ABSTRACT
This paper describes the development and the validation of a questionnaire assessing the opinions of the relatives of patients with schizophrenia on the causes and the social consequences of the disorder. The final version of the questionnaire includes 28 items, grouped in four sub-scales (social restrictions, social distance, utility of treatments, biopsychosocial causes of schizophrenia), whose intra-rater reliability ranges from 0.36 to 0.84. Cronbach's alpha coefficient, which tests the content validity of the sub-scales, ranges from 0.56 to 0.66. Factor analysis identifies two factors (opinions on social consequences and the utility of treatments, and the beliefs on the causes of schizophrenia), which account for the 73% of the total variance. This questionnaire may be particularly useful to assess relatives'beliefs about schizophrenia and to target psychosocial interventions in the families of patients with schizophrenia.
Subject(s)
Attitude to Health , Family Health , Schizophrenia , Social Adjustment , Surveys and Questionnaires , Adaptation, Psychological , Cost of Illness , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
OBJECTIVE: Description of burden, attitudes and received professional support in a sample of relatives of patients with schizophrenia recruited in 8 Italian Mental Health Services (MHS), stratified by geographic areas and population density. DESIGN: Cross-sectional study on key-relatives of clinically stable patients with a DSM-IV diagnosis of schizophrenia. Evaluation of: a) relationships of family burden with patient's clinical characteristics, family's socio-demographic variables, relative's attitudes toward the patient, professional and social support received by the family; b) differences in the levels of burden, attitudes and support received by the family with respect to geographical area and population density. SETTING: 8 Italian MHS stratified by geographic areas (Northern, Central, Southern Italy) and population density (urban vs. rural areas). MAIN OUTCOME MEASURES: Patient's clinical status and social functioning: BPRS and ADC. Family burden, attitudes and support received by the family: FPQ. RESULTS: Data on 144 patients and their key-relatives were collected. Higher levels of burden were found among relatives referring to Southern MHS. The burden was found positively correlated with the levels of patients' BPRS positive and manic/hostility symptoms and disability, and with the number of daily hours spent by the relative in contact with the patient, and negatively correlated with the levels of professional support received by the family. CONCLUSIONS: The results of this study highlight the need to provide rehabilitative programmes for patients with schizophrenia as well as informative and psychoeducational interventions for their families.
Subject(s)
Cost of Illness , Family Health , Family Therapy , Schizophrenia/therapy , Adolescent , Adult , Aged , Brief Psychiatric Rating Scale , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Schizophrenia/diagnosis , Surveys and QuestionnairesABSTRACT
The authors describe the evolution of mental health services put in place in Trieste over the last 25 years. They identify the principles that have led to institutional transformation and to the replacement of the traditional psychiatric hospital with a complete organization of services across the Trieste territory. By defining the spirit presiding over these transformations, the authors describe the variety of services offered. Finally, while the Trieste experience is linked to social and historical conditions favoring its emergence, the authors draw general principles in order to guide and transform the practice of community psychiatry.
