RESUMEN
AIM: The aim of this study was to find out what the patients opinion about psychoeducation in schizophrenia is. METHOD: We examined 169 patients suffering from schizophrenia. They answered a questionnaire about demographic data, their opinion about participation in sessions, the motivation to psychoeducation and the themes of sessions. RESULTS: . 84% of the patients declared that they like psychoeducation. The main reason for participation in psychoeducation was the willingness to get more information about the illness and prevent relapses. The most important therapist attributes are: high communication abilities and appropriate knowledge. CONCLUSIONS: The patients want to get more information about the illness and obtain more knowledge how to cope with symptoms in order to improve the quality of their life. It is important for the therapists to create an emotional atmosphere which helps to understand each other. During the psychoeducation sessions the therapist should use more various means to get the patients involved in participation.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Educación del Paciente como Asunto/métodos , Satisfacción del Paciente/estadística & datos numéricos , Esquizofrenia/rehabilitación , Psicología del Esquizofrénico , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto/estadística & datos numéricos , Polonia , Relaciones Profesional-Paciente , Calidad de Vida , Índice de Severidad de la Enfermedad , Ajuste Social , Encuestas y Cuestionarios , Adulto JovenRESUMEN
AIM: The aim was to obtain the information regarding the choice of antipsychotic drugs in the treatment of first episode schizophrenia. In particular, the factors influencing doctors' preferences and their opinion about several antipsychotics and the availability of these drugs were evaluated. METHODS: The anonymous questionnaire was presented to 100 psychiatrists; 50 of them were in hospital and 50 were in the out-patient practice. The questionnaire consisted of 17 questions regarding the pharmacological treatment of the first schizophrenic episode. RESULTS: The most frequently prescribed drug was olanzapine (33%), then risperidone (26%), and perazine (25%). In hospitals, risperidone was more frequently administered than perazine (29% and 24% respectively) while in out-patient clinics perazine slightly outnumbered risperidone (25% vs 23%). Fluoxetine was prescribed to 18% of out-patients, but not to hospitalized ones. Doctors performed treatment verification mainly (in 39% of patients) after 4 weeks of therapy. The change of antipsychotics was made more frequently in 28% of those hospitalized than the out-patients (16%) and mainly due to the lack of efficacy. More psychiatrists considered the most important attribute of the drug to be the efficacy toward the negative symptoms (77%) than the positive symptoms (59% of doctors). CONCLUSIONS: Prescription practice of psychiatrists shows the popularity of olanzapine and risperidone in the treatment of the first psychotic episode, but also indicates the strong position of perazine, which results from the current administrative regulations. Three times more psychiatrists think that patients should have an unrestricted (by the law) access to olanzapine or risperidone than to perazine. The most important attribute of an antipsychotic in the first episode schizophrenia turned out to be its efficacy toward the negative symptoms. Psychiatrists admitted that they chose an antipsychotic much more frequently on the basis of their own knowledge than on the basis of experts' opinion or the administrative regulations.
Asunto(s)
Antipsicóticos/administración & dosificación , Actitud del Personal de Salud , Pautas de la Práctica en Medicina/estadística & datos numéricos , Esquizofrenia/tratamiento farmacológico , Antagonistas de la Serotonina/administración & dosificación , Benzodiazepinas/administración & dosificación , Esquema de Medicación , Quimioterapia Combinada , Diagnóstico Precoz , Fluoxetina/administración & dosificación , Haloperidol/administración & dosificación , Humanos , Olanzapina , Perazina/administración & dosificación , Polonia/epidemiología , Guías de Práctica Clínica como Asunto , Risperidona/administración & dosificación , Esquizofrenia/epidemiología , Índice de Severidad de la EnfermedadRESUMEN
AIM: The aim of this paper is to present and to discuss the results of an investigation conducted among Polish psychiatrists in 2007, especially its part relating to the practice of therapeutic patterns in refractory schizophrenia. METHOD: Structured individual interviews were conducted from 100 psychiatrists chosen at random in 9 larger cities in Poland. The interviews were followed by a questionnaire consisting of 52 questions relating to the principles of treatment and a perception of the features of antipsychotics. One part of the interview focused on refractory schizophrenia treatment. The perception of antipsychotics was interpreted with the use of the Pin Points Analysis method. RESULTS: In-patient schizophrenic patients are treated most often with clozapine (57%), but olanzapine (38%) and risperidone (32%) are the most common in out-patients. Other neuroleptics are prescribed considerably seldom. According to the doctors' declaration, their choices of medicines would be different, if there were no external limitations in drug prescription. In spite of this, the psychiatrists' claim, that their choice of antipsychotics is based on their own knowledge (44%), to a smaller degree it is based on the experts' recommendations (32%) and the currently valid reimbursement rules (24%). CONCLUSIONS: The Refractory schizophrenia treatment that is applied in practice, is generally convergent with the principles of the treatment. Clozapine still has a significant place in therapy. Use of all the remaining atypicals, besides risperidone and the olanzapine, they are limited by the high price for patient.
Asunto(s)
Antipsicóticos/administración & dosificación , Actitud del Personal de Salud , Pautas de la Práctica en Medicina/estadística & datos numéricos , Esquizofrenia/tratamiento farmacológico , Antagonistas de la Serotonina/administración & dosificación , Antipsicóticos/economía , Benzodiazepinas/administración & dosificación , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Fluoxetina/administración & dosificación , Humanos , Olanzapina , Polonia/epidemiología , Guías de Práctica Clínica como Asunto , Recurrencia , Risperidona/administración & dosificación , Esquizofrenia/economía , Esquizofrenia/epidemiología , Psicología del Esquizofrénico , Antagonistas de la Serotonina/economíaRESUMEN
AIM: The aim of this article is to show the effects of the Consulting Trade Place for people seeking employment "On the way to work", which exists thanks to the KRKA company. The aim of the trade place is the stimulation of mentally ill people in social life, through giving them the ability to work. RESULTS: Throughout the year, 215 people enrolled, especially schizophrenic patients. Almost half of them received information about where they could work or where one could find informations about it. Getting the job, or even the hope to get it, awakes resources which where put aside by the long period of illness. People who get a job, stress the satisfaction of "being someone useful", "being someone important and valuable", "being accepted by the society". The willingness to live increases and so does faith in normal functioning. The persons studied said, that they once again become the integral part of society, no more are they the margin of society. They once again became necessary and useful. The relevant part of this change was an improvement of their financial situation, and by implication, the improvement of the family relations. Their poor net of social relations got widened with new people, and often with new friendships. CONCLUSION: Summing up, the first year of the consulting trade place activity, we have to say that it is a new, and original method of helping mentally ill persons, who are trying to overcome the existing disability. It is also an initiative fitted to the needs and abilities of the chronically mentally ill, who have just left the mental hospital.
Asunto(s)
Empleos Subvencionados/organización & administración , Satisfacción en el Trabajo , Trastornos Mentales/rehabilitación , Enfermos Mentales/estadística & datos numéricos , Educación del Paciente como Asunto/métodos , Rehabilitación Vocacional/estadística & datos numéricos , Adulto , Servicios Comunitarios de Salud Mental/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción Personal , Polonia , Medio Social , Apoyo Social , Adulto JovenRESUMEN
AIM: The aim of this study was to analyse the level of compliance measured by patients, their families and psychiatrists. METHOD: 2009 patients who suffered from schizophrenia, 1791 members of their families and 203 psychiatrists were studied. They answered a questionnaire about the level of compliance and the factors which influence it. RESULTS: The level of compliance in schizophrenia was evaluated by psychiatrists as 48%, families--73% and patients--85%. The psychiatrists assessed that 60% of the schizophrenic patients did not have the sense of illness. 11% of the patients said that they have no benefits from pharmacotherapy. CONCLUSIONS: The level of compliance is the least in doctor's evaluation. The patients evaluation of the level of compliance was the biggest. The level of compliance was related to patients' insight, negative attitude to pharmacotherapy, cognitive deficits. Women were more cooperative with medication than men.
Asunto(s)
Enfermos Mentales/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Esquizofrenia/rehabilitación , Psicología del Esquizofrénico , Negativa del Paciente al Tratamiento/estadística & datos numéricos , Adolescente , Adulto , Antipsicóticos/uso terapéutico , Relaciones Familiares , Femenino , Humanos , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Enfermos Mentales/psicología , Persona de Mediana Edad , Cooperación del Paciente/psicología , Relaciones Médico-Paciente , Polonia/epidemiología , Esquizofrenia/epidemiología , Encuestas y Cuestionarios , Negativa del Paciente al Tratamiento/psicología , Adulto JovenRESUMEN
AIM: The aim of the study was an estimation of the rate of deletion 22q11.2 among psychiatric patients and an attempt at the assessment of the degree in which this rate is influenced by the coexistence of dysmorphic features and congenital defects. METHODS: Cytogenetic examination was performed in 255 patients with psychosis. Patients were divided into two groups. Group I was composed of 61 patients with psychosis and at least two phenotypic features characteristic of 22q11.2 deletion syndrome (22q11DS), group II was composed of 194 patients with psychosis without phenotypic features of 22q11DS. Banding and fluorescence in situ hybridization (FISH) techniques were applied. RESULTS: 22q11.2 deletion was found in 3/61 patients of group I (4.9%) and in 3/255 among all psychiatric patients (1.2%). This incidence was significantly higher than in the general population (p < 0.001). The frequency of the deletion was even higher among psychiatric patients revealing phenotypic features of 22q11DS: 3/61 (4.9%) (p < 0.0001). In all the cases with the deletion, the phenotype features were characteristic of 22q11DS. Three other psychiatric patients had sex chromosomes' aberrations: 47, XYY, 47, XXY and 47, XXX. Moreover one case of balanced translocation t(2;10) (q10; q10) was detected. Conclusions. (1) 22q11.2 deletion was found to be 40 times more common among psychiatric patients than in the general population; sex chromosome aberrations are also significantly more common than in the general population. (2) The presence of dysmorphic features and some congenital defects in psychiatric patients increases the rate of deletion 22q11.2 significantly.
Asunto(s)
Cromosomas Humanos Par 22 , Eliminación de Gen , Trastornos Psicóticos/genética , Anomalías Múltiples/genética , Adulto , Bandeo Cromosómico , Femenino , Humanos , Hibridación Fluorescente in Situ , Masculino , Fenotipo , Polonia , SíndromeAsunto(s)
Servicios Comunitarios de Salud Mental/organización & administración , Atención a la Salud/organización & administración , Trastornos Mentales/diagnóstico , Trastornos Mentales/terapia , Enfermedad Aguda , Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/terapia , Catatonia/diagnóstico , Catatonia/terapia , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/terapia , Guías como Asunto , Humanos , Anamnesis/normas , Escalas de Valoración Psiquiátrica , Psicometría/métodos , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/terapia , Esquizofrenia/diagnóstico , Esquizofrenia/terapia , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/terapia , Intento de Suicidio/prevención & controlAsunto(s)
Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Dopaminérgicos/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Algoritmos , Antidepresivos de Segunda Generación/uso terapéutico , Preparaciones de Acción Retardada , Humanos , Pruebas Neuropsicológicas , Psicología del EsquizofrénicoRESUMEN
AIM: To compare the effectiveness and tolerability of olanzapine and other antipsychotic treatments (6 months after enrollment) in Polish patients with schizophrenia participating in the IC-SOHO (the Intercontinental Schizophrenia Outpatient Health Outcomes) study. METHOD: IC-SOHO is a 3-year, global, prospective, observational study examining health outcomes in outpatients with schizophrenia undergoing treatment with antipsychotics. Patients were offered enrollment by a psychiatrist if they initiated or changed antipsychotic medication for the treatment of schizophrenia. The study was designed to provide two patient cohorts of approximately equal size: patients who initiated or switched to olanzapine, and patients who initiated or switched to non-olanzapine antipsychotic therapy. Mean changes in positive, negative, cognitive, depressive and overall symptoms from baseline to 6 months, as measured using the CGI scale, were assessed. The incidence of extrapyramidal symptoms and sexual dysfunctions and weight changes were compared. RESULTS: Out of 7648 patients participating in the IC-SOHO study, 626 patients were enrolled in Poland. After 3 and 6 months of treatment, significantly greater improvement in overall symptoms measured using the CGI scale was observed in patients with olanzapine than in those with other antipsychotics. Response rate at 6 months was significantly higher in the olanzapine group than in the non-olanzapine group. Incidence of extrapyramidal symptoms and sexual dysfunctions was lower in olanzapine group. CONCLUSIONS: After 6 months, olanzapine-treated patients showed greater improvement of clinical status compared with other antipsychotic treatment. Olanzapine treatment was more beneficial for patients; comparing to other antipsychotic treatment less extrapyramidal symptoms and sexual dysfunctions were observed.
Asunto(s)
Antipsicóticos/uso terapéutico , Benzodiazepinas/uso terapéutico , Pacientes Ambulatorios/estadística & datos numéricos , Esquizofrenia/tratamiento farmacológico , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Antipsicóticos/administración & dosificación , Antipsicóticos/efectos adversos , Benzodiazepinas/administración & dosificación , Benzodiazepinas/efectos adversos , Estudios de Cohortes , Depresión/tratamiento farmacológico , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Humanos , Masculino , Estudios Multicéntricos como Asunto , Olanzapina , Polonia , Estudios Prospectivos , Inhibidores Selectivos de la Recaptación de Serotonina/administración & dosificación , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del TratamientoRESUMEN
AIM: The aim of the research was to analyse the subjective quality of life of schizophrenic patients and their caretakers. METHOD: The quality of life was measured by the Polish adaptation of Mercier and Tempier's scale. We examined 50 patients and their relatives. RESULTS: The patients' quality of life was compared to the quality of life of their relatives. They evaluate the quality of life similarly. The differences between the patients and their caretakers concern the evaluations of social relations. Only several demographic characteristics influenced quality of life. CONCLUSIONS: The similarity of quality of life is based on taking similar criterions of evaluation. The satisfaction from life was decreased for patients and their carers. It can be connected with the impact of schizophrenia on the family.
Asunto(s)
Cuidadores/psicología , Relaciones Familiares , Familia/psicología , Calidad de Vida , Esquizofrenia/rehabilitación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polonia , Esquizofrenia/diagnóstico , Psicología del Esquizofrénico , Índice de Severidad de la Enfermedad , Ajuste Social , Medio Social , Encuestas y CuestionariosRESUMEN
AIM: The aim of this study was to obtain answers to the following questions: 1. Are there differences in the level of knowledge among the patients divided into two groups t. i. social skills training group (SSTG) and psychoeducation group (SG)? 2. Do the differences correlate with the level of subjective quality of life (SQOL)? 3. Does the participation at two groups influence SQOL and whether this correlates with two different methods of running of rehabilitation activities such as social skills training and psychoeducation? METHOD: The group of 47 patients diagnosed with schizophrenia by DSM-IV were tested. They were divided into two groups: SSTG (24 persons) and SG (23 persons). RESULTS: The increase of knowledge in coping with schizophrenia symptoms was significant in the whole tested group but it was significantly higher in the training group. The SQOL and the level of knowledge in schizophrenia do not correlate. The level of SQOL decreased after taking part in social skills training. CONCLUSIONS: 1) The participation at any of tested rehabilitation activities causes an increase in the knowledge of coping with the problems resulting from schizophrenia. 2) The level of knowledge in schizophrenia does not directly influence SQOL. The level of SQOL significantly decreased in SSTG. It suggests that clinicians should concentrate on the stage just after the training cycle in order to support the patients by giving positive reinforcement.
Asunto(s)
Estado de Salud , Solución de Problemas , Calidad de Vida , Esquizofrenia/rehabilitación , Ajuste Social , Actividades Cotidianas , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Esquizofrenia/complicaciones , Psicología del Esquizofrénico , Índice de Severidad de la EnfermedadRESUMEN
The aim of the research was to analyse the subjective quality of life of chronic, schizophrenic patients. The patients' quality of life was compared to the evaluation of their family. They evaluate the quality of life similarly. The differences concern the relationship between the quality of life and clinical characteristics.