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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.
Patient-reported outcomes in schizophrenia
- Authors:
- McCABE Rosemarie, SAIDI Marya, PRIEBE Stefan
- Journal article citation:
- British Journal of Psychiatry, 191(Supplement), August 2007, pp.s21-s28.
- Publisher:
- Cambridge University Press
Patient-reported outcomes are increasingly used to evaluate the care of people with schizophrenia. Patient-reported outcomes in schizophrenia relate either to evaluation of illness and benefit from treatment or to resilience of the self. Of the former, needs for care, treatment satisfaction and the therapeutic relationship are most common. Less common are symptoms, insight, attitude towards medication, and clinical communication. Increasing expectations of treatment have led to new measures assessing resilience of the self, including empowerment, self-esteem, sense of coherence and recovery. Scores of different patient-related outcomes overlap and are influenced by a general tendency, largely influenced by mood, for more or less positive appraisal. The conceptual and empirical basis for different patient-reported outcomes varies, with most data available for treatment satisfaction. More than one such outcome should be used only if there is a specific hypothesis. For new patient-reported outcomes, relative independence from existing constructs should be demonstrated.
Assessing the stability of schizophrenia patients' explanatory models of illness over time
- Authors:
- McCABE Rosemarie, PRIEBE Stefan
- Journal article citation:
- Journal of Mental Health, 13(2), April 2004, pp.163-169.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
There is increasing interest in explanatory models of illness in mental health care and the possibility that they vary according to cultural background. However, little is known about their stability over time as a factor influencing long-term outcome. The aim was to assess the stability over time of explanatory models of illness among people with schizophrenia. A modified version of the Short Explanatory Model Interview was used to elicit explanatory models with 8 participants from four ethnic groups on two occasions. The interviews took place approximately 1 year apart. The concept and cause of illness along with treatment preferences tended to be inconsistent in all patients between the baseline and follow-up interview. On the other hand, perceived severity of illness and prognosis were more inclined to be consistent over time. The consistency in responses was partly a function of the question type. Open-ended questions were more likely to elicit less consistent responses than questions with implied choice responses. The lack of stability of explanatory models may be a feature of explanatory models or it may be a weakness of the method used. This instability may limit their usefulness in predicting long-term outcome. Future research is warranted to investigate whether a more valid method could identify a stable component of explanatory models over time, whether this is then related to outcome and, if so, in what ways.