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Abnormalities of psychomotor development schizophrenia: A rehabilitation perspective
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SCHIZOPHRENIA, SOCIAL CLASS AND FIRST ADMISSION TO STATE OR PRIVATE PSYCHIATRIC HOSPITALS Carles Muntaner*,
Paula Wolyniec,
Ann E. Pulver
Laboratory of Socio-environmental Studies, NIMH, Room BIA-12, Federal Building, 7550 Wisconsin Avenue. Bethesda, MD 20892, USA
The present study examines whether there is an association between the social class of patients with schizophrenia, bipolar disorder, or other Axis I “functional” psychoses, the first admission to public or private for-profit psychiatric hospitals. First admission male psychotic inpatients admitted to hospitals in the Bahimore MSA were identified in the Maryland Epidemiologic Sample (Pulver and Bale, 1989). Participants were administered a version of the DIS modified to improve its assessment of psychotic symptoms. For each participant, social class at time of admission were obtained through standard survey questions. After adjusting for age and type of psychotic disorder, we found that psychotic patients with low levels of skills/credentials or originating from low skill/credentials families were more likely to be admitted to state psychiatric hospitals than patients with bipolar disorder. Being schizophrenic and being from a lower social class further increased the odds of being admitted to a state psychiatric hospital. These findings emphasize the relevance of schizophrenia and social class as determinants of differences in psychiatric care utilization. Further research should address the effects of gender and ethnicity on psychiatric care utilization. Finally, the incentives which shape the selection of specific psychotic disorders into state or private psychiatric hospitals need to be determined.
HEALTH STATE PREFERENCES IN SCHIZOPHRENIA: COMPARING THE VALUES OF PATIENTS, FAMILIES AND CLINICIANS S. Nuttall, E.J. Collins, R. Sorenson, R. Roy, T. Hogan, J. Trainor
ferences across groups (p402). For symptoms, patients were significantly different from clinicians and family members (p<.OO7). Regards dysfunction and disadvantages, clinicians were significantly different from family members and patients (pc.048 and pc.004). Gender, age, education, length of time in the system, and discipline did not influence these differences. Results show that there are differences in how patients, family members and clinicians view schizophrenia. These differences may help explain the misunderstanding and communication diffculties evident between these three constituent groups of the mental health system.
ABNORMALITIES OF PSYCHOMOTOR DEVELOPMENT SCHIZOPHRENIA: A REHABILITATION PERSPECTIVE M. Provenza*, Rosa,
C. Pegna,
P. Cavedini, F. Tosoni, M. Alietti, S. Di S. Scarone
Rehabilitation Unit Psychiatric Branch, Instituto Scientifico H.S. Raffaele, via Prinetti 29 20127 Milano, Italia Several lines of research in clinical psychology and psychopathology suggests that schizophrenia is frequently associated with highly disparate neurofunctional disabilities underlying different maladaptative social behaviours (Cutting. 1985). Among other things, psychomotor impoverishment (Liddle and Barnes, 1990) has been critically associated with schizophrenic chronicity and, in some way, inherent in the negative aspects of the disease. More interestingly, a rehabilitation perspective, suggested that impaired psychomotor functioning is a critical determinant in the maintenance of psychotic disabilities (Ciompi, 1989). This study was an evaluation of the psychomotor profile of a group of 22 schizophrenic outpatients, compared with 21 sex and age matched controls, investigated by means of a test battery developed for the assessment of psychomotor profiles in 10 to 12 year old children. Analysis indicates that abnormal psychomotor development is an inherent feature of the disease and probably is antecedent to a full psychopathological picture.
Queen Street Mental Health Centre, Toronto, Canada Health-state preferences measure the distress and desirability individuals attach to varying health conditions. They have been used to study health decision making, in developing measures of quality of life, and in measuring utility ratings for economic analysis. This study compared the health-state preferences in schizophrenia of 106 patients, 85 family members and 172 clinicians, Health-states describing the schizophrenic experience were compiled through narrative interviews and review of existing scales. The 57 items included symptoms, dysfunction, and disadvantages rated on 5 point scales of desirability from 1 (very desirable) to 5 (very undesirable). Reliability assessment included a Cronbach’s alpha of .75 and a test-retest coefficient of ~86. ANOVA showed significant dif-
THE EFFECTS OF SOCIAL VS. NON-SOCIAL RElNFORCEMENT ON PERCEPTUAL PERFORMANCE IN SCHIZOPHRENICS B. Roberts*
and C. Schooler
Laboratory of Socio-environmental MD 20892, USA
Studies, NIMH, Bethesda,
Twenty four medicated schizophrenics were tested using a perceptual speed task in which performance feedback was provided either by the experimenter (social condition) or by a message on
SCHIZOPHRENIA, SOCIAL CLASS AND FIRST ADMISSION TO STATE OR PRIVATE PSYCHIATRIC HOSPITALS Carles Muntaner*,
Paula Wolyniec,
Ann E. Pulver
Laboratory of Socio-environmental Studies, NIMH, Room BIA-12, Federal Building, 7550 Wisconsin Avenue. Bethesda, MD 20892, USA
The present study examines whether there is an association between the social class of patients with schizophrenia, bipolar disorder, or other Axis I “functional” psychoses, the first admission to public or private for-profit psychiatric hospitals. First admission male psychotic inpatients admitted to hospitals in the Bahimore MSA were identified in the Maryland Epidemiologic Sample (Pulver and Bale, 1989). Participants were administered a version of the DIS modified to improve its assessment of psychotic symptoms. For each participant, social class at time of admission were obtained through standard survey questions. After adjusting for age and type of psychotic disorder, we found that psychotic patients with low levels of skills/credentials or originating from low skill/credentials families were more likely to be admitted to state psychiatric hospitals than patients with bipolar disorder. Being schizophrenic and being from a lower social class further increased the odds of being admitted to a state psychiatric hospital. These findings emphasize the relevance of schizophrenia and social class as determinants of differences in psychiatric care utilization. Further research should address the effects of gender and ethnicity on psychiatric care utilization. Finally, the incentives which shape the selection of specific psychotic disorders into state or private psychiatric hospitals need to be determined.
HEALTH STATE PREFERENCES IN SCHIZOPHRENIA: COMPARING THE VALUES OF PATIENTS, FAMILIES AND CLINICIANS S. Nuttall, E.J. Collins, R. Sorenson, R. Roy, T. Hogan, J. Trainor
ferences across groups (p402). For symptoms, patients were significantly different from clinicians and family members (p<.OO7). Regards dysfunction and disadvantages, clinicians were significantly different from family members and patients (pc.048 and pc.004). Gender, age, education, length of time in the system, and discipline did not influence these differences. Results show that there are differences in how patients, family members and clinicians view schizophrenia. These differences may help explain the misunderstanding and communication diffculties evident between these three constituent groups of the mental health system.
ABNORMALITIES OF PSYCHOMOTOR DEVELOPMENT SCHIZOPHRENIA: A REHABILITATION PERSPECTIVE M. Provenza*, Rosa,
C. Pegna,
P. Cavedini, F. Tosoni, M. Alietti, S. Di S. Scarone
Rehabilitation Unit Psychiatric Branch, Instituto Scientifico H.S. Raffaele, via Prinetti 29 20127 Milano, Italia Several lines of research in clinical psychology and psychopathology suggests that schizophrenia is frequently associated with highly disparate neurofunctional disabilities underlying different maladaptative social behaviours (Cutting. 1985). Among other things, psychomotor impoverishment (Liddle and Barnes, 1990) has been critically associated with schizophrenic chronicity and, in some way, inherent in the negative aspects of the disease. More interestingly, a rehabilitation perspective, suggested that impaired psychomotor functioning is a critical determinant in the maintenance of psychotic disabilities (Ciompi, 1989). This study was an evaluation of the psychomotor profile of a group of 22 schizophrenic outpatients, compared with 21 sex and age matched controls, investigated by means of a test battery developed for the assessment of psychomotor profiles in 10 to 12 year old children. Analysis indicates that abnormal psychomotor development is an inherent feature of the disease and probably is antecedent to a full psychopathological picture.
Queen Street Mental Health Centre, Toronto, Canada Health-state preferences measure the distress and desirability individuals attach to varying health conditions. They have been used to study health decision making, in developing measures of quality of life, and in measuring utility ratings for economic analysis. This study compared the health-state preferences in schizophrenia of 106 patients, 85 family members and 172 clinicians, Health-states describing the schizophrenic experience were compiled through narrative interviews and review of existing scales. The 57 items included symptoms, dysfunction, and disadvantages rated on 5 point scales of desirability from 1 (very desirable) to 5 (very undesirable). Reliability assessment included a Cronbach’s alpha of .75 and a test-retest coefficient of ~86. ANOVA showed significant dif-
THE EFFECTS OF SOCIAL VS. NON-SOCIAL RElNFORCEMENT ON PERCEPTUAL PERFORMANCE IN SCHIZOPHRENICS B. Roberts*
and C. Schooler
Laboratory of Socio-environmental MD 20892, USA
Studies, NIMH, Bethesda,
Twenty four medicated schizophrenics were tested using a perceptual speed task in which performance feedback was provided either by the experimenter (social condition) or by a message on