Factors Affecting the Empowerment Experienced by Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: To identify various factors that might affect the empowerment of outpatients with schizophrenia. METHODS: Of patients who had been receiving outpatient treatments at the department of psychiatry in Dong-A university hospital, 116 patients with a DSM-IV-TR diagnosis of stable schizophrenia were enrolled in this study. The empowerment, psychiatric symptoms, social functions, insight, family attitude, social support and self-esteem were assessed through an interview or self-report measures. Overall, multiple regression analyses were performed in consideration of 11 factors (age, sex, level of education, age of onset, frequency of hospitalization, symptoms, social functions, insight, family attitude, social support, self-esteem) as explanatory variables for the empowerment. RESULTS: Multiple regression analyses using a backward elimination revealed that the following four factors were found to be significant explanatory variables for the empowerment: age of onset, social functions, family attitude and self-esteem. A coefficient of determination for these four explanatory variables was 0.65. CONCLUSION: In conclusion, the results showed that four factors, such as age of onset, social functions, family attitude and self-esteem, were found to be significant explanatory variables for the empowerment of outpatients with schizophrenia. Since these four variables accounted for 65% of total empowerment, however, further studies in a larger group of patients are warranted to identify other potential factors for the empowerment.

Factors Affecting a Stigma That is Experienced by Outpatients with Schizophrenia / 신경정신의학

OBJECTIVES: To identify various factors that might affect stigmas affecting outpatients with schizophrenia, and to further clarify the effects of both factors affected by the treatment and other factors on stigmas in a clinical setting. METHODS: Of patients who had been receiving outpatient treatments at the Donga University Hospital Department of Psychiatry and those who had been attending the community mental health center and community psychiatric rehabilitation center, 178 patients with a DSM-IV diagnosis of schizophrenia with stable symptoms were enrolled in this study. In these patients, through an interview or self-reporting, we assessed stigmas (the Korean version of Mental Health Consumers' Experience of Stigmas), psychiatric symptoms (the Korean version of the Positive and Negative Syndrome Scale), social functions (the Korean version of the Social Functioning Scale), insight (the Self-Appraisal of Illness Questionnaire), empowerment (a Consumer-Constructed Empowerment Scale), and self-esteem (Rosenberg Self-Esteem Scale). In more detail, we performed an ANOVA in consideration of 11 factors (age, gender, the level of education, economic status, the duration of disease, the frequency of hospitalization, symptoms, insight, self-esteem, empowerment, and social functions) as explanatory variables for stigmas. RESULTS: On a multiple regression analysis using backward elimination, the following five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia : the disease of duration, self-esteem, insight, age, and gender. The coefficient of determination for these five explanatory variables was 0.44. CONCLUSION: In conclusion, our results showed that five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia. These five factors were the duration of the disease, self-esteem, insight, age, and gender. Because these five variables accounted for only 44% of total stigmas, however, further studies in a larger group of patients are warranted to identify other factors that might affect stigmas.

A comparsion study on the social functions promotion of different medicine treatment strategies on the patients with treatment-resistant depression / 中华行为医学与脑科学杂志

Objective To evaluate the effectiveness of different medicine treatment strategies on the social functions promotion on the patients with treatment-resistant depression (TRD). Methods 375 Patients with TRD were randomly grouped into 8 groups, and each group was received 8 weeks different treatment for paroxetine,venlafaxine, mirtazapine, paroxetine plus risperidone, paroxetine plus sodium valproate, paroxetine plus buspirone, paroxetine plus trazodone,or paroxetine plus thyroxine, respectively. The efficacy and social functions were evaluated with HAMD-17, SDSS and SF-36. Results There were significant difference in SDSS scores between 8th week and the baseline( P＜0.01 ) , and for social functions factor scores of SF-36 there was significant difference between 4th ,8th week and the baseline in each groups( P＜0.01 ). There were significant difference in social functions factor scores of SF-36 and subtracting scores between 4th and 8th week in all groups except group paroxetine and group venlafaxine(P ＜ 0.05 or P ＜ 0.01 ). There were significant difference in SDSS subtracting scores at 8th week among 8 groups( paroxetine plus risperidone group 7.05 ± 6.39, mirtazapine group 6.53 ± 4.75, paroxetine plusthyroxine group 5.14 ± 4.94, paroxetine group 5.13 ± 4.94 ,paroxetine plus trazodone group 5.00 ± 4.94, paroxetine plus sodium valproate group 4.60 ± 4.09, venlafaxine group 4.57 ± 4.18, paroxetine plus buspirone group 4.24 ± 4.95 ) ( Z = 2.076, P ＜ 0.05 ), between group paroxetine plus risperidone and group venlafaxine , group paroxetine plus sodium valproate, group paroxetine plus buspirone,as group mirtazapine and group paroxetine plus buspirone(P＜ 0.05 ), respectively. The influencing factors on improving social functions are the severity, improvement of depressive symptoms and latest onset time. Conclusions These 8 treatment strategies all can promote social functions on the patients with TRD. But the intensity and chronological order of improvement werent the same among 8 groups. The influencing factors on improving social functions are the severity, improvement of depressive symptoms and latest onset time.

Study on the social functions and roles of public hospitals / 中华医院管理杂志

This paper analyzed the social functions and roles played by public hospitals. Whatever the health system looks like National Health Services or Social Health Insurance, the functions of the public hospitals in society can be summarized as the following: Firstly, they are the providers of medical services with equal access by the residents. Secondly, they are the important components of the medical security system. Thirdly, they are the positive influencing forces in the medical market. Fourthly, they are the security forces for the nation and society. Fifthly, they are the incubator for training of human resources for health and lastly, they are also the developer of medical sciences. Hence, the existence and well-functioning of public hospitals are very crucial to meet the goal of universal coverage for basic health demands of the whole population.