Survival of patients with severe mental disorders: Influence of social functioning.

BACKGROUND: Patients with severe mental disorders have a high risk of premature death due to the interaction of various factors. Social functioning is a strategic functional factor in understanding the course of psychotic disorders. AIM: Analyze the relationship between social functioning and its various dimensions and survival during a 10-year follow-up. METHOD: The Social Functioning Scale (SFS) was administered to 163 close relatives of patients under treatment at a Community Mental Health Unit. Survival was described by Kaplan-Meier analysis and any differences in survival by level of social functioning were found by long-rank analysis. Finally, Cox regression was used to predict premature mortality. RESULTS: Significant differences in mortality were identified in the interpersonal behavior dimension of social functioning, while there were no significant gender or diagnostic differences in the rest of the dimensions. The interpersonal behavior dimension and age were found to be factors predicting premature death. CONCLUSION: These findings show the protective effect of social functioning retained by patients with psychotic disorders on their survival, and the need to apply evidence-based psychotherapy focused on recovery of social functioning in the early stages of the disorder.

Ten-year follow-up of social functioning and behaviour problems in people with schizophrenia and related disorders.

BACKGROUND: In recent years, several variables in the course of schizophrenia and related psychotic disorders have been studied. However, an instrumental analysis of the evolution of social functioning and behaviour problems has scarcely been explored. AIM: To analyse the evolution of social functioning and behaviour problems and find any diagnosis or gender differences. METHOD: The Social Functioning Scale (SFS) and the Behaviour Problems Inventory (BPI) were administered in Stages I (2003-2007) and II (2014-2017) to 100 close relatives of patients under treatment at a Community Mental Health Unit. A related samples t-test, analysis of variance and multivariate analysis of variance were performed to study the evolution and differences in social functioning and behaviour problems. Then a stepwise multiple linear regression analysis was done to predict the evolution of social functioning. RESULTS: No deterioration in the evolution of social functioning or behaviour problems was observed, and schizophrenia patient scores were lower. Women scored higher in withdrawal/social engagement, interpersonal behaviour, independence-performance, independence-competence and total social functioning, with no significant differences in behaviour problems. Previous social functioning, underactivity/social withdrawal and education are predictive factors in the evolution of social functioning. Conclusion: The results show the need for implementing psychosocial intervention programs that promote functional recovery and keep problems from becoming chronic.

Gender influence on severe mental disorders: relationship between behavior problems and family burden / Influencia del género en trastornos mentales graves: relación entre problemas de comportamiento y carga familiar

Gender differences in behavior problems and their relationship with family burden in severe mental disorders were analyzed. The Behavior Problems Inventory (BPI) and two items related to family burden (FB 1: "Do you feel able to endure the illness or disorder and the problems it causes?" and FB 2: "How often are you overwhelmed by these behavior/illness problems?") were administered to 235 key informants under treatment in a community mental health unit. The results show that men presented more behavior problems and family burden, with significant differences in impulse dyscontrol and severe behavior problems. A positive correlation was found between behavior problems and family burden, where the inactivity/social withdrawal dimension was the best predictor of family load for men and women. We conclude that men have more behavior problems and that the inactivity/social withdrawal dimension has the most explanatory power for family burden in both men and women. (AU)

Se analizan las diferencias de género en problemas de conducta y su relación con la carga familiar en trastornos mentales graves. El Inventario de Problemas de Conducta (BPI) y dos ítems relativos a la carga familiar ("¿Se siente usted capaz de sobrellevar la enfermedad o trastorno y los problemas que ocasiona?" y "¿Con qué frecuencia se ve usted desbordado/a por estos problemas de comportamiento/enfermedad?") se administraron a 235 informantes clave de pacientes en tratamiento en una unidad de Salud Mental Comunitaria. Los hombres presentaban mayores problemas de conducta y carga familiar, existiendo diferencias significativas en descontrol de impulsos y en problemas de comportamiento graves. Se halla una correlación positiva entre problemas de comportamiento y carga familiar, siendo la dimensión inactividad/aislamiento social la mejor predictora de carga familiar. Respecto a la carga familiar, es la dimensión inactividad/aislamiento social la que posee mayor capacidad explicativa en hombres y mujeres. (AU)