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[Problems of patients with schizophrenic disorders and of their families]
D Lanzara1, U Cosentino, A M Lo Maglio
1Unità Operativa di Psichiatria, Azienda Ospedaliera di Vimercate, Milano.
Objective:
To evaluate psychopathological symptoms, disabilities and family burden in schizophrenic patients and to analyse predictors of family burden and relatives' satisfaction.
Design:
Descriptive study of 203 patients with an ICD 10--F2 diagnosis (schizophrenia and related disorders) in contact with the Desio Department of Mental Health on 31st December 1994.
Setting:
The Desio Department of Mental Health.
Main Outcome Measures:
The patients have been evaluated in three areas: disability (by ADC-DAS), psychiatric symptoms (by 24 items BPRS) and family burden (by Family Problems questionnaire). The outpatient, hospital and residential care contacts of the patients have been collected for six months by our service information system. For each area (DAS, BPRS and FP) a principal component analysis and a rotation of the significant components have been performed. Eleven factors, derived from three scales, have been retained as explanatory variables. Finally, a multiple regression analysis has been performed to assess the influence of explanatory variables on the set of response variables regarding family burden and relatives' satisfaction.
Results:
One third of patients suffer of moderate-severe positive symptoms, while negative symptoms are less frequent. Manic symptoms are rare while depressive ones more frequent. Disability, related to work and sexual problems, is frequent; social withdrawn, underactivity, lack of participation in household duties and lack of self care are less frequent. Family burden is severe in one third of relatives, mainly in social relationships. Disability is the main predictor of family burden; manic and positive symptoms, time spent by the carer with the patient and carer's social support are less important. Satisfaction with services is predicted by family burden.
Conclusions:
To be more responsive to the needs of patients and relatives we should increase activities in rehabilitation and family support areas. Further analysis of severity of psychosocial and psychiatric problems, based on an epidemiological based sample, could give interesting results on the case-mix of different services.