- Email: [email protected]
399 – Humanistic and economic outcomes associated with negative symptoms in patients with schizophrenia
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ABSTRACTS / Schizophrenia Research 98 (2008) 3–199
Background: Insight in schizophrenia has been known to be a significant factor in positive treatment outcome. This study examined the relationship between the objective measures of insight, cognitive function, and quality of life in chronic schizophrenia. Methods: A sample of 72 patients (23 males, 49 females) of chronic schizophrenia(39.3 ± 10.7 years) were assessed. The symptom assessments included the 8-item shortened version of the Positive and Negative Syndrome Scale (PANSS) and 18-item Brief Psychiatric Rating Scale (BPRS). The objective measures of Quality of Life Scale (K-QOL) and Sheehan Disability Scale (SDS) were included to examine the functional aspects of daily life. For insight, the abridged version of the Scale to Assess Unawareness of Mental Disorder (SUMD) was used. The Executive Interview was administered to measure the executive function. Results: The correlation analysis revealed lack of insight by the abridged SUMD to be significantly related to the positive, negative and general psychopathology subscales of the PANSS (r = .51, .37, .57, respectively, p b .01) and anxiety–depression, thinking disturbance, withdrawal–retardation, hostile–suspiciousness, and tension–excitement subscales of the BPRS (r = .43, .79, .55, .61, .41, respectively, p b .001). Lack of insight also significantly correlated with poorer quality of life by the K-QOL(r = − .408, p b .001) and more specifically, social consequences, medication, blunted affect, anhedonia, and asociality items(r = − .41, − .33, − .40, − .46, − .31, respectively, p b .01) were significantly related. Furthermore, SUMD was also significantly correlated with the number of completely disabled days (r = −.25, p b .05) and ineffective functioning days(r = − .24, p b .05). Conclusions: Better insight was found to be related to less severe psychopathological symptoms, better quality of life and less days of disability in chronic schizophrenia. Our results can be interpreted as suggesting that social and emotional aspects of daily functioning may be more directly related to the quality of life than cognitive functioning in chronic schizophrenia patients. doi:10.1016/j.schres.2007.12.464
included forty inpatients and one hundred and sixteen outpatients on treatment for schizophrenia. Psychiatric diagnosis was confirmed using the MINI-DSM IV. Patients' symptoms were identified and categorized using the PANSS and the extent of felt stigma was evaluated using the Internalized Stigma of Mental illness (ISMI) scale. Associations were sought between high levels of Felt stigma and patients demographic and illness characteristics. Results: High levels of Felt stigma occurred in 34.6% of all respondents, 42.5% of inpatients and 31.9% outpatients had high levels of felt stigma though this difference was not statistically significant (p = 0.224). High levels of felt stigma were significantly associated with a bad relationship with sibling, more severe symptoms (particularly positive), negative and general psychopathology symptoms in these patients. Difficulty in abstract thinking and Disorientation were symptoms which predicted high levels of Felt stigma after multiple logistic regression. Conclusions: High levels of felt stigma were present in a substantial portion of the study population. These were associated with patient characteristics. This could inform the development of local stigma assessment measures and interventions aimed at enabling persons with schizophrenia cope with felt Stigma. doi:10.1016/j.schres.2007.12.465
399 – HUMANISTIC AND ECONOMIC OUTCOMES ASSOCIATED WITH NEGATIVE SYMPTOMS IN PATIENTS WITH SCHIZOPHRENIA D. Velligan 1, L. Kleinman 2, S. Mannix 3, O. Leeuwenkamp 4, D.A. Revicki 3. 2
United BioSource Corporation, Seattle, WA, USA United BioSource Corporation, Bethesda, MD, USA 4 NV Organon, Oss, The Netherlands 3
398 – FELT STIGMA AND ITS RELATIONSHIP TO SYMPTOM PRESENTATION IN PATIENTS WITH SCHIZOPHRENIA
Presenting Author details: [email protected] 7703 Floyd Curl Drive, 78229 San Antonio, United States, Tel.: +1 210 567 5508; fax: +1 210 567 1291.
B. Mutamba 1, T. Onen 1.
Background: Negative symptoms in patients with schizophrenia include diminished responsiveness, asociality, anhedonia, apathy, flat affect, and impoverished speech. Primary negative symptoms are an intrinsic and persistent clinical dimension of schizophrenia. Secondary negative symptoms are attributable to other causes, including drug adverse effects, such as extrapyramidal symptoms and may resolve with improved drug efficacy and tolerability. Our goal was to provide an overview of the impact of negative symptoms on humanistic and economic outcomes. Methods: We conducted a systematic literature review of 4 databases, including MEDLINE and EMBASE, to identify articles published between 1995 and 2005 that reported humanistic or economic outcomes associated with negative symptoms of schizophrenia. Results: After reviewing more than 600 abstracts, we retrieved 182 fulltext articles, of which 27 articles on humanistic outcomes and 4 on economic outcomes met our criteria for inclusion. Data from crosssectional studies supported a positive association between negative symptoms and poor health-related quality of life and functional status, although results from longitudinal studies were mixed. The few available
1
Butabika National Mental Referral Hospital, Kampala, Uganda
Presenting Author details: [email protected] PO BOX 7017, – Kampala, Uganda, Tel.: +256 41 504376; fax: +256 41 504760. Background: Stigma has been defined as a societal hallmark of shame or disgrace that sets a person apart from others and often leads to discrimination, prejudice, rejection and isolation in various sectors of society. Felt stigma is reported to be the most disruptive form of stigma for patients with mental illness. Schizophrenia is probably the most stigmatized of all mental disorders. Though stigma of mental illness is considered to be very high in Uganda, there is no documentation of its prevalence and how it impacts on the lives of the mentally ill, especially those with schizophrenia. Methods: One hundred and fifty-six patients with schizophrenia were studied in a cross sectional descriptive study. Study participants
ABSTRACTS / Schizophrenia Research 98 (2008) 3–199 data on economic outcomes specifically related to negative symptoms suggest higher direct and indirect costs in patients with negative symptoms. Conclusions: Negative symptoms of schizophrenia are associated with poor humanistic outcomes and may also be associated with increased direct and indirect costs. These findings suggest that
199
adequate treatment of negative symptoms could improve quality of life and patient functioning and might decrease the overall costs of schizophrenia. doi:10.1016/j.schres.2007.12.466
ABSTRACTS / Schizophrenia Research 98 (2008) 3–199
Background: Insight in schizophrenia has been known to be a significant factor in positive treatment outcome. This study examined the relationship between the objective measures of insight, cognitive function, and quality of life in chronic schizophrenia. Methods: A sample of 72 patients (23 males, 49 females) of chronic schizophrenia(39.3 ± 10.7 years) were assessed. The symptom assessments included the 8-item shortened version of the Positive and Negative Syndrome Scale (PANSS) and 18-item Brief Psychiatric Rating Scale (BPRS). The objective measures of Quality of Life Scale (K-QOL) and Sheehan Disability Scale (SDS) were included to examine the functional aspects of daily life. For insight, the abridged version of the Scale to Assess Unawareness of Mental Disorder (SUMD) was used. The Executive Interview was administered to measure the executive function. Results: The correlation analysis revealed lack of insight by the abridged SUMD to be significantly related to the positive, negative and general psychopathology subscales of the PANSS (r = .51, .37, .57, respectively, p b .01) and anxiety–depression, thinking disturbance, withdrawal–retardation, hostile–suspiciousness, and tension–excitement subscales of the BPRS (r = .43, .79, .55, .61, .41, respectively, p b .001). Lack of insight also significantly correlated with poorer quality of life by the K-QOL(r = − .408, p b .001) and more specifically, social consequences, medication, blunted affect, anhedonia, and asociality items(r = − .41, − .33, − .40, − .46, − .31, respectively, p b .01) were significantly related. Furthermore, SUMD was also significantly correlated with the number of completely disabled days (r = −.25, p b .05) and ineffective functioning days(r = − .24, p b .05). Conclusions: Better insight was found to be related to less severe psychopathological symptoms, better quality of life and less days of disability in chronic schizophrenia. Our results can be interpreted as suggesting that social and emotional aspects of daily functioning may be more directly related to the quality of life than cognitive functioning in chronic schizophrenia patients. doi:10.1016/j.schres.2007.12.464
included forty inpatients and one hundred and sixteen outpatients on treatment for schizophrenia. Psychiatric diagnosis was confirmed using the MINI-DSM IV. Patients' symptoms were identified and categorized using the PANSS and the extent of felt stigma was evaluated using the Internalized Stigma of Mental illness (ISMI) scale. Associations were sought between high levels of Felt stigma and patients demographic and illness characteristics. Results: High levels of Felt stigma occurred in 34.6% of all respondents, 42.5% of inpatients and 31.9% outpatients had high levels of felt stigma though this difference was not statistically significant (p = 0.224). High levels of felt stigma were significantly associated with a bad relationship with sibling, more severe symptoms (particularly positive), negative and general psychopathology symptoms in these patients. Difficulty in abstract thinking and Disorientation were symptoms which predicted high levels of Felt stigma after multiple logistic regression. Conclusions: High levels of felt stigma were present in a substantial portion of the study population. These were associated with patient characteristics. This could inform the development of local stigma assessment measures and interventions aimed at enabling persons with schizophrenia cope with felt Stigma. doi:10.1016/j.schres.2007.12.465
399 – HUMANISTIC AND ECONOMIC OUTCOMES ASSOCIATED WITH NEGATIVE SYMPTOMS IN PATIENTS WITH SCHIZOPHRENIA D. Velligan 1, L. Kleinman 2, S. Mannix 3, O. Leeuwenkamp 4, D.A. Revicki 3. 2
United BioSource Corporation, Seattle, WA, USA United BioSource Corporation, Bethesda, MD, USA 4 NV Organon, Oss, The Netherlands 3
398 – FELT STIGMA AND ITS RELATIONSHIP TO SYMPTOM PRESENTATION IN PATIENTS WITH SCHIZOPHRENIA
Presenting Author details: [email protected] 7703 Floyd Curl Drive, 78229 San Antonio, United States, Tel.: +1 210 567 5508; fax: +1 210 567 1291.
B. Mutamba 1, T. Onen 1.
Background: Negative symptoms in patients with schizophrenia include diminished responsiveness, asociality, anhedonia, apathy, flat affect, and impoverished speech. Primary negative symptoms are an intrinsic and persistent clinical dimension of schizophrenia. Secondary negative symptoms are attributable to other causes, including drug adverse effects, such as extrapyramidal symptoms and may resolve with improved drug efficacy and tolerability. Our goal was to provide an overview of the impact of negative symptoms on humanistic and economic outcomes. Methods: We conducted a systematic literature review of 4 databases, including MEDLINE and EMBASE, to identify articles published between 1995 and 2005 that reported humanistic or economic outcomes associated with negative symptoms of schizophrenia. Results: After reviewing more than 600 abstracts, we retrieved 182 fulltext articles, of which 27 articles on humanistic outcomes and 4 on economic outcomes met our criteria for inclusion. Data from crosssectional studies supported a positive association between negative symptoms and poor health-related quality of life and functional status, although results from longitudinal studies were mixed. The few available
1
Butabika National Mental Referral Hospital, Kampala, Uganda
Presenting Author details: [email protected] PO BOX 7017, – Kampala, Uganda, Tel.: +256 41 504376; fax: +256 41 504760. Background: Stigma has been defined as a societal hallmark of shame or disgrace that sets a person apart from others and often leads to discrimination, prejudice, rejection and isolation in various sectors of society. Felt stigma is reported to be the most disruptive form of stigma for patients with mental illness. Schizophrenia is probably the most stigmatized of all mental disorders. Though stigma of mental illness is considered to be very high in Uganda, there is no documentation of its prevalence and how it impacts on the lives of the mentally ill, especially those with schizophrenia. Methods: One hundred and fifty-six patients with schizophrenia were studied in a cross sectional descriptive study. Study participants
ABSTRACTS / Schizophrenia Research 98 (2008) 3–199 data on economic outcomes specifically related to negative symptoms suggest higher direct and indirect costs in patients with negative symptoms. Conclusions: Negative symptoms of schizophrenia are associated with poor humanistic outcomes and may also be associated with increased direct and indirect costs. These findings suggest that
199
adequate treatment of negative symptoms could improve quality of life and patient functioning and might decrease the overall costs of schizophrenia. doi:10.1016/j.schres.2007.12.466