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Work performance over time for patients with schizophrenia
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SCHIZOPHRENIC PATIENTS’ RELATIVES AND CONTACT: OUTCOME M.B. Lebell*, S.R. Marder, J. Mintz, Wirshing, M. Tompson, J. McKenzie,
PERCEPTIONS ONE-YEAR
OF
L.I. Mintz, WC. K. Johnston-Crank
West Los Angeles VA Medical Center, Wilshire & Sawtelle Blvds., Building 210, Room 15, Los Angeles, CA 90073, USA Thirty-nine male schizophrenic outpatients’ perceptions of their key relatives were assessed. Two scales predicted the risk of psychotic exacerbation during a one-year follow-up: patients’ perceptions of the relatives’ attitudes toward the patients (log-rank x2 =7.91, pc.005) and patients’ own attitudes toward the relatives (x2 =8.29, p<.OO4). Subjects were dichotomized into an Optimal Perceptions of Feelings (N=22) group and a Sub-Optimal Perceptions of Feelings (N=17) group based on the sum of these two scales. Survival was statistically better in the Optimal Perceptions of Feelings group, 53% versus 18% in the other group (log-rank x*=6.01; p=.O14). Survival analysis of data in a 2x2 factorialcombining degree of contact with the relatives and the patients’ perceptions of their relatives-found that patients in frequent contact with a positively-perceived relative had significantly fewer psychotic exacerbations than any of the other groups (p levels ranged from .002-,014). These findings suggest that patients’ perceptions of their relatives may help identify patients at risk for relapse, and that more frequent contact with relatives perceived by the patient as supportive may be protective for the vulnerable schizophrenic patient. This has implications for psychosocial interventions and future research.
EXPLORING EXPRESSED SYMPTOMS
emphasis on its relation to relapse, and the implication that families are to blame for patient outcomes. This research provides insight into changes in the interaction between kinds of symptoms and the components of EE regardless of relapse status, as well as increased understanding of how family members cope with various symptoms over time.
WORK PERFORMANCE OVER TIME FOR PATIENTS WITH SCHIZOPHRENIA P.H. Lysaker*, Psychology USA
M.D.
Bell, R.M.
Milstein,
J.L. Coulet
Service, VA Medical Center, West Haven, CT 06516,
Impairment in the ability to work is a defining characteristic of schizophrenia. Little is known, however, about the response of work impairment to participation in psycho-social rehabilitation. Do certain skills improve over time, or are aspects of work impairment intractable’? This study examines changes in work performance of 48 subjects with schizophrenia or schizoaffective disorder over 13 weeks of work in a psycho-social rehabilitation study. Using the Work Personality Profile (WPP), work performance was assessed biweekly along five dimensions: Task Orientation, Social Skills, Work Motivation, Work Conformance and Personal Presentation. Results show subjects’ social skills improve significantly over the course of 13 weeks of work. There appears to be a positive trend for personal presentation over time and a negative trend for work conformance as well as work motivation. Subjects’ work skills do not appear to change over time. Implications for treatment planning and the nature of work impairment in schizophrenia are discussed
THE RELATIONSHIP BETWEEN EMOTION AND CHANGES IN OVER TIME
E.P. Lukens* Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York City, NY10032, USA
AN RCT OF ENRICHED PSYCHOSOCIAL TREATMENTS FOR SCHIZOPHRENIA: EFFECTS ON FAMILY BURDEN L. McCleaty*
Research on Expressed Emotion (EE) has focused on its value as a predictor of the relapse of selected positive symptoms of schizophrenia, with little consideration for the interaction between EE and the full range of positive and negative symptoms which patients manifest over time. The poster will explore the relationship between this range of symptoms, as measured by the “Brief Psychiatric Rating Scale” and the “Schedule for the Assessment and the two primary components of of Negative Symptoms”, EE (i.e. criticism and overinvolvement), as measured by the Camberwell Family Interview. Data will be presented for 133 well diagnosed outpatients (DSM III-R) aged 18 to 45 and their families at patients’ admission to and discharge from hospital, and one and two years post discharge, using correlation analysis and repeated measures ANOVA. The EE literature has been criticized for the possibility that its components reflect very different underlying constructs, the
and H. Munroe-Blum
Department of Psychiatry, McMaster University, Hamilton Psychiatric Hospital, Rm C125. PO Box 585, Station A, Hamilton, Ont., Canada, L8N 3K7 Relatives bear considerable burden as a result of schizophrenia in a family member. Evaluations of psychosocial interventions for patients and relatives have focused primarily on outcomes other than family burden. It is hypothesized that psychosocial interventions targeting both the patient and the relative will result in a greater decrease in family burden than interventions for either party alone. Outcome data from a three armed RCT of enriched social treatments for schizophrenia are examined here. 159 relatives of 90 schizophrenic outpatients are enrolled in the trial. 80% of the relatives are parents. Just over half live with the patient. At inclusion the relatives report most burden
SCHIZOPHRENIC PATIENTS’ RELATIVES AND CONTACT: OUTCOME M.B. Lebell*, S.R. Marder, J. Mintz, Wirshing, M. Tompson, J. McKenzie,
PERCEPTIONS ONE-YEAR
OF
L.I. Mintz, WC. K. Johnston-Crank
West Los Angeles VA Medical Center, Wilshire & Sawtelle Blvds., Building 210, Room 15, Los Angeles, CA 90073, USA Thirty-nine male schizophrenic outpatients’ perceptions of their key relatives were assessed. Two scales predicted the risk of psychotic exacerbation during a one-year follow-up: patients’ perceptions of the relatives’ attitudes toward the patients (log-rank x2 =7.91, pc.005) and patients’ own attitudes toward the relatives (x2 =8.29, p<.OO4). Subjects were dichotomized into an Optimal Perceptions of Feelings (N=22) group and a Sub-Optimal Perceptions of Feelings (N=17) group based on the sum of these two scales. Survival was statistically better in the Optimal Perceptions of Feelings group, 53% versus 18% in the other group (log-rank x*=6.01; p=.O14). Survival analysis of data in a 2x2 factorialcombining degree of contact with the relatives and the patients’ perceptions of their relatives-found that patients in frequent contact with a positively-perceived relative had significantly fewer psychotic exacerbations than any of the other groups (p levels ranged from .002-,014). These findings suggest that patients’ perceptions of their relatives may help identify patients at risk for relapse, and that more frequent contact with relatives perceived by the patient as supportive may be protective for the vulnerable schizophrenic patient. This has implications for psychosocial interventions and future research.
EXPLORING EXPRESSED SYMPTOMS
emphasis on its relation to relapse, and the implication that families are to blame for patient outcomes. This research provides insight into changes in the interaction between kinds of symptoms and the components of EE regardless of relapse status, as well as increased understanding of how family members cope with various symptoms over time.
WORK PERFORMANCE OVER TIME FOR PATIENTS WITH SCHIZOPHRENIA P.H. Lysaker*, Psychology USA
M.D.
Bell, R.M.
Milstein,
J.L. Coulet
Service, VA Medical Center, West Haven, CT 06516,
Impairment in the ability to work is a defining characteristic of schizophrenia. Little is known, however, about the response of work impairment to participation in psycho-social rehabilitation. Do certain skills improve over time, or are aspects of work impairment intractable’? This study examines changes in work performance of 48 subjects with schizophrenia or schizoaffective disorder over 13 weeks of work in a psycho-social rehabilitation study. Using the Work Personality Profile (WPP), work performance was assessed biweekly along five dimensions: Task Orientation, Social Skills, Work Motivation, Work Conformance and Personal Presentation. Results show subjects’ social skills improve significantly over the course of 13 weeks of work. There appears to be a positive trend for personal presentation over time and a negative trend for work conformance as well as work motivation. Subjects’ work skills do not appear to change over time. Implications for treatment planning and the nature of work impairment in schizophrenia are discussed
THE RELATIONSHIP BETWEEN EMOTION AND CHANGES IN OVER TIME
E.P. Lukens* Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York City, NY10032, USA
AN RCT OF ENRICHED PSYCHOSOCIAL TREATMENTS FOR SCHIZOPHRENIA: EFFECTS ON FAMILY BURDEN L. McCleaty*
Research on Expressed Emotion (EE) has focused on its value as a predictor of the relapse of selected positive symptoms of schizophrenia, with little consideration for the interaction between EE and the full range of positive and negative symptoms which patients manifest over time. The poster will explore the relationship between this range of symptoms, as measured by the “Brief Psychiatric Rating Scale” and the “Schedule for the Assessment and the two primary components of of Negative Symptoms”, EE (i.e. criticism and overinvolvement), as measured by the Camberwell Family Interview. Data will be presented for 133 well diagnosed outpatients (DSM III-R) aged 18 to 45 and their families at patients’ admission to and discharge from hospital, and one and two years post discharge, using correlation analysis and repeated measures ANOVA. The EE literature has been criticized for the possibility that its components reflect very different underlying constructs, the
and H. Munroe-Blum
Department of Psychiatry, McMaster University, Hamilton Psychiatric Hospital, Rm C125. PO Box 585, Station A, Hamilton, Ont., Canada, L8N 3K7 Relatives bear considerable burden as a result of schizophrenia in a family member. Evaluations of psychosocial interventions for patients and relatives have focused primarily on outcomes other than family burden. It is hypothesized that psychosocial interventions targeting both the patient and the relative will result in a greater decrease in family burden than interventions for either party alone. Outcome data from a three armed RCT of enriched social treatments for schizophrenia are examined here. 159 relatives of 90 schizophrenic outpatients are enrolled in the trial. 80% of the relatives are parents. Just over half live with the patient. At inclusion the relatives report most burden