[Strategies for coping in schizophrenia]

Few studies have documented how schizophrenic patients perceived their needs and which coping skills they have spontaneously developed. All 48 patients of the Louis-H. Lafontaine Young Adults Clinic, a specialised schizophrenia clinic in Montreal, were invited to complete the Task Motivation and Problem Appraisal in Long Term Psychiatric Patients questionnaire. Our study utilised a descriptive approach and a classification of patient's reported problems and their coping skills. A panel of researchers and clinical staff then regrouped patient's perceived problems into four categories: symptoms, coping strategies, organisation of daily activities and interpersonal contacts. The main coping strategies utilised by these young patients are confrontation (52%) emotion-centered coping (57%). Clinical applications can be drawn from paying attention to the reports of schizophrenic patients. For example, rehabilitation activities can be developed which cater to their perceived needs. Because of frontal lobe hypoactivity, which make cognitive appreciation more difficult, their coping strategies should be diversified. Patients suffering from negative symptoms of schizophrenia mainly attempt to modify emotional impact, until they have discovered a way of confronting deficit symptoms. Better motivation to therapeutic programmes would result from paying attention to their perspectives.