Does employment promote the process of recovery from schizophrenia? A review of the existing evidence.

The aim of this review is to appraise current evidence on the association between employment and specific, non-vocational components that are indicators of recovery from schizophrenia, such as symptom remission, neurocognitive functioning, social cognitive functioning, and quality of life. Out of 754 studies identified in a comprehensive bibliographical data search, 43 were selected for abstract screening and 18 were included in the final review. The studies were categorized in terms of the type of employment investigated (supported employment, Individual Placement and Support, competitive employment). Studies on the Individual Placement and Support programs provide the strongest evidence for their effectiveness in terms of non-vocational outcomes. Quality of life, psychopathology and well being were the most frequently investigated outcomes and only 2 studies utilized a global concept of recovery as a measure. Employment was also associated with positive changes in domains that are not directly related to working, e.g., leisure activities. The current review reports promising, but not conclusive, results in the improvement of quality of life, social functioning and other indicators of recovery, but there is still a need for high quality, long term follow-up, randomized studies to further investigate this relationship.

[The role of a psychiatrist in treatment and recovery process of persons suffering from schizophrenia]. / Lekarz psychiatra w procesie leczenia i zdrowienia osób chorych na schizofrenie.

OBJECTIVES: Research results indicate that possibility of building a therapeutic relationship in schizophrenia treatment facilitates better functioning, more effective reduction in psychotic symptoms and fulfillment of patients' personal goals. The aim of the present study was to investigate whether patients systematically cooperating with psychiatrists are more scrupulous in complying with doctors' orders and whether their social and clinical functioning is more effective, while compared to noncompliant patients. METHODS: 300 patients suffering from schizophrenia were included in the study. Patients were divided into two groups: experimental group including patients systematically cooperating with their doctors, and control group including non-cooperative patients. Data was collected during single interview with the use of the Questionnaire of Pharmacological Treatment Assessment, Life Satisfaction Scale, Emotions Control Scale, Life Orientation Scale, General Self-Efficacy Scale, The positive and negative syndrome scale for schizophrenia and Socio-demographic Questionnaire. RESULTS: While compared to non-cooperative patients, patients systematically cooperating with their psychiatrists were more compliant with treatment, had wider knowledge about their treatment and were more satisfied with its effects. They also demonstrated better social functioning, more frequent professional activity and better assessment of their lives in terms of being in control, optimism and life satisfaction. CONCLUSIONS: Results indicate that systematic cooperation with a doctor facilitates better functioning of patients with schizophrenia.

[Sense of coherence and ways of coping in the relationship with brother or sister in healthy siblings of mentally ill persons]. / Poczucie koherencji i sposoby radzenia sobie ze stresem w relacji z bratem lub siostra u zdrowego rodzenstwa osób chorych psychicznie.

AIM: The aim of the present study was to investigate sense of coherence in healthy siblings of persons suffering from schizophrenia as well as their ways of coping in the relationship with ill brother or sister. METHODS: 40 healthy brothers and sisters of persons with ICD- 10 diagnosis of F20 to F29 participated in the present study. Orientation to Life Scale (SOC- 29) was used to assess sense of coherence and Ways of Coping with Stress questionnaire (SRSS) was used to examine stress coping strategies. RESULTS: Mean global score of siblings of persons with schizophrenia was 111 points. Subjects used coping strategies focused on problem significantly more often than those focused on emotions. CONCLUSIONS: Therapeutic work with healthy siblings should focus on strengthening sense of personal competence, development of personal resources and different ways of coping with stress, investigation of emotions that healthy siblings experience in the relationship with ill brother or sister as well as supporting the process of accepting changes in the relationship with the ill sibling.

[Significance of psychiatrists' personal variables in treatment of persons suffering from schizophrenia]. / Znaczenie zmiennych osobowych psychiatrów w leczeniu osób chorych na schizofrenie

AIM: The aim of the study is to investigate the significance of psychiatrists' personal variables in treatment and functioning of persons suffering from schizophrenia. METHODS: 150 patients with schizophrenia indicated by 30 psychiatrists were included in the study. Data was collected during single interview with the use of Dyadic Questionnaire of the Therapist-Patient Relationship, Questionnaire of Pharmacological Treatment Assessment, Life Satisfaction Scale, Emotion Control Scale, Life Orientation Test, Overall Self-Efficacy Scale, Social Functioning Scale and Sociodemographic Questionnaire. Stepwise regression was used to determine the psychiatrist's related variables which explain variables associated with a patient. RESULTS: Psychiatrists' personal variables explained up to 20% of variance in social functioning of the patients with schizophrenia. Variables describing psychiatrists were most significant in explaining assessment of psychiatrist's professionalism and rejection of a psychiatrist by a patient. The abilities to identify medication symptoms and adherence to pharmacotherapy were only slightly explained by patient - psychiatrist collaboration length. CONCLUSIONS: Results indicate that psychiatrists' personal characteristics are significant for the development of the relationship between persons with schizophrenia and their psychiatrists.

[Gender-related differences in social support program for mentally ill persons]. / "Gender differences" w programie wsparcia spolecznego dla osób chorujacych psychicznie.

AIM: The current study is a part of a research program on schizophrenia course in the system of community based assistance and support for mentally ill persons who do not use regular mental health system. The aim of this study was to investigate both the accessibility of the system for gender populations and its applicability in terms of addressing the needs of both males and females. METHOD: 105 subjects (46 males and 59 females) using home care services in three Warsaw districts were included in the study. The following domains of the functioning were assessed: the scope, content and efficiency of the social networks as well as social functioning of home care services users. RESULTS: Males and females differed significantly with regard to several attributes of social networks as well as social functioning. CONCLUSIONS: Comparing to males, females had greater opportunity to receive support from more distant categories of persons constituting their social networks. The differences in social functioning of males and females were limited only to stereotypical gender roles and were not noted in other areas of social functioning.

[Sociodemographic and clinical profile of patients with dual diagnosis living in Warsaw district Mokotow in comparison with participants in other European countries--results of the international, multicentre research project ISADORA]. / Profil spoleczno-demograficzny i kliniczny pacjentów z podwójna diagnoza mieszkajacych w warszawskiej dzielnicy mokotów na tle badanych w innych miastach europejskich--wyniki wieloosrodkowego, miedzynarodowego programu badawczego ISADORA.

AIM: The aim of the present study was to compare socio-demographic and clinical profile of the inpatients with dual diagnosis in Warsaw with the profile of inpatients treated in other European centres. METHOD: 50 patients consecutively admitted in Warsaw were included in the study; total number of patients recruited from 7 European centers was 352. Recruitment was conducted in general inpatient psychiatric departments and specialized dual diagnosis inpatient wards. Data was collected during single interview with the use of M.I.N.I and EuropAsi questionnaires. RESULTS: Both in Warsaw and overall study population males constituted almost 2/3 of the group. Patients in Warsaw were more frequently living with relatives or other close persons as well as remained in intimate relationships in comparison to patients from other study sites. Depression was the most common diagnosis in Warsaw and it was significantly more often found it this center than in Tampere. Moreover, patients in the Warsaw group were significantly less frequently diagnosed with cannabis use disorder and more frequently - with tranquillizers use disorder. CONCLUSIONS: The differences among sites regarding socio- demographic and clinical profiles of dual diagnosis patients were due to both socio-cultural factors (e.g. psychoactive substances accessibility) and the research methodology.

Psychosocial interventions in workplace mental health promotion: an overview.

A review based on the DataPrev final report concerning workplace mental health promotion is presented. Out of 4865 studies identified in a comprehensive bibliographical data search, 315 were selected for abstract screening and 79 were included in the final review. The studies were categorized in terms of their aims/expected outcomes and evaluated for quality on the grounds of their design and type of analysis. The most frequent aims were stress reduction and better coping, followed by increased job satisfaction and effectiveness, mental health enhancement and reduction in mental health-related absenteeism. In the 79 intervention studies, 99 outcome variables were measured using 163 instruments, mostly developed for the study purposes. Different intervention categories turned out to be used to attain the same aim, with skills training being the most popular (other approaches included improvement of occupational qualifications and working conditions, physical exercise, relaxation and multicomponent interventions). Among the few intervention programs that were implemented and evaluated in two or more studies, the Stress Inoculation Training (Cecil and Forman, in Effects of stress inoculation training and coworker support groups on teachers' stress. Journal of School Psychology, 28, 105, 1990) based on the model by Meichenbaum (Meichenbaum, in Stress Inoculation Training. Pergamon Press, New York, 1985) seemed to be the most promising. Its effectiveness, evidenced in a majority of the measures, was evaluated in studies using the randomized controlled design. This paper is illustrated by high-quality intervention studies. In high and moderate quality studies, positive effects were reported in about a half of the examined outcome variables. However, conclusive evidence of intervention programs effectiveness would require further research-repetition of studies using treatments equivalent to the experimental ones, and outcome evaluation taking into account other criteria, e.g. behavioural.

[The participation of patients with schizophrenia in psychoeducation--the analysis from the patients' perspective]. / Uczestnictwo w psychoedukacji osób chorych na schizofrenie--analiza zajec z perspektywy pacjentów.

AIM: The aim of this study was to find out what the patients opinion about psychoeducation in schizophrenia is. METHOD: We examined 169 patients suffering from schizophrenia. They answered a questionnaire about demographic data, their opinion about participation in sessions, the motivation to psychoeducation and the themes of sessions. RESULTS: . 84% of the patients declared that they like psychoeducation. The main reason for participation in psychoeducation was the willingness to get more information about the illness and prevent relapses. The most important therapist attributes are: high communication abilities and appropriate knowledge. CONCLUSIONS: The patients want to get more information about the illness and obtain more knowledge how to cope with symptoms in order to improve the quality of their life. It is important for the therapists to create an emotional atmosphere which helps to understand each other. During the psychoeducation sessions the therapist should use more various means to get the patients involved in participation.