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PubMed2004

Relationship between family attitudes and social functioning in schizophrenia: a nine-month follow-up prospective study in Spain.

The objective was to study the relationship between family attitudes and social functioning in schizophrenia. A cohort of 80 patients was followed-up for 9 months after their hospitalization. The relatives' critical attitude and poor empathic attitude were measured by means of the Semantic Differential and the Questionnaire of Empathy, respectively. Time of useful work and social relations of the patients were measured before admission and at the end of follow-up. Symptoms, premorbid adjustment, and other course and demographic factors were also measured. Significant relationships were found between the relatives' poor empathic attitude and the patients' occupational functioning and social relations. These associations were maintained after controlling for the effects of other prognostic factors. These results suggest that empathy in the relative is an independent predictor of social functioning in people with schizophrenia. Different attitudinal dimensions of family attitudes might show different relationships with the social and clinical outcomes in this disorder.

Adolescent↗
PubMed1986

Social function of adults with isolated ventricular septal defects. Possible negative effects of surgical repair?

Possible long-term deterioration of social function has been studied in adults over 30 years of age with congenital, isolated ventricular septal defects (VSD). This deterioration may possibly have been caused by brain damage connected with open heart surgery performed after age 10 years. Thirty-five patients with a mean age of 39 (range 31-61) years have been followed up for an average of 15 (3-21) years when restudied after surgical repair of VSD performed at a mean age of 23 (10-51) years (Group 1). Their social status was compared with 61 non-operated subjects with basically smaller defects, mean age 43 (31-73) years, who had been followed up for an average of 14 (3-21) years. Group 1 had a higher educational level, were less stressed at work, had a higher gross income (NS) and were less physically disabled (p less than 0.01). Both groups had a higher educational level than normal 40-year-old Norwegians. The percentages receiving disablement pension were 12% in group 1 and 13% in group 2. Despite a higher abortion rate (33% vs. 18%), group 1 females had a higher number of liveborn babies than those in group 2 (NS). Regular medical check-ups were attended by 45% and 60% in groups 1 and 2 respectively, and about half took antibiotics prophylactically. Unlike when initially investigated, group 1 had a better cardiac condition than group 2. Compared with the non-operated group, the operated patients had suffered no detrimental effects on their social function. We therefore advocate a liberal policy for surgical repair of VSD after age 10 years.

Adolescent↗
PubMed2004

[The frequency of going outdoors, and physical, psychological and social functioning among community-dwelling older adults].

PURPOSES: This cross-sectional study examined the relationship between the frequency of going outdoors and physical, psychological, and social functioning among community-dwelling older people. METHODS: Out of all residents aged 65 and over residing in Yoita town, Niigata prefecture (n = 1,673), 1,544 living at home participated in an interview survey held in November 2000. Physical, psychological, and social functioning were compared among four groups defined by the frequency of going outdoors: (1) at least once a day, (2) about once per 2-3 days, (3) about once a week, and (4) seldom. To examine the independent association between the frequency of going outdoors and potential factors, we used multiple logistic regression analysis. RESULTS: Overall distribution of the frequency of going outdoors among the subjects was 76.3% for at least once a day, 13.1% for about once per 2 or 3 days, 3.7% for about once a week, and 6.9% for seldom. The frequency of going outdoors did not differ between genders, but showed significant decrease with advancing age in both sexes. Elderly going outdoors more often were less functionally impaired, scored less for depression and were more socially active than their counterparts going outdoors less often. Multiple logistic regression analysis with the forced entry method identified walking difficulty and fear of falls as the most powerful independent factors associated with going outdoors less than or equal to once a week, while low social activity and a more depressed score were important factors associated with going outdoors about once per 2-3 days. CONCLUSIONS: The frequency of going outdoors may be regarded as a generic health indicator among community-dwelling elderly people.

Activities of Daily Living↗
PubMed2000

Effects of cognitive therapy on psychological symptoms and social functioning in residual depression.

BACKGROUND: About 30% of psychiatric out-patients with major depression demonstrate partial remission. AIMS: To explore whether the addition of cognitive therapy (CT) had any differential effect on residual symptoms or social adjustment. METHOD: Patients with residual symptoms of major depression (n=158) were randomised to receive clinical management (CM) alone, or CM plus 18 sessions of CT. Subjects' depressive symptoms and social functioning were assessed regularly over 16 months. RESULTS: The addition of CT produced statistically significant differential effects on: two out of four measures of overall severity of depression; specific psychological symptoms (guilt, self-esteem and hopelessness); and social functioning (including dependency, interpersonal behaviour and friction). CONCLUSIONS: In patients showing only partial response to antidepressants, the addition of CT produced modest improvements in social and psychological functioning. The implications for research on the mechanisms of action of CT are discussed.

Adult↗
PubMed2000

Cognitive impairment in schizophrenia: its impact on social functioning.

OBJECTIVE: To examine cognitive impairment in schizophrenia and its impact on social functioning. METHOD: Cohort studies recording cognitive and social development, studies of predictors of poor community outcome, and evidence from brain imaging studies are reviewed. RESULTS: Executive function deficits, and poor performance in verbal memory, vigilance, and working memory tests are strong predictors of poor community outcome and impairment in skills learning. PET scans of regional cerebral blood flow suggest a dynamic imbalance between different cerebral areas rather than overall loss of brain function. CONCLUSION: Chronic cognitive impairment is the strongest predictor of social disability. Results suggest that the impairment of brain function associated with executive deficits is not necessarily irreversible and may therefore be treatable with appropriate drug therapy.

Brain↗
PubMed1994

Social functioning and overall mortality: prospective evidence from the Kuopio Ischemic Heart Disease Risk Factor Study.

We studied the associations between 11 scales of social functioning and risk of death over an average follow-up time of 71 months in 42- to 60-year-old men in the Kuopio Ischemic Heart Disease Risk Factor Study. In age-adjusted analyses, men were at increased risk of death if they reported few persons to whom they gave or received social support, nonparticipation in organizations, low quality of social relationships, a small number of friends, or not currently being married. Frequency of interaction, shyness, and use of emotional support when troubled were not associated with risk of death; the use of instrumental support when troubled was associated with increased risk. There was little evidence of confounding of these associations by the presence of 31 chronic or acute conditions, perceived health status, or six risk factors. Consistent associations were found in a healthy subgroup. These data add to the growing body of literature linking mortality risk with social functioning, especially in relation to organizational participation and quality of relationships.

Adult↗
PubMed2002

Long-term follow-up of 246 adults with juvenile idiopathic arthritis: social function, relationships and sexual activity.

OBJECTIVE: To examine social function, relationships and sexual activity in adults with juvenile idiopathic arthritis (JIA). PATIENTS AND METHODS: Two hundred and forty-six adults identified with long-standing JIA had an average disease duration of 28.3 yr. Specific information was sought on marital status, offspring, age at first sexual encounter, and problems related to disease in sexual activity and pregnancy. RESULTS: Fewer patients (42.8%) were in stable relationships than their siblings (55.3%). The percentage of patients with children was 27.5. Twenty-three per cent of all known pregnancies ended in miscarriage. Of the women who had had a Caesarean, 78.9% had either reduced hip mobility or short stature. JIA had a detrimental effect on body image in 50.7% of patients but relationships were affected in only 28.2%. The percentage of patients who were sexually active or had had previous sexual experience was 83.3; 58.3% of these had disease-related sexual problems. CONCLUSIONS: A significant proportion of individuals are sexually active before transfer to adult rheumatology care at the age of 18 yr. This highlights the need to introduce sexual counselling in adolescent clinics. The high incidence of psychological sexual problems may benefit from appropriate counselling and training.

Abortion, Spontaneous↗
PubMed1992

Plastic surgery on children with Down syndrome: parents' perceptions of physical, personal, and social functioning.

Plastic facial surgery is being carried out on children with Down syndrome with the objective of improving these children's physical, personal, and social functioning. This study investigated the effect of such surgery on parents' perceptions, both of the current status of their children's functioning and of changes in this functioning. Perceptions of parents of children who had undergone this surgery in Israel in the years 1982 and 1983 were compared with perceptions of parents of children who had not undergone the operation. This comparison produced little evidence for the positive impact of the surgery on parents' perceptions of their children's physical, personal, and social functioning.

Activities of Daily Living↗
PubMed1995

A 15-20 year follow-up of adult psychiatric patients. Psychiatric disorder and social functioning.

BACKGROUND: An exploratory study was undertaken of the importance of personality disorder in predicting the long-term outcome for both episodic disorders and social functioning. METHOD: In 1966-67, a representative series of patients with children, free of episodic illness for at least one year, was sampled from the Camberwell Psychiatric Register and systematically assessed over a four-year period, using measures of known reliability and validity. Psychiatric disorder was measured using a PSE-compatible instrument. The follow-up after 15-20 years used the PSE and a systematic assessment of social functioning. RESULTS: Overall outcomes were similar across diagnoses, but an initial categorical diagnosis of personality disorder predicted much poorer outcomes on psychiatric and social measures for patients with unipolar depressive disorders than for those with other diagnoses. CONCLUSIONS: The findings indicate the importance for prognosis of including a systematic assessment of personality disorder in the clinical assessment of patients with depressive disorder.

Adolescent↗
PubMed2003

Assessment of social cognition in frail older adults and its association with social functioning in the nursing home.

PURPOSE: The aims of this study were to reliably assess a range of social-cognitive functioning in frail seniors and to examine the association between measures of social cognition and nurses' ratings of residents' social functioning in a nursing home. DESIGN AND METHODS: Forty nursing home residents with and without cognitive impairment completed 11 social cognition tasks on two occasions after assessment of their cognitive functioning with the Cambridge Cognitive Examination-Revised (CAMCOG), CAMCOG Executive Function, and two tests of working memory. Staff on the nursing units completed two measures of social behavior. RESULTS: Participants completed the social cognition protocol without difficulty. The measures demonstrated good internal (median alpha =.75) and test-retest reliability (median correlation =.70). Four of the social cognition measures were significantly associated with the measures of cognitive functioning; three additional measures showed significant positive associations with subsets of the cognitive tests. Regression analyses revealed that measures of social cognition were significantly and independently associated with nurses' ratings of residents' social functioning after age, gender, education, and the four measures of cognitive functioning were controlled for. One measure of social cognition that assessed interpersonal problem-solving accounted for 45% of the variance in nurses' ratings of participants' social functioning (F = 41.35; df = 1,17; p <.001). IMPLICATIONS: Measures of social cognition assess a domain of functioning that is not evaluated by traditional tests of cognitive status. These measures are informative about frail, older adults' ability to understand and respond to others and could be used to predict patterns of social functioning in nursing homes and other naturalistic settings.

Aged↗
PubMed2000

Dispositional emotionality and regulation: their role in predicting quality of social functioning.

Individual differences in emotionality and regulation are central to conceptions of temperament and personality. In this article, conceptions of emotionality and regulation and ways in which they predict social functioning are examined. Linear (including additive) and nonlinear effects are reviewed. In addition, data on mediational and moderational relations from a longitudinal study are presented. The effects of attention regulation on social functioning were mediated by resiliency, and this relation was moderated by negative emotionality at the first, but not second, assessment. Negative emotionality moderated the relation of behavior regulation to socially appropriate/prosocial behavior. These results highlight the importance of examining different types of regulation and the ways in which dispositional characteristics interact in predicting social outcomes.

Child↗
PubMedDate not supplied

Psychopathology and social functioning in men prenatally exposed to diethylstilbestrol (DES).

Previous research has suggested increased psychopathology in prenatally diethylstilbestrol (DES)-exposed persons. The current study compares the psychiatric histories and social functioning of 27 men with a history of high-dose prenatal DES exposure and their unexposed brothers. We expected DES subjects to show greater lifetime psychopathology and poorer social functioning than controls. Both groups showed high rates of lifetime depression, lifetime alcoholism, and current psychiatric symptoms in excess of community norms. The only diagnosis on which DES subjects exceeded their unexposed brothers was Major Depressive Disorder (MDD). DES-exposed men had almost twice the prevalence of at least one episode of MDD and had significantly more recurrent episodes. The relatively small number of subjects with concomitant lack of statistical power may have contributed to the difficulty obtaining significant effects.

Adult↗
PubMed1998

Depression and social functioning in general hospital in-patients.

Impairment of social functioning is often associated with depression and contributes to an unfavorable course of the disease. Although it must be suspected that both social maladaptation and depression could obstruct recovery from somatic diseases, little attention has been paid to their interaction in general hospital patients. To assess social integration in depressive and psychiatrically healthy general hospital in-patients, 250 patients were studied with the Composite International Diagnostic Interview (CIDI), a structured clinical interview, and the Social Interview Schedule (SIS). From clinical interviews, it was established that 16.4% of the patients suffered from depressive disorders (ICD-10). When these patients were compared with patients without psychiatric disorder, only a tendency to social dysfunctioning with regard to social management and satisfaction with social situations was observed. But when the depressive sample was divided into three diagnostic groups (depressive episode, dysthymia, depressive adjustment disorder), significant social impairments were found in the dysthymia subsample. Family and other interpersonal problems were most prominent. When depression preceded somatic illness, a higher level of impairment was observed. The majority of dysthymia patients suffered from long-term somatic diseases, often cancer, which were preceded by depression. The results of this study single out a small group of patients who seem to be at an extensive risk of chronic psychiatric and somatic illnesses and should therefore be a focus of consultation/liaison (C/L) interventions.

Aged↗
PubMed1999

Impaired health status, and mental health, lower vitality and social functioning in women general practitioners in Sweden. A cross-sectional survey.

OBJECTIVE: The aim was to analyse differences between female and male general practitioners (GPs) in health status and lifestyle and compared with the general population in health-related quality of life. DESIGN: A simple random sample of 1004 GPs from the whole of Sweden (71.2%) participated in a survey in May 1996 about self-reported health status, smoking habits, physical activity, and SF-36 quality of life survey. They were compared as regards SF-36 with the general population in Sweden in three approximately similar-sized age groups of women and men aged 30-44, 45-49, and 50-64. RESULTS: Female GPs had a higher risk than male GPs of impaired health status. Of the female GPs aged 45-49, 22.8% reported that their health was impaired compared with 12.6% of male GPs. Less than 5% of the GPs younger than 45 were daily smokers. Female GPs had higher means for physical functioning but lower means for vitality, social functioning, and role emotional and mental health compared with the general population. CONCLUSIONS: The significant increased risk in poor health among female GPs, especially those aged 45-49, is worrying and argues for appropriate analysis and prevention that are tailored to their working conditions.

Adult↗
PubMedDate not supplied

The relations of parental warmth and positive expressiveness to children's empathy-related responding and social functioning: a longitudinal study.

This study examined the concurrent and cross-time relations of parental observed warmth and positive expressivity to children's situational facial and self-reported empathic responding, social competence, and externalizing problems in a sample of 180 elementary school children. Data was collected when the children were in second to fifth grades (age: M = 112.8 months), and again 2 years later. Cross-sectional and longitudinal structural equation models supported the hypothesis that parents' (mostly mothers') positive expressivity mediated the relation between parental warmth and children's empathy, and children's empathy mediated the relation between parental positive expressivity and children's social functioning. These relations persisted after controlling for prior levels of parenting and child characteristics. Moreover, concurrent and cross-time consistencies were found on measures of parenting, children's situational empathic responding, and social functioning.

Child↗
PubMedDate not supplied

[Family psychoeducational interventions for schizophrenia in routine settings: impact on patients' clinical status and social functioning and on relatives' burden and resources].

OBJECTIVE: This study explored the effectiveness of a psychoeducational family intervention for schizophrenia on patients' clinical status and disability and relatives' burden and perceived support. METHODS: The study has been carried out in 17 mental health centres. In each of them, 2 professionals were trained in a psychoeducational intervention and applied it for six months with families of users with schizophrenia. At baseline and six months later, patients' clinical status and disability, and relatives' burden, social network and professional support were assessed by validated tools. RESULTS: Of the seventy-one recruited families, 48 (68%) completed the intervention. At six months, a significant improvement was found in patients' clinical status and social functioning, as well as in relatives' burden and social and professional support. In particular, the percentage of patients with poor or very poor global social functioning dropped from 50% to 27% at six months. Forty percent of patients and 45% of relatives reported a significant improvement in their social contacts over the intervention period. CONCLUSIONS: The results of this study confirm the hypothesis that psychoeducational family interventions may have a significant effect on social outcome and family burden in schizophrenia when provided in routine conditions.

Catchment Area, Health↗
PubMed2001

Outpatients with schizophrenia and bipolar I disorder: Do they differ in their cognitive and social functioning?

The authors used a battery of cognitive and social functioning measures to evaluate stable outpatients with schizophrenia (n=74) and bipolar I disorder (n=26) who were receiving care at community and rehabilitation programs. The groups did not differ significantly on 36 of 41 measures. For most variables, comparisons between groups yielded effect sizes of <0.5. These results suggest that individuals with bipolar I disorder receiving community and rehabilitation services have many social and cognitive deficits that are as severe as those in schizophrenia.

Adult↗
PubMed1993

Object relations and social functioning of schizophrenic and borderline patients: a cross-sectional developmental perspective.

Using a cross-sectional design, this study compared patients with schizophrenic and borderline personality disorders on measures of object relations and social functioning. Although we found that on measures of object relations the borderline group remained less impaired than the schizophrenics, during the course of the lifespan the schizophrenic patients appeared to surpass the borderlines on social functioning. These results are integrated with the literature that compares the long-term course and outcomes for these disorders and are discussed within the context of differential adaptive capacities, change mechanisms, and treatment interventions.

Adult↗