OBJECTIVEThis study explored the views of 241 patients with schizophrenia about their own disorder.METHODSPatients' knowledge of their diagnosis, confidence that they will be well again, and ...perception of limitations in their own life as a result of the disorder were explored in relation to patients' opinions about the social consequences of schizophrenia. Study results were presented to participants, and suggestions were collected regarding how these study results should be used.RESULTSSeventy-two respondents (30%) reported that a psychiatrist told them that they have schizophrenia. Respondents who were confident that they would be well again had a lower duration of contact with psychiatric services and a less pronounced perception of affective and social difficulties related to schizophrenia. Respondents who did not feel limited in their life by the disorder reported less social distance and more optimism about the usefulness of treatments.CONCLUSIONSParticipatory studies may provide ideas for a more constructive interaction between patients and professionals.
This study compares the social network of a sample of 709 relatives of patients with schizophrenia, 646 relatives of patients with physical diseases, and 714 lay respondents, recruited in 30 randomly ...selected Italian areas, stratified for geographic location and population density. Each respondent was asked to fill in the Social Network Questionnaire. The social network was less extended and supportive in relatives of patients with schizophrenia than in those of patients with physical diseases and in the general population. Multivariate analyses revealed that social contacts were similarly reduced in relatives of patients with schizophrenia and physical diseases, while social support was significantly lower in relatives of patients with schizophrenia than in the other two groups. Social resources were higher in young respondents and in those living in rural areas. These results highlight the need to provide the families of those with long-term diseases with interventions aimed at increasing their social resources.
OBJECTIVE: This study explored the feasibility of providing psychoeducational interventions for persons with schizophrenia and their families. METHODS: The study was carried out in 23 Italian mental ...health centers. Two professionals from each center attended three monthly training sessions on psychoeducational interventions. After the training, each professional provided informative sessions on schizophrenia to five families of service users with schizophrenia, which consisted of three meetings with each family on clinical aspects of schizophrenia, drug treatments, and detection of early signs of relapse. Each professional then provided the intervention to families for six months. RESULTS: Thirty-eight of the 46 participants completed the training course, and 34 provided the intervention to 71 families. Twenty-nine of the 34 provided the entire intervention to the families and five of the 34 held only informative sessions on schizophrenia. Ninety-one percent of the participants who completed the study reported difficulties in integrating the intervention with their other work responsibilities, and 96 percent acknowledged the positive effect that the intervention had on the center's relationship with patients with schizophrenia and their families. CONCLUSIONS: These results support the idea that it is possible to introduce psychoeducational interventions in mental health services after a relatively brief period of training and supervision.
The belief that mental disorders involve a high risk of unpredictable behaviours is a factor which influences negatively the social acceptance of the mentally ill. In this paper, we compare the ...beliefs about the causes and psychosocial consequences of schizophrenia expressed by 536 respondents who had the firm conviction that patients with schizophrenia are unpredictable and by 457 respondents who firmly believed that they are not.
The survey was conducted in 30 Italian geographic areas, randomly selected taking into account their location and population density. The data were collected by the Questionnaire about Opinions on Mental Illness (QO).
Respondents who believed that patients with schizophrenia are unpredictable reported more frequently factors such as use of alcohol and drugs and frequenting bad company as being involved in the development of the disorder. In addition, this group showed more restrictive opinions about patients' civil and affective rights. Low education was found to be significantly associated with perception of "unpredictability" in schizophrenia.
These results suggest the need to: a). inform the general public on the main clinical characteristics of schizophrenia and on the risk of unpredictable behaviours in the acute phases of this mental disorder; b). carry out sensitisation campaigns against discrimination toward people with schizophrenia emphasising successful experiences of social integration.
The authors explored the social network of caregivers of patients with schizophrenia in relation to relatives' sociodemographic characteristics, patients' clinical variables, family burden, and ...pessimism about the consequences of the disease. They evaluated 709 key relatives of patients with schizophrenia concerning the above-mentioned variables by means of well-validated questionnaires. A more supportive social network was found in relatives who reported lower levels of burden and pessimism about schizophrenia. The effect of social network on relatives' burden and opinions about schizophrenia was significantly different in relation to relatives' gender. Strengthening the relatives' social network may represent a useful strategy to alleviate their burden and pessimism about schizophrenia.
This study explored patients' relatives' beliefs about schizophrenia in Italy, a country with a long history of community-based psychiatry. The study was conducted among 709 key relatives of patients ...with schizophrenia who were recruited in 30 mental health departments. Relatives seemed to believe that mental hospitals are not appropriate places in which to treat their loved ones, even though most of them felt that they were alone in coping with the burden of their ill relative's disease. Most of the relatives agreed that people who have schizophrenia should be allowed to vote, but they appeared to have a stricter attitude toward affective rights, such as the patient's right to get married and have children, and tended to perceive their loved ones as being subject to social discrimination. The findings of this study may be useful for developing psychoeducational intervention and sensitization campaigns for the general population.
Objective: This study explored the effectiveness of a psychoeducational family intervention for schizophrenia on patients' personal and social functioning as well as on relatives' burden and ...perceived support. Methods: Thirty-four mental health professionals from 17 public mental health centers in Italy selected 71 families of consumers with schizophrenia. Forty-two families were randomly assigned to a group that received the intervention for six months, and 29 families were assigned to a waiting list for six months. At baseline and six months later, validated tools were used to assess patients' clinical status, personal and social functioning, and social network as well as relatives' burden, social resources, and perception of professional support. Results: In the intervention group the number of patients with poor or very poor global personal and social functioning decreased significantly, from 17 (47 percent) at baseline to nine (25 percent) at follow-up. A significant improvement was found for the intervention group in patients' social relationships, interests in obtaining a job, maintenance of social interests, and management of social conflicts. Twenty-seven patients (74 percent) reported that their social relationships had improved during the six-month period. For both the intervention and control groups, family burden significantly improved. Relatives' social contacts and perception of professional support significantly increased only in the intervention group. Conclusions: The results suggest that a psychoeducational family intervention may have a significant impact on functional outcomes of schizophrenia when provided to patients and caregivers in real-world settings.PUBLICATION ABSTRACT
This study aims to: (a) describe the type and doses of psychotropic drugs received by outpatients with schizophrenia in Italy; (b) explore the relationship between prescription and patients' clinical ...conditions, disability and socio-demographic characteristics; and (c) estimate the percentage of patients receiving polypharmacy and antipsychotics within the official recommended ranges.
A total of 682 patients with schizophrenia were consecutively recruited in 30 Italian mental health departments, randomly selected taking into account the geographic location and population density of their catchment areas.
Of the sample, 98% were in treatment with neuroleptics, 47% received benzodiazepines, 25% were on anticholinergics, 10% were prescribed antidepressants and 8% were on mood stabilisers. Polypharmacy was found in 29% of the sample. Patients treated with one neuroleptic received this within therapeutic doses in 77% of cases. In patients who received two neuroleptics (24%), the former was prescribed within the official range in 71% of cases and the latter in 46%. Polytherapy was more frequently prescribed in patients treated with typicals (60% versus 34%) and in those who also received benzodiazepines (61% versus 41%) and anticholinergics (44% versus 16%). Patients in treatment with atypicals (45%) were mainly younger and lived in highly populated areas. Depot medications (25%) were more frequently prescribed to patients living in areas of low population density, who were older and who had a lower educational level, a longer duration of illness and milder anxiety/depression symptoms.
The consistent percentage of patients receiving polypharmacy and neuroleptics outside the therapeutic doses highlights the need to promote interventions aimed at increasing a rational use of psychotropic drugs among mental health professionals.
This study compares the social network of a sample of 709 relatives of patients with schizophrenia, 646 relatives of patients with physical diseases, & 714 lay respondents, recruited in 30 randomly ...selected Italian areas, stratified for geographic location & population density. Each respondent was asked to fill in the Social Network Questionnaire. The social network was less extended & supportive in relatives of patients with schizophrenia than in those of patients with physical diseases & in the general population. Multivariate analyses revealed that social contacts were similarly reduced in relatives of patients with schizophrenia & physical diseases, while social support was significantly lower in relatives of patients with schizophrenia than in the other two groups. Social resources were higher in young respondents & in those living in rural areas. These results highlight the need to provide the families of those with long-term diseases with interventions aimed at increasing their social resources. Tables, References. Copyright 2005 Elsevier Ltd.
Background: What patients’ relatives and health professionals think about causes, treatments and psychosocial consequences of schizophrenia can influence its detection and outcome.
Aims: To compare ...the beliefs about schizophrenia in 190 nurses, 110 psychiatrists and 709 relatives of patients with this mental disorder, recruited in 30 randomly selected mental health centres.
Methods: In each centre, the key-relatives of the first consecutive 25 subjects with schizophrenia, and the nurses and psychiatrists who had been working in the service for at least one year, were asked to complete the Questionnaire on the Opinions about Mental Illness (QO).
Results: The factors most frequently mentioned by psychiatrists and nurses among the causes of schizophrenia were heredity, stress and family conflicts, while those most frequently mentioned by relatives were stress, traumas and love breakdown. Nurses had opinions: (a) similar to those expressed by psychiatrists concerning patients’ ability to work equally as other people, and patients’ punishability in case of illegal acts; (b) similar to those expressed by relatives about patients’ unpredictability and political rights; (c) significantly different from the other two samples as concerns recognition of patients’ affective rights.
Conclusions: Family psychoeducational interventions and nurses’ training should address not only clinical aspects but also disability and psychosocial consequences of schizophrenia.
