Factors Predicting Response to the Recovery-Oriented Cognitive Behavioural Workshop for Persons Diagnosed with Schizophrenia.

A recovery-oriented, cognitive behavioural workshop for service users diagnosed with schizophrenia was developed, implemented and evaluated in a pilot study. Further analysis is required regarding factors which contribute to better treatment response, as this will provide useful information for workshop adaptation. Secondary multilevel model analyses were performed to determine whether workshop and booster session attendance, as well as sociodemographic variables such as gender, age, education, and duration of illness, predicted workshop responsiveness. Results showed that completers had lower responsiveness to the workshop in terms of confidence and hope, whereas those who attended an online booster session demonstrated better responsiveness as to psychosocial functioning. Longer duration of illness and older age generally predicted lower intervention responsiveness. In conclusion, adaptations utilising more booster sessions and accommodating older participants with longer duration of illness are required, as is further workshop evaluation in a randomised controlled study.

Development and Evaluation of a Recovery-Oriented Cognitive Behavioural Workshop for People Diagnosed with Schizophrenia.

BACKGROUND: There is a need to develop culturally adapted interventions that support the personal recovery and real-world functioning of people diagnosed with schizophrenia. AIMS: This study reports on the development and evaluation of a culturally adapted, recovery-oriented, cognitive behavioural workshop for service users with schizophrenia. METHOD: The feasibility and acceptability were assessed, as were changes over time in personal recovery and psychosocial functioning (primary outcomes) along with psychopathology and health-related behaviours (secondary outcomes), using multi-level modelling. It was also assessed whether personal recovery predicts psychosocial functioning. RESULTS: The workshop was feasible and was received favourably. Participants improved over time regarding confidence and hope, feeling less dominated by symptoms, psychosocial functioning, and psychopathology. Personal recovery predicted decreased psychosocial difficulties. CONCLUSIONS: The workshop is a promising intervention. It shows potential in terms of both improving personal recovery as well as real-life functioning of people diagnosed with schizophrenia. Further workshop evaluation in a randomized controlled study is required.

Investigating the roles of loneliness and clinician- and self-rated depressive symptoms in predicting the subjective quality of life among people with psychosis.

PURPOSE: To examine the roles of loneliness and clinician- and self-rated depressive symptoms as predictors of the subjective quality of life (QoL) in psychosis. METHODS: This cross-sectional study was conducted on a sample of 207 patients diagnosed with psychotic disorders. They were assessed with self-reported measures of QoL, loneliness and depression and with clinician-rated measures of depression and overall psychopathology. Multiple indicators multiple causes (MIMIC) modeling was used to analyze the data. RESULTS: Both loneliness and depression turned out to be independent predictors of impaired QoL. However, once loneliness was accounted for, the effect of depression on QoL was markedly reduced and the effect of loneliness proved to be visibly larger. Self-rated depression was found to be more strongly associated with QoL than clinician-rated depression. Each type of depression measure explained a unique amount of variance in QoL. Depression moderated the relationship between loneliness and QoL in such a way that the negative effect of loneliness on QoL weakened with the increasing intensity of depressive symptoms. CONCLUSIONS: Therapeutic programs aiming to enhance the QoL of people with psychotic disorders should incorporate interventions targeting both loneliness and depression and need to be tailored to the clinical status of patients. The emphasis on alleviating loneliness should be placed first of all in the case of those with low levels of depression, among whom the negative impact of loneliness on QoL is especially strong. Researchers should be aware that the method chosen for assessing depressive symptoms in models predicting QoL in psychosis matters.

The relationship between internalized stigma and quality of life among people with mental illness: are self-esteem and sense of coherence sequential mediators?

PURPOSE: To elucidate the mechanism through which internalized stigma reduces the quality of life (QoL) of people with mental illness by exploring the mediating roles of self-esteem and sense of coherence (SOC). METHODS: A cross-sectional analysis of 229 patients diagnosed with schizophrenia or affective disorders was undertaken to test a sequential mediation model assuming that more severe internalized stigma is related to lower self-esteem, which is associated with weaker SOC, which in turn relates to worse QoL. RESULTS: The proposed model was supported by the data. A sequential indirect effect from internalized stigma to QoL via self-esteem and SOC turned out to be significant [beta = -0.06, SE = 0.02; 95% CI (-0.11, -0.03)]. Support was also found for simple mediation models with either self-esteem or SOC as single mediators between internalized stigma and QoL. CONCLUSIONS: Self-esteem and SOC are personal resources that should be considered as potential targets of interventions aiming to prevent the harmful consequences of internalized stigma for the QoL of people receiving psychiatric treatment.

A Qualitative Study of the Subjective Appraisal of Recovery Among People with Lived Experience of Schizophrenia in Poland.

The objective of this study was to explore definitions of recovery among Polish service users with lived experience of schizophrenia and to hear their recommendations regarding elements that should be considered in the planning of a recovery oriented psychosocial intervention. Four semi-structured focus groups were conducted in the Institute of Psychiatry and Neurology in Warsaw, Poland. A total of 28 service users' narratives were examined using the inductive thematic analysis approach. Five main recovery themes emerged from the combined users accounts, listed in order of frequency: psychological dimension of recovery, relationships with others, wellness strategies, clinical understanding of recovery and support systems. Service user recommendations referred to the above identified recovery themes as well as indications that the intervention should be flexible, individualized, and facilitative of personal growth. The findings indicate that for service users with lived experience of schizophrenia in Poland it is culturally feasible to embrace the person-oriented approach to practice and develop a recovery-oriented psychosocial intervention emphasizing psychological domains of recovery such as positive identity, personal strengths, or meaning and purpose in life alongside the other relevant recovery dimensions. Actions regarding the system level of change are also required.

Disability and recovery in schizophrenia: a systematic review of cognitive behavioral therapy interventions.

BACKGROUND: Schizophrenia is a disabling disease that impacts all major life areas. There is a growing need for meeting the challenge of disability from a perspective that extends symptomatic reduction. Therefore, this study aimed to systematically review the extent to which traditional and "third wave" cognitive - behavioral (CBT) interventions address the whole scope of disabilities experienced by people with lived experience of schizophrenia using the WHO's International Classification of Functioning, Disability and Health (ICF) as a frame of reference. It also explores if current CBT interventions focus on recovery and what is their impact on disability domains. METHODS: Medline and PsycINFO databases were searched for studies published in English between January 2009 and December 2015. Abstracts and full papers were screened against pre-defined selection criteria by two reviewers. Methodological quality of included studies was assessed by two independent raters using the Effective Public Health Practice Project Quality assessment tool for quantitative studies (EPHPP) guidelines. RESULTS: A total of 50 studies were included, 35 studies evaluating traditional CBT interventions and 15 evaluating "third wave" approaches. Overall, traditional CBT interventions addressed more disability domains than "third wave" approaches and mostly focused on mental functions reflecting schizophrenia psychopathology. Seven studies met the inclusion criteria of recovery-oriented interventions. The majority of studies evaluating these interventions had however a high risk of bias, therefore evidence on their effectiveness is inconclusive. CONCLUSIONS: Traditional CBT interventions address more disability domains than "third wave" therapies, however both approaches focus mostly on mental functions that reflect schizophrenia psychopathology. There are also few interventions that focus on recovery. These results indicate that CBT interventions going beyond symptom reduction are still needed. Recovery-focused CBT interventions seem to be a promising treatment approach as they target disability from a broader perspective including activity and participation domains. Although their effectiveness is inconclusive, they reflect users' views of recovery and trends towards improvement of mood, negative symptoms and functioning are shown.

Exploring Factors Associated with the Psychosocial Impact of Stigma Among People with Schizophrenia or Affective Disorders.

Stigmatization can exert a variety of pernicious effects on the lives of persons with mental illnesses. The purpose of this study was to explore factors related to the psychosocial impact of stigma among 229 people receiving psychiatric treatment: 123 with schizophrenia [International Classification of Diseases, 10th Revision (ICD-10): F20] and 106 with affective disorders (ICD-10: F31-F33). In the whole sample, the factors most prominently associated with a greater impact of stigma on personal and family life were schizophrenia diagnosis, current inpatient treatment, actually experienced stigma and self-stigma. However, the patterns of predictors varied between the two diagnostic categories. For the schizophrenia group, only self-stigma significantly contributed to a stronger stigma impact. In the affective group, a more severe impact of stigma was significantly predicted by inpatient status and experienced stigma. Anti-stigma programs should address the specific features of stigmatization associated with various psychiatric diagnoses.

Adaptation and validation of the Columbia-Suicide Severity Rating Scale (C-SSRS) - screen version. / Polska adaptacja i walidacja wersji przesiewowej Skali Oceny Ryzyka Samobójstwa z Uniwersytetu Columbia (C-SSRS).

OBJECTIVES: To perform an adaptation and psychometric validation of the Polish version of the Columbia-Suicide Severity Rating Scale (C-SSRS) screen version in a clinical sample of patients admitted to the psychiatric hospital. METHODS: This was a single-center, observational and cross-sectional study. A total of 318 consecutive patients completed a set of questionnaires upon their admission to acute psychiatric units. The set comprised C-SSRS screener and the reference measures: the Suicidal Behaviors Questionnaire - Revised (SBQ-R), the Suicidal Ideation Attributes Scale (SIDAS), the Center of Epidemiological Studies Depression Scale - Revised (CESD-R), the Scale of Psychache, the Purpose in Life scale (PIL), and alcohol misuse screen test (CAGE). RESULTS: Cronbach's α of the C-SSRS was 0.89. Two latent components were identified in the factor analysis: (1) suicidal thoughts, intentions and plans, and (2) history of suicidal attempts. There were differences in the mean scores of all the utilized questionnaires (namely, SBQ-R, the Psychache scale, CAGE, SIDAS, PIL and CESD-R) between the C-SSRS risk groups (p=0.01). The C-SSRS risk group was associated with the category of the primary psychiatric diagnosis (p<0.001). CONCLUSIONS: The Polish version of the Columbia-Suicide Severity Rating Scale screener is a questionnaire with good psychometric features to assess the suicidal risk among psychiatric in-patients. It can be used for the purposes of a routine assessment of suicidal risk among hospitalized patients.

The Stigma subscale of the Consumer Experiences of Stigma Questionnaire (CESQ): a psychometric evaluation in Polish psychiatric patients.

OBJECTIVE: There is a scarcity of well validated measures of the subjective experience of the stigma of mental illness. The aim of this paper was to evaluate the psychometric properties of the Stigma subscale of the Consumer Experiences of Stigma Questionnaire (CESQ). METHODS: A secondary analysis of the data from two cross-sectional studies using the CESQ was conducted in order to assess the factor structure, internal consistency and concurrent validity of the Stigma subscale. Sample 1 included 373 diagnostically heterogeneous patients (65% had psychotic disorders) and Sample 2 included 136 patients with schizophrenia. RESULTS: Since none of the factor models of the original 9-item scale was satisfactory, it was shortened by removing two psychometrically weakest items. The abbreviated 7-item scale proved to be a one-dimensional instrument, with good estimates of internal consistency. Its concurrent validity was partly confirmed by demonstrating negative correlation with quality of life and positive correlations with self-rated psychopathological symptoms. However, contrary to theoretical expectations, the stigma score was not associated with global functioning and clinician-rated symptoms. CONCLUSIONS: The psychometric properties of the Stigma subscale of the CESQ may be improved by shortening the instrument. Although the reliability and validity of the abbreviated version were partly established, further research is needed to explore in particular its test-retest reliability and concurrent validity.

Disability and schizophrenia: a systematic review of experienced psychosocial difficulties.

BACKGROUND: Schizophrenia is a significantly disabling disease that affects all major areas of life. There is a lack of comprehensive synthesis of research findings on the full extent of psychosocial difficulties (PSDs) experienced by people living with schizophrenia. This paper provides a systematic review of the literature concerning PSDs and their associated factors in schizophrenia. PSDs were conceptualized in accordance with the International Classification of Functioning, Disability and Health (ICF) as disabilities, in particular impairments of mental functions, activity limitations and participation restrictions. METHODS: An electronic search using MEDLINE and PsychINFO plus a manual search of the literature was performed for qualitative and longitudinal studies published in English between 2005 and 2010 that examined PSDs in persons with schizophrenia. The ICF was used as a conceptual framework. RESULTS: A total of 104 papers were included. The most frequent PSDs addressed in the literature were not specific ones, directly linkable to the ICF categories of mental functions, activity limitations or participation restrictions, but broad areas of psychosocial functioning, such as psychopathological symptoms (53% of papers) or global disability and functioning (37%). Among mental functions, the most extensively studied were cognitive functions (27%) and emotional functions (27%). Within the domain of activities and participation, the most widely investigated were difficulties in relationships with others (31%) and employment (20%). Of the factors associated with the intensity or course of PSDs, the most commonly identified were treatment modalities (56%), psychopathological symptoms (26%), and socio-demographic variables (24%). Medication tended to improve the most relevant PSD, but at the same time was the only consistently reported determinant of onset of PSDs (emerging as unwanted side-effects). CONCLUSIONS: The present review illustrates the remarkably broad scope and diversity of psychosocial areas affected in schizophrenia and shows how these areas are interconnected and how they interact with contextual factors. The need for a shift in focus of schizophrenia research is suggested--from an excessive reliance on global measures of psychopathology and disability for defining outcomes to the creation of profiles of specific PSDs that have a more direct bearing on the disabling experience and real-world functioning of patients and can serve to guide interventions and monitoring over time.

[Language disorders and cognitive functions in persons with schizophrenic disorders]. / Zaburzenia jezykowe a inne wybrane funkcje poznawcze u osób chorujqcych na zaburzenia schizofreniczne.

AIM: The aim of this study is to evaluate the relationship between clinical and neuropsychological measures of language disorders as well as characteristics of the mental condition of patients diagnosed as having schizophrenic disorders. METHOD: There were 45 persons with schizophrenic disorder (acc. ICD-10) examined with The Positive and Negative Syndrome Scale (PANSS), the side effect rating scale (UKU), Wisconsin Cards Storting Test (WCST), verbal fluency task, Ruff's Test, "Similarities" --WAIS-R subtest, 10 graphics of The Thematic Apperception Test (TAT). Patient's speech was evaluated independently by two diagnosticians using Thought, Language and Communication Scale (TLCS). RESULTS: Time since the onset of illness and the number of hospitalisations were associated with total TLCS scores and with most of the WCST indicators. Total amount and most of the particular language disorders correlated positively with total PANSS scores. Total amount of language disorders was connected with the number of trials, which were necessary to complete the first category and also with the global scores obtained in "Similarities". There were also many correlations between particular language phenomenons and results of several neuropsychological tests. CONCLUSIONS: Correlation between psychopathological evaluation of language disorders according to TLCS and evaluation of the schizophrenic syndrome score is found to be significant. The psychopathological rating of general and particular language disorders shows significant correlations with some indicators of executive function, verbal and nonverbal fluency and the ability for abstract thinking.

How are various aspects of personal stigma related to secrecy about mental health problems among people diagnosed with psychotic disorders? A cross-sectional analysis.

OBJECTIVE: Service users commonly keep their mental illness secret in order to avoid rejection. However, this stigma-coping orientation is not necessarily effective and may lead to a number of negative psychological consequences. The purpose of the present study was to investigate the roles of various aspects of personal stigma in predicting secrecy about mental health problems among persons with psychosis. METHODS: A sample of 147 individuals diagnosed with psychotic disorders was recruited for the study. They were administered a set of questionnaires to gather data about sociodemographic and illness-related background characteristics, levels of social functioning, depressive symptoms, and overall psychopathology, elements of personal stigma (i.e., perceived stigma, experienced discrimination, self-stigma, and stigma-related stress), as well as the endorsement of secrecy as a way of coping with stigma. Hierarchical linear regression was utilized for data analysis. RESULTS: Personal stigma measures were entered into the regression equation as a block and explained as much as 29% of variance in the dependent variable over and above sociodemographic and clinical features. After accounting for all controls, higher perceived stigma (ß = 0.47, p < .01) and higher stigma stress (ß = 0.19, p < .05) were found to be independent predictors of secrecy, whereas experienced discrimination and self-stigma were not. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Perceived stigma and stigma stress appraisal should be considered as targets of interventions aiming to reduce the shame and fear of rejection associated with mental illness and to guide and support people's everyday decisions about coming out. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The self-disclosure of mental health problems: Its extent, predictors and consequences for people with psychotic disorders. / Ujawnianie problemów ze zdrowiem psychicznym: zakres, predyktory i konsekwencje dla osób z rozpoznaniem zaburzen psychotycznych.

OBJECTIVES: The analysis of the extent, sociodemographic and clinical predictors, and consequences of disclosing mental health problems for people with psychotic disorders. METHODS: 147 individuals with a diagnosis of psychotic disorder (ICD-10 categories F20-F29) were examined with questionnaires to assess the extent and consequences of their disclosing of mental health problems to others, as well as their social functioning, depressive symptoms, and the global severity of psychopathological symptoms. RESULTS: The majority of respondents talked openly about their mental health problems to their parents, spouses or life partners, as well as physicians and other non-psychiatric health care professionals, while a substantial minority (less than one-fifth) talked about these issues to casual acquaintances, neighbors, teachers and lecturers, co-workers, police officers and municipal guards, representatives of the court system, or public officials. Multiple regression analysis showed that the older the respondents were, the less willing they were to disclose their mental problems to others (ß = -0.34; p <0.05). In contrast, the longer they were ill, the more inclined they were to disclose their mental health issues (ß = 0.29; p <0.05). Disclosure of mental health problems had varying effects on the subjects' social relationships, with a significant proportion reporting no difference in the way they were treated by others, while others reported either deterioration or improvement in this area. CONCLUSIONS: The results of the study provide clinicians with practical guidance on supporting and assisting patients with psychotic disorders in the process of making informed decisions about "coming out".

Practice of prescribing antipsychotics in schizophrenia during 2013-2018 based on data from the National Health Fund. / Praktyka preskrypcyjna w zakresie leków przeciwpsychotycznych w schizofrenii w latach 2013­2018 na podstawie danych Narodowego Funduszu Zdrowia.

AIM: The aim of the study was to analyse the prescribing pattern of antipsychotic drugs in patients with schizophrenia during the years 2013-2018. METHOD: Schizophrenia is analysed as one of the diseases with the highest rate of Disability-Adjusted Life Years - DALY. In this study, the unitary data of the National Health Fund (NFZ) reported in the years 2013-2018 were used. Adult patients were identified by their Personal Identification Number (PESEL), and the antipsychotics were identified by the European Article Number (EAN). The study included 209,334 adults who were diagnosed with F20 to F20.9 (according to ICD-10) and were prescribed at least one antipsychotic within a year. The active substances of prescribed antipsychotic medication have been divided into typical (first generation), atypical (second generation) and long-acting injectable antipsychotics (both first and second generation). The statistical analysis contains descriptive statistics for selected sections. A linear regression, one-way analysis of variance and t-test were used in the study. All statistical analyses were performed using R, version 3.6.1 and Microsoft Excel. RESULTS: In the years 2013-2018, the number of patients in the public sector diagnosed with schizophrenia increased by 4%. The largest increase was recorded among persons diagnosed with other schizophrenia (F20.8). In the analysed years, the number of patients who were prescribed second-generation oral antipsychotics increased significantly as well as the number of patients who were prescribed long-acting antipsychotics, especially the secondgeneration agents (risperidone LAI, olanzapine LAI). The most prescribed first-generation antipsychotics included: perazine, levomepromazine and haloperidol with a downward trend for each; and the most common second-generation drugs included: olanzapine, aripiprazole and quetiapine. A noteworthy finding was an extremely high increase in the frequency of prescribing haloperidol in the form of depot. CONCLUSIONS: Extending the study to include information on applied prescriptive practice in the private sector would provide a fuller picture of the studied phenomenon.

Analysis of psychiatric services for patients diagnosed with schizophrenia, reported to the National Health Fund in the years 2009-2018. / Analiza swiadczen psychiatrycznych dla pacjentów z rozpoznaniem schizofrenii sprawozdanych do Narodowego Funduszu Zdrowia w latach 2009­2018.

AIM.: Analysis of psychiatric services for patients diagnosed with schizophrenia, reported to the National Health Fund in the years 2009-2018. MATERIAL AND METHODS: Schizophrenia is analyzed as one of the diseases with the highest rate of Disability-Adjusted Life Years - DALY. In the study, the unitary data of the National Health Fund (NFZ) was used, reported in the years 2009-2018. Patients were identified by the Personal Identity Number (PESEL). The services for adults were analyzed, i.e., people who were at least 18 years old in the year when the services were discontinued, for whom the main disease was schizophrenia classified by ICD-10 codes: F20 to F20.9. Provided services were analyzed according to those specified in the ordinance of the President of the National Health Fund of June 28, 2019 - organizational units and billing product codes. RESULTS: Between 2009 and 2018, the number of patients diagnosed with schizophrenia treated in the public sector increased by 5%. In the analyzed years, the number of in-patients decreased by 9%, while the number of people using out-patient services and community treatment increased by 6%. In forensic psychiatry departments, a very high increase (by 212%) in the number of hospitalized patients was observed. In 2018, the average number of hospitalization days in a general psychiatric ward was 43, in the forensic ward 279. A very low percentage of patients (less than 3%) used day therapy. In out-patient treatment, the mainstay of therapy was a medical consultation; less than 10% of patients used other types of services. In 2018, an average of four visits/consultations per patient was reported. There has been a very high decrease in the number of patients (by 77%) using group therapy, family therapy and support. CONCLUSIONS: In 2009-2018, most patients diagnosed with schizophrenia in the public sector were treated using the traditional model of care: medical consultation and psychiatric hospitalization. It is advisable to reorganize the system - implementation and development of comprehensive care coordinated within the community care model. Extending the study with information from the non-public sector would give a full picture of system functioning and facilitate service needs estimation for this group of patients.

[Patients' and families' satisfaction from services provided in community care--pilot study]. / Satysfakcja pacjentów i rodzin z opieki srodowiskowej--badanie pilotazowe.

AIM: To evaluate patients' and families' satisfaction from services provided in community care and to analyse the correlation between patients' psychopathology, quality of life and satisfaction. METHOD: The study is anonymous. In 2008, nienety-seven patients from five community care settings in Warsaw filled in Frankfurt Scale short version, Quality of Life Scale QS and Verona Scale version for the patient. 38 patients' relatives from three community care settings in Warsaw filled in the Verona Scale version for the family. Care settings were evaluated using The European Service Mapping Schedule - ESMS. RESULTS: The level of total treatment-related satisfaction in all the researched centres, with the exception of one, was in excess of 80%. The study also revealed a negative correlation between service satisfaction and patient's mental condition. The quality of patients' lives does not correlate with service satisfaction. CONCLUSIONS: The research gives no unequivocal answer to the question regarding the factors that increase service satisfaction, but it evidently shows deficiencies in the current psychiatric care system. The results of our studies point out at the lack of the variety of forms of community care available. Especially important is to involve the family in the process of treatment and offer the crisis intervention as a part of the service.

[Patient, client or...--the terms preferred in mental health services]. / Pacjent, klient, czy...--okreslenia preferowane w psychiatrycznej opiece zdrowotnej.

AIM: To analyse the patients' and staff opinions on preferred terms in regards recipients of mental health services. METHOD: In 2008, 489 patients and 318 providers from one of Warsaw mental health services answered the survey on preferred terms in regards recipients of mental health services anonymously. RESULTS: The term "patient" was the most preferred, as well as by the recipients (77.5%), as the providers (87.7%) of the services. The second choice in both groups, however much less preferred was the term "person with mental disorders" (respectively 18.2% and 22.3%) and indicated by the patients "person using mental health services" (18.2%). The less preferred were the terms: "user" (2.0% by the patients, 1.6% the providers), "beneficiary" (respectively 3.3%, 2.5%), "client" (5.5%, 5%). The patients from day hospitals and community based facilities also favoured the term "patient" (85.0% responders). In spite of staff occupation and number of years spent working in mental health services, the term "patient" was the most preferred one. CONCLUSIONS: The term "patient" was the most preferred one in the group of patients and service providers. The form of services provided did not differentiate the patients' opinion in regards to the preferred terms. Occupation and number of years spent working in mental health services did not differentiate the providers' opinion in regards to the preferred terms. Further dialogue on the preferred terms is needed, since they might empower or stigmatise.

Disentangling the relationships between interpersonal competence, social network, social support and the experience of being stigmatized among people with psychotic disorders: A path modeling approach.

BACKGROUND: Deficits in social skills are common among people with psychosis and may contribute to the severity of the stigmatization they experience. The aim of the present research was to shed light on the mechanisms through which lack of interpersonal competence may lead to an increased exposure to stigma by investigating the mediating effects of social network and social support. METHODS: A sample of 207 patients diagnosed with psychotic disorders was recruited for the study. The pattern of relationships between interpersonal competence, social network, social support and experienced stigma was analyzed using path modeling. RESULTS: The level of interpersonal competence was found to be directly negatively related to the intensity of experienced stigma (ß = -0.20, SE = 0.08; P < 0.05) and directly positively related to the scope of social network (ß = 0.36, SE = 0.08, P < 0.01) and social support (ß = 0.36, SE = 0.08, P < 0.01). The analysis of mediation pathways between interpersonal competence and stigma experiences revealed significant indirect effect through social support (ßIND = -0.08, 95% CI: -0.16 to -0.02) and sequential effect through social network and social support (ßIND = -0.03, 95% CI: -0.06 to -0.01). The indirect pathway from interpersonal competence to stigma via social network alone turned out to be non-significant. CONCLUSIONS: The findings indicate that poor interpersonal competence may increase the extent of the stigma experienced by people with psychotic illness both directly and indirectly, with social support being the key mediator. Since interpersonal competence, social network and social support are potentially modifiable factors, they should be considered as possible targets of anti-stigma interventions.

[Patients' opinions on services provided in psychiatric and neurological wards--a comparison]. / Porównanie opinii pacjentów o jakosci opieki na oddzialach psychiatrycznych i neurologicznych.

AIM: To compare patients' opinions about services in psychiatric and neurological wards in the years 2005 and 2007. METHOD: In 2005, 272 responders from psychiatric wards and 245 neurological ones and in 2007, 370 and 233 responders respectively answered the In-Patient's Opinion Questionnaire anonymously. RESULTS: Both groups regarded staff politeness, kindness, patience and friendliness as the most positive element of hospitalisation. Responders from psychiatry most often complain about in-patient specifics; from neurology about the stay conditions. Comparison of patients' opinions from psychiatry in 2005 and 2007 year indicates stability of positive opinions in majority of areas; the second study shows the essential growth of positive opinions in neurological wards. In both groups, satisfaction regarding information accessibility, form of contact with staff (less satisfying in neurological wards) and emotional support is still too low. Persons' percentage confirming emotional support from staff is higher in psychiatric wards than neurological ones in both studies. CONCLUSIONS: Staff friendliness plays a very important role during the hospitalisation. Both groups indicate dimensions requiring improvement: access to information, form of contact with staff, emotional support. The resultsindicate a contrast between the system of support on psychiatric wards and lack of this on the neurological ones. The neurological wards can use psychiatric ward positive experience regarding patients' emotional support received from nurses and the building staff patients relationship based on ideas of the therapeutic community. The changes in medical care between 2005 and 2007 had no effect on the quality of services in both kinds of wards. Progress of quality in psychiatric and neurological wards requires structural changes in medical care.

International classification of diseases/disorders diagnosis and International Classification of Functioning, Disability and Health activity/participation limitation among psychiatric patients: a cross-sectional and exploratory study.

To explore the relationships between international classification of diseases/disorders (ICD)-10 diagnoses and International Classification of Functioning, Disability and Health (ICF) disability dimensions - activity and participation restriction among mental health service users. Three hundred sixty patients from different health services diagnosed with diverse mental disorders (ICD-10) participated in the study. Functioning restrictions were evaluated by use of the Mini-ICF-APP. Selected sociodemographic and clinical variables were also analysed. The Mini-ICF-APP scores correlated positively with the clinical impression of disease severity and negatively with general functioning. As independent factors determining the Mini-ICF-APP score, regression analysis suggests diagnosis and severity of disorder but also contextual factors such as general functioning and active occupation. Percentage and percentile distributions of activity and participation restrictions in diagnostic sections and categories revealed noticeable variability regardless of diagnosis-related differences. The diagnosis determines them neither in an ambiguous nor an absolute manner. There is a need to further explore the covariability between clinical diagnosis and ICF activity and participation restriction, particularly in regard the rationalization of social welfare benefits.