli, R. (2000). Introduction of a structured method for the planning and the evaluation of rehabilitative programmes: the experience of the VADO. In Abstracts of the VII World Congress, World Association for Psychosocial Rehabilitation, Paris, p. 192.
Buchkremer, G., Klingberg, S., Holle, R., Schulze-Monking, H. & Hornung, W.P. (1997). Psychoeducational psychotherapy for schizphrenic patients and their key relatives or care-givers: result of e two years follow-up. Acta Psychiatrica Scandinavica 96, 483491.
Bustillo, J., Laurtiello, J., Horan, W. & Keith, S. (2001). The psychosocial treatment of schizophrenia: an update. American Journal of Psychiatry 158(2), 163175.
Carpiniello, B. & Carta, M.G. (2002). La disabilità nella schizofrenia: fattori intrinseci e predizione dell'esito psicosociale. Epidemiologia e Psichiatria Sociale 11, 4558.
de Girolamo, G. & Cozza, M. (2000). The Italian Psychiatric Reform: a 20 years perspective. International Journal of Law and Psychiatry 23 (3-4), 197214.
de Girolamo, G. & Piccardi, A. (2000). Progetto Nazionale PROGRESS sulle Strutture Psichiatriche. Progetto Nazionale Salute Mentale, Laboratorio di Epidemiologia e Biostatistica, Istituto di Superiore di Sanità, Rapporti ISTISAN: Roma.
De Salvia, D. & Barbato, A. (1993). Recent trends in mental health service in Italy: an analysis of national and local data. Canadian Journal Psychiatry 38 (3), 185202.
Drake, R.E., Goldman, H.H., Leff, H.S., Lehaman, A.F., Dixon, L., Mueser, K.T. & Torrey, W.C. (2001). Implementing evidence-based practices in routine mental health service setting. Psychiatric Services 52 (2), 179182
Eckman, T.A., Wirshing, W.C., Marder, S.R., Liberman, R.P., Johnston-Cronk, K., Zimmermann, K. & Mintz, J. (1992). Technique for training schizophrenic patient in illness self-management: a controlled trial. American Journal of Psychiatry 149(11), 15491555.
Falloon, I. (1994). Intervento Psicoeducativo Integrato in Psichiatria: Guida al Lavoro con le Famiglie, 2. ed. rivista ed ampliata. Erickson: Trento.
Fowler, D., Garety, P. & Kuipers, E. (1995). Cognitive Behaviour Therapy for Psychosis: Theory and Pratice. Wiley: Chichester (Trad. It.: Terapia cognitivo comportamentale delle psicosi, 1998, Masson: Milano).
Lauriello, J., Bustillo, J. & Keith, S.J. (1999). A critical review of research on psychosocial treatment of schizophrenia. Biological Psychiatry 46 (10), 14091417.
Lukoff, D., Nuechterlein, K.H. & Ventura, J. (1986). Manual for expanded Brief Psychiatric Scale. Schizophrenia Bulletin 12, 594602.
Magliano, L., Malangone, C., Guameri, M., Marasco, C., Fiorillo, A. & May, M. (2001). The condition of families with schizophrenia in Italy: burden, social network, and professional support. Epidemiologia e Psichiatria Sociale 10(2), 96106.
Marshall, M., Crowther, R., Almaraz-Serrano, A., Creed, F., Sledge, W., Kluiter, H., Roberts, C., Hill, E., Weirsma, D., Bond, G.R., Huxley, P. & Tyrer, P. (2001). Systematic reviews of the effectiveness of day care for people with severe mental disorders: (1) acute day hospital versus admission; (2) vocational rehabilitation; (3) day hospital versus outpatient care. Health Technology Assessment 5(21), 175.
Morosini, P. (1995). La valutazione degli esiti nell'attività di routine dei servizi psichiatrici. Epidemiologia e Psichiatria Sociale 4 (1), 110.
Morosini, P., Magliano, L. & Brambilla, L. (1998). VADO Valutazione di Abilità e Definizione di Obiettivi. Erickson: Trento.
Morosini, P., Magliano, L., Brambilla, L. & Ugolini, S. (2000). Development, rehability and acceptability of a new version of the DSM IV Social and Occupational Functionig Assesment Scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica 101, 323329.
Mueser, K.T., Salyers, M.P. & Mueser, P.R. (2001). A prospective analysis of work in schizophrenia. Schizophrenic Bulletin 27 (2), 281296.
Roeder, V., Brenner, H.D., Müller, D., Lächler, M., Zorn, P., Reisch, T., Bösch, J., Bridler, R., Christen, C., Jaspen, E., Schmidl, F. & Schwemmer, V. (2002). Development of specific social skills training programmes for schizophrenia patients: result of a multicentre study. Acta Psychiatrica Scandinavica 105, 363371.
Roncone, R., Ventura, J., Impallomeni, M., Fallon, I.R., Morosini, P.L., Chiaravalle, E. & Casacchia, M. (1999). Reliability of an Italian standardized and expanded Brief Psychiatric Rating Scale (BPRS4.0) in raters with high vs. low clinical experience. Acta Psychiatrica Scandinavica 100, 229236.
Smith, E.T., Bellack, A.S. & Liberman, R.P. (1996). Social skill training for schizophrenia: review and future direction. Clinical Psychology Review 16, 599617.
Velligan, D.I., Bow-Thomas, C.C., Huntzinger, C., Ritch, J., Ledbetter, N., Prihoda, T.J. & Miller, A.L. (2000). Randomized controlled trial of the use of compensatory strategies to enhance adaptive functioning in outpatient with schizophrenia. American Journal of Psychiatry 157(8), 13171323.


VADO approach efficacy in psychiatric rehabilitation: a controlled study

  • Michela Vittorielli (a1), Rosaria Pioli (a1), Luisa Brambilla (a1), Luigina Archiati (a1), Giuseppe Rossi (a1), Charlotte Sleijpen (a1), Lorenza Magliano (a2), Franco Veltro (a3), Pierluigi Morosini (a4) and Gruppo Di Lavoro (a5)...


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