Search results for ‘Author:"priebe stefan"’ Sort:
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Social outcomes in schizophrenia
- Author:
- PRIEBE Stefan
- Journal article citation:
- British Journal of Psychiatry, 191(Supplement), August 2007, pp.s15-s20.
- Publisher:
- Cambridge University Press
Outcomes reflecting the social situation are widely considered as important in the treatment of people with schizophrenia. Concepts of social outcomes in schizophrenia lack agreed definitions and theoretical models. A fundamental issue is the distinction between objective and subjective indicators. More research has focused on subjective indicators, which are only weakly correlated with objective are only weakly correlated with objective life situation and show consistent correlations with mood. Various assessment instruments have been developed pragmatically, particularly to measure quality of life and social functioning, and the literature provides extensive data. Established instruments exist to measure social outcomes in schizophrenia. Their use requires an awareness of the specific strengths and limitations.
Sign of progress or confusion? a commentary on the European Commission Green Paper on mental health
- Author:
- PRIEBE Stefan
- Journal article citation:
- Psychiatric Bulletin, 30(8), August 2006, pp.281-282.
- Publisher:
- Royal College of Psychiatrists
The paper came out in October 2005 following the World Health Organization European Ministerial Conference on Mental Health in the same year. It has the noble intention ‘to launch a debate with the European institutions, governments, health professionals, stakeholders and other sectors... about the relevance of mental health for the EU [European Union], the need for a strategy at EU-level and its possible priorities’. It portrays ‘mental ill health’ as a growing problem in the EU with wide economic consequences, and suggests preventive action, social inclusion of people with mental illness and more data on mental health across the EU. In the paper, the Commission invited all potential stakeholders in mental healthcare in the EU to contribute to a consultation process, which ended in May 2006.
Psychiatry in the future: where is mental health care going? A European perspective
- Author:
- PRIEBE Stefan
- Journal article citation:
- Psychiatric Bulletin, 28(9), September 2004, pp.315-316.
- Publisher:
- Royal College of Psychiatrists
European nations - including Britain - have a common pattern in their history of mental health care. Most western and central European countries established large asylums in the 19th century and engaged in some form of de-institutionalisation during the second half of the 20th century. Since the 1950s, major mental health reforms have significantly improved the quality of care. Although time of onset, pace, fashion and outcomes of reforms varied greatly between countries, throughout western Europe community-based services have been established and become part of routine service provision. Predictions about the future of mental health care are not simply a speculative forecast. Professionals are not merely subject to future changes, they are also active players with influence in the wider societal context. There certainly is an opportunity to utilise their professional status and the (still) strong interest of large sections of the public in mental health issues to initiate a lively debate on the ethical principles and the function of mental health care in modern societies. More or less directly, such debate might help to influence values as well as to further visions and plans. User empowerment, in a wide sense of the word, should be seen as a welcome driver towards change, and professionals must be prepared to adopt new roles. The challenge is to take a proactive role in creating the shape of mental health care in the future.
Research into mental health supported accommodation – desperately needed but challenging to deliver
- Authors:
- KILLASPY Helen, PRIEBE Stefan
- Journal article citation:
- British Journal of Psychiatry, 218(4), 2021, pp.179-181.
- Publisher:
- Cambridge University Press
Around 100 000 people live in mental health supported accommodation in England, at considerable cost to the public purse, but there is little evidence to guide investment in the most effective models. We consider the various barriers to research in this field and offer suggestions on how to address them. (Edited publisher abstract)
Effectiveness of a volunteer befriending programme for patients with schizophrenia: randomised controlled trial
- Authors:
- PRIEBE Stefan, et al
- Journal article citation:
- British Journal of Psychiatry, 217(3), 2020, pp.477-483.
- Publisher:
- Cambridge University Press
Background: Befriending by volunteers has the potential to reduce the frequent social isolation of patients with schizophrenia and thus improve health outcomes. However, trial-based evidence for its effectiveness is limited. Aims: To conduct a randomised controlled trial of befriending for patients with schizophrenia or related disorders. Method: Patients were randomised to a befriending programme for 1 year or to receive information about social activities only (trial registration: ISRCTN14021839). Outcomes were assessed masked to allocation at the end of the programme; at 12 months and at a 6-month follow-up. The primary outcome was daily time spent in activities (using the Time Use Survey (TUS)) with intention-to-treat analysis. Results: A total of 124 patients were randomised (63 intervention, 61 active control) and 92 (74%) were followed up at 1 year. In the intervention group, 49 (78%) met a volunteer at least once and 31 (49%) had more than 12 meetings. At 1 year, mean TUS scores were more than three times higher in both groups with no significant difference between them (adjusted difference 8.9, 95% CI −40.7 to 58.5, P = 0.72). There were no significant differences in quality of life, symptoms or self-esteem. However, patients in the intervention group had significantly more social contacts than those in the control group at the end of the 12-month period. This difference held true at the follow-up 6 months later. Conclusions: Although no difference was found on the primary outcome, the findings suggest that befriending may have a lasting effect on increasing social contacts. It may be used more widely to reduce the social isolation of patients with schizophrenia. (Edited publisher abstract)
Resource-oriented therapeutic models in psychiatry: conceptual review
- Authors:
- PRIEBE Stefan, et al
- Journal article citation:
- British Journal of Psychiatry, 204(4), 2014, pp.256-261.
- Publisher:
- Cambridge University Press
For this conceptual review, a literature research was conducted to identify a range of resource-oriented therapeutic models in psychiatry, that is those that tap into individuals strengths and use their positive social and personal resources. The review focused on patients with severe mental illness and aimed to identify shared characteristics of the models and interventions. Key texts for each model were analysed using a narrative approach to synthesise the concepts and their characteristics. Ten models were included: befriending, client-centred therapy, creative music therapy, open dialogue, peer support workers, positive psychotherapy, self-help groups, solution-focused therapy, systemic family therapy and therapeutic communities. Six types of resources were utilised: social relationships, patients’ decision-making ability, experiential knowledge, patients’ individual strengths, recreational activities and self-actualising tendencies. Social relationships are a key resource in all the models, including relationships with professionals, peers, friends and family. Two relationship dimensions - reciprocity and expertise - differed across the models. The review suggests that a range of different therapeutic models in psychiatry address a persons personal and social resources rather than deficits. In various ways, they all utilise social relationships to induce therapeutic change. A better understanding of how social relationships affect mental health may inform the development and application of resource-oriented approaches. (Edited publisher abstract)
Measuring patient-reported outcomes in psychosis: conceptual and methodological review
- Authors:
- REININGHAUS Ulrich, PRIEBE Stefan
- Journal article citation:
- British Journal of Psychiatry, 201(4), October 2012, pp.262-267.
- Publisher:
- Cambridge University Press
The use of patient-reported outcomes (PROs) for patients with psychosis is being actively encouraged. Monitoring individual outcomes and service use can feed into patient-client communication, reflective practice, quality management and service development. However here is no universally accepted terminology and definition of such outcomes. This literature search examined the concepts and measures of four widely used PROs: treatment satisfaction, subjective quality of life, needs for care and the quality of the therapeutic relationship. Three key findings emerged. First, despite the increasing popularity of PROs with numerous concepts and measures, evidence of their methodological quality remains limited. Second, there is considerable conceptual, operational and empirical overlap across measures designed to assess different PROs, although some concepts and measures also include aspects specific to individual PROs. Finally, the influence of cognitive deficits and psychiatric symptoms appears limited and unlikely to be of clinical significance. The authors conclude that the popularity of PROs has not been matched by progress in their conceptualisation and measurement. Based on the current evidence, they recommend distinct and short measures with clinical relevance and good psychometric properties. It is suggested that future research should be aimed at optimising the validity and precision of PROs, while reducing the assessment burden.
Population-based indices for the funding of mental health care: a review and implications
- Authors:
- TULLOCH Simon, PRIEBE Stefan
- Journal article citation:
- Journal of Public Mental Health, 9(2), June 2010, pp.15-22.
- Publisher:
- Emerald
Population-based indices of needs have an influence on mental health care funding. Over the last 30 years, a number of needs indices have been developed that utilise sociodemographic and service utilisation data to calculate a proxy indicator of population-based need. This approach is used because indicators of socio-economic disadvantage expressed as weighted deprivation show a strong relationship with mental health morbidity. This paper reviews the existing population-based indices of mental health needs in the UK: the Underprivileged Areas score; the York Index; the Mental Illness Needs Index; the Psychiatric Needs Index; the Indices of Multiple Deprivation; and the Local Index of Needs. It illustrates the application of these indices using east London as an example, and considers the methodological and conceptual limitations of these indices. Although none of the current indices provide a definitive picture, commissioners and providers may find them to be a useful source of contextual information, which may be useful in combination. In England, this is particularly relevant in the light of the increased liberalisation of commissioning services and changes in the funding process.
Patients’ views of involuntary hospital admission after 1 and 3 months: prospective study in 11 European countries
- Authors:
- PRIEBE Stefan, et al
- Journal article citation:
- British Journal of Psychiatry, 196(3), March 2010, pp.179-185.
- Publisher:
- Cambridge University Press
The authors suggest that the debate on the most appropriate regulations and practice for involuntary hospital admissions is guided by little research. Legislation and practice varies considerably throughout Europe and although some studies have looked at patents’ retrospective views of the appropriateness of their treatment, the results varied according to the exact question and time since admission. This prospective study explored patients’ views in 11 European countries, 2326 consecutive involuntary patients admitted to psychiatric hospital departments were interviewed within 1 week of admission; 1809 were followed up one month and 1613 three months later. The primary outcome was patients’ views as to whether the admission was right but the study also looked for variation between countries and whether the results held true after controlling for differences in patient characteristics. Depending on the country, between 39 and 71% (mean 55%) felt the admission was right after one month, and between 46 and 86% (mean 63%) after three months. Females, those living alone and those with a diagnosis of schizophrenia had more negative views. Adjusting for confounding factors, some differences between countries were significant for example, patients’ views in England were significantly less favourable than those in seven of the countries studied. The authors suggest that differences in legislation and practice may be associated with differences in patients’ views but note that exact causal factors and mechanisms remain poorly understood.
Patients’ views and readmissions 1 year after involuntary hospitalisation
- Authors:
- PRIEBE Stefan, et al
- Journal article citation:
- British Journal of Psychiatry, 194(1), January 2009, pp.49-54.
- Publisher:
- Cambridge University Press
The aim was to assess involuntary readmissions and patients’ retrospective views of the justification of the admission as 1-year outcomes and to identify factors associated with these outcomes. Socio-demographic data and readmissions were collected for 1570 involuntarily admitted patients. Within the first week after admission 50% were interviewed, and of these 51% were re-interviewed after 1 year. At 1 year, 15% of patients had been readmitted involuntarily, and 40% considered their original admission justified. Lower initial treatment satisfaction, being on benefits, living with others and being of African and/or Caribbean origin were associated with higher involuntary readmission rates. Higher initial treatment satisfaction, poorer initial global functioning and living alone were linked with more positive retrospective views of the admission. Patients’ views of treatment within the first week are a relevant indicator for the long-term prognosis of involuntarily admitted patients.