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At least 649 records · Page 36Linked to original sources
PubMed2006

A six-month outcome of long-stay inpatients resettled in a hostel.

This prospective study evaluated a 6-month outcome of resettlement of long-term psychiatric inpatients to a hostel-based residence. Participants included 92 patients with DSM-IV chronic psychotic disorders, aged 18 to 65 years, hospitalized for 16.7 +/- 10.6 years. Evaluations performed at 2 weeks before their resettlement and following 6 months of hostel residence included the Positive and Negative Syndromes Scale, Montgomery and Asberg Depression Scale, Clinical Global Impression, Global Assessment of Functioning, Social Adaptive Functioning Evaluation and Social Behavior Schedule. The Nurses' Observation Scale for Inpatient Evaluation was completed regularly. Psychopathological symptoms declined and social interaction increased. Hostel-based deinstitutionalization programs are a promising alternative for long-term psychiatric inpatients.

Activities of Daily Living↗
PubMed1978

Factors in adjustment to blindness.

We wished to explore the relationship between certain blinding eye diseases, residual vision and psychosocial adjustment, including acceptance of blindness. One hundred and fourteen patients were grouped according to level of vision, age, type of disease, general physical health and duration of blindness. Psychological symptoms were measured by the Minnesota Multiphasic Personality Inventory (M.M.P.I.) and social function by an adaptation to blindness of the Gunzberg Progress Chart of Social Function. Social adjustment was best and psychological morbidity least in those with non-diabetic retinal disorders, those who had the best vision and those who accepted their blindness. Non-acceptance of blindness was associated with the most psychological distress and the lowest scores in social adjustment. People with glaucoma and diabetic retinal disorders seemed more poorly adjusted. An attempt should be made to identify those most prone to maladjustment so as to assist them in rehabilitation.

Adaptation, Psychological↗
PubMed2006

Health inequality and non-monotonicity of the health related social welfare function.

In a recent paper in this journal Abasolo and Tsuchiya [Abasolo, I., Tsuchiya, A., 2004. Exploring social welfare functions and violation of monotonicity: an example from inequalities in health. Journal of Health Economics 23, 313-329] have strongly argued for the use of a non-monotonic health related social welfare function. This note discusses both the limitations of the measure proposed by Abasolo and Tsuchiya [Abasolo, I., Tsuchiya, A., 2004. Exploring social welfare functions and violation of monotonicity: an example from inequalities in health. Journal of Health Economics 23, 313-329] and the problems associated with their empirics. We are able to show how non-monotonicity may lead to paradoxical results and policies. Further we examine the empirics of Abasolo and Tsuchiya [Abasolo, I., Tsuchiya, A., 2004. Exploring social welfare functions and violation of monotonicity: an example from inequalities in health. Journal of Health Economics 23, 313-329] and provide an alternative explanation to the observed patterns in the data that do not violate monotonicity. Finally we briefly mention why the Atkinson-Sen framework may be more appropriate as a way forward.

Health Services Accessibility↗
PubMed2006

Cognitive function and social abilities in patients with schizophrenia: relationship with atypical antipsychotics.

Although atypical antipsychotics have been associated with improvements in cognitive function in schizophrenia, the neurochemical basis for such effects is not well understood. Candidate neurotransmitter systems primarily involve dopamine and serotonin. The current study explored this issue by examining the cognitive abilities, social function and quality of life in patients with schizophrenia who were medicated with atypical antipsychotics. Comparisons were done for matched schizophrenia patients who were on antipsychotics with (i) an affinity for multiple receptors (olanzapine, clozapine, quetiapine) versus those that have preferential affinity for dopamine receptors (risperidone, amisulpride); and patients on medication with (ii) a high affinity for serotonin (5HT-2A) receptors (risperidone, olanzapine, clozapine) versus those with a low (or no) affinity for 5HT-2A receptors (quetiapine, amisulpride). No differences emerged between groups on any cognitive or social variable when the groups were compared for the dopaminergic properties of antipsychotic medication. By contrast, differences did emerge when patients were compared on the 5HT-2A affinity of their antipsychotic medications. Patients on low 5HT-2A-affinity antipsychotics exhibited a better performance on a measure of selective attention and adjustment to living. These findings accord with the notion that serotonergic mechanisms are important determinants of both the cognitive and the social effects of the atypical antipsychotics.

Adult↗
PubMed2001

Social skills performance assessment among older patients with schizophrenia.

OBJECTIVE: Social functioning is an important outcome dimension in schizophrenia. Measures of social skills frequently rely on self-report, and most measures which directly assess social functioning are time consuming. Here we describe a brief performance-based measure, the Social Skills Performance Assessment (SSPA), modified from an instrument published by Bellack et al. (Bellack, A., Morrison, R., Wixted, J., Mueser, K., 1990. An analysis of social competence in schizophrenia. Br. J. Psychiatry 156, 809--818). METHOD: 83 middle-aged and elderly patients with schizophrenia or schizoaffective disorder, and 52 normal comparison subjects (NCs) were rated on two standardized role plays, one requiring introduction to a stranger and another requiring assertive behavior with their landlord. Ratings in eight areas ranging from 'social appropriateness' to 'grooming' were made. RESULTS: SSPA required about 12 min to complete both role play and ratings, and had excellent interrater reliability, and good test-retest reliability. Patients demonstrated significantly greater disability in all areas of social functioning compared with NCs. Social performance was related to severity of negative symptoms and cognitive deficits, but not that of positive or depressive symptoms. SSPA scores were significantly correlated with health-related quality of well-being and observed performance on activities of daily living, but not to a self-reported measure of social functioning. CONCLUSION: The SSPA is a reliable and useful instrument. Direct assessment of social skills may provide a more accurate picture of functioning than self-report measures among patients who frequently lack insight into their own behavior.

Aged↗
PubMed1993

Neurobehavioral functioning and social behavior of children at risk for schizophrenia.

The neurobehavioral functioning and social behavior of children with mentally ill and mentally healthy parents were examined. The children, 8 to 13 years of age, were assessed with a battery of neurobehavioral tests. The children's teachers rated their interpersonal behavior. Each of the families was rated on quality of childbearing environment. Children of schizophrenic parents performed more poorly on the neurobehavioral tests, in particular those assessing perceptual-cognitive functioning, than children of parents with other psychiatric disorders or with no history of mental illness. There were no group differences in aggressive behavior. Sons of schizophrenic parents were rated as more withdrawn than the other children in the study. The relationship between childrearing environment, neurobehavioral functioning, and social behavior was in the expected direction for the children of mentally healthy parents. An atypical pattern emerged for the offspring of mentally ill parents.

Brain↗
PubMed1999

Quality of life in patients with obstructive sleep apnea: effect of nasal continuous positive airway pressure--a prospective study.

BACKGROUND: Obstructive sleep apnea (OSA) is a common condition and is associated with excessive daytime sleepiness and neuropsychological dysfunction. There is limited evidence on the effect of OSA on the quality of life and its response to nasal continuous positive airway pressure (nCPAP) treatment. STUDY OBJECTIVE: To determine the effect of nCPAP on the quality of life in patients with OSA. DESIGN: Prospective determination of nCPAP effect in a case-series analysis. PATIENTS: We studied 29 patients (23 were male and 6 were female) with a mean (+/-SE) age of 4.4+/-2.3 years, a body mass index 36.3+/-2.0 kg/height (m)2, and a diagnosis of OSA with respiratory disturbance index (RDI; apnea/hypopnea) of 77+/-9 events/h. MEASUREMENTS AND RESULTS: The quality of life was assessed by administering a Medical Outcomes Study Short Form-36 questionnaire before and after 8 weeks of nCPAP therapy in polysomnographically documented OSA. All dimensions of the quality of life were significantly impaired when compared with an age- and gender-matched population, expressed as a percentage of normative data: physical functioning, 75%; vitality, 41%; role functioning (physical, 54%; emotional, 61%; social, 66%); general health, 88%; and mental health, 76%. nCPAP therapy significantly improved the sleep-disordered breathing and sleep fragmentation. The nCPAP level for the group was 9.4+/-0.7 cm H2O. Eight weeks of nCPAP therapy improved vitality (75%), social functioning (90%), and mental health (96%). The magnitude of improvement was related to the degree of quality of life impairment prior to treatment, rather than to the severity of disease as measured by the RDI and arousal indices. CONCLUSIONS: All aspects of the quality of life, from physical and emotional health to social functioning, are markedly impaired by OSA. nCPAP therapy improved those aspects related to vitality, social functioning, and mental health.

Adaptation, Psychological↗
PubMed2006

[Quality of life and functional status in congestive heart failure].

OBJECTIVE: To assess health related quality of life of patients with congestive heart failure (CHF), to correlate quality of life with other functional parameters; maximal oxygen uptake (peak VO2) with submaximal tests (two minute walking test and shuttle walk test) and New York Heart Association (NYHA) with other clinical variables. METHODS: We evaluated 35 stable congestive heart failure patients (NYHA II-III). Functional status was assessed by NYHA classification, maximal oxygen uptake (peak VO2) and submaximal tests (two minute walk test and shuttle walk test). Health related quality of life was measured with short form 36 health survey (SF 36). RESULTS: NYHA functional class was correlated with social functioning of SF 36, peak VO2 and shuttle walk test. Peak VO2 was correlated with most of the parameters of SF 36. On the other hand 2 minute walk test and shuttle walk test were correlated with social functioning of SF 36. There was a correlation between peak VO2 and submaximal test, but there was no correlation between left ventricular ejection fraction, peak VO2 and NYHA class. CONCLUSION: Social functioning is impaired in patients with congestive heart failure. There is a correlation between maximal and submaximal tests. The maximal and submaximal tests can explain some degree of quality of life. Functional status can be explained with peak VO2 and shuttle walk test apart from NYHA class.

Adult↗
PubMed2004

Persistent social dysfunction in anxious and depressed patients with personality disorder.

OBJECTIVE: To determine the long-term social function of psychiatric patients with anxiety and depressive disorders and to relate this to personality status and other factors. METHOD: A cohort of 210 patients (mean age 35 years) with dysthymic disorder, generalized anxiety disorder or panic disorder diagnosed using a structured interview (SCID) were assessed at baseline for personality status using the Personality Assessment Schedule (PAS) and ratings of anxiety and depression. Exactly 12 years later social function was assessed using the Social Functioning Questionnaire (SFQ) and personality reassessed with the PAS by a rater blind to initial personality status. Individual social function items were examined in those with and without personality disorders. RESULTS: Social function was significantly better in those with little or no baseline personality disturbance (P < 0.001) and the domains of close relationships, stress in completing tasks, use of spare time and family relationships showed the largest personality differences. A multiple linear regression model showed that self-rated depression scores, single marital status and personality status were the main baseline variables predicting social function at 12 years. CONCLUSION: Although personality characteristics may change over time social dysfunction persists and persistent social dysfunction in mental state disorders may be a strong indicator of personality disturbance rather than an indicator of treatment resistance.

Adult↗
PubMed2003

Social characteristics of seasonal affective disorder patients: comparison with suicide attempters with non-seasonal major depression and other mood disorder patients.

Although it is evident from numerous studies that patients with mood disorders generally have a deficient social functioning and a weak social network, little is known about these aspects of seasonal affective disorder (SAD) patients. We studied the social situation, the social network and the social functioning of SAD (n = 20) patients in comparison with matched suicide attempters (SA) with non-seasonal major depression, and with findings from other major depressive disorder (MDD) studies and community samples. The social situation and the clinical background of both the SAD and the SA groups were almost similar and the social networks were equally disadvantageous and weaker than those observed in some community/healthy populations. Furthermore, the data on global functioning and social adjustment of the SAD group were well comparable to those of other MDD patients and significantly worse than that of a community sample. Thus, the results indicate a considerable social impairment in SAD.

Adult↗
PubMed2003

Identifying older people at risk of abuse during routine screening practices.

OBJECTIVES: To examine the association between various characteristics of community-based older people and a constructed measure of potential elder abuse. DESIGN: Cross-sectional design. SETTING: Public community-based long-term care programs in Michigan. PARTICIPANTS: Individuals aged 60 and older seeking home and community-based services in Michigan between November 1996 and October 1997 (N = 701). MEASUREMENTS: Data were collected using the Minimum Data Set for Home Care (MDS-HC) assessment. The dependent variable is a constructed measure of potential elder abuse reflecting physical and emotional abuse and neglect. Independent variables include demographic characteristics; diagnoses; behavioral measures; and cognitive, physical, and social functioning. RESULTS: Several measures of social support and social function were strongly associated with the signs of a potentially abusive environment: brittle support (odds ratio (OR) = 3.5, 90% confidence interval (CI) = 1.5-8.1), older person feels lonely (OR = 2.4, 90% CI = 1.3-4.5), and older person expresses conflict with family/friends (OR = 2.3, 90% CI = 1.2-4.3). Home care participants' alcohol abuse, psychiatric illness, lack of ease interacting with others, and short-term memory problems were also significantly associated with the signs of potential elder abuse. CONCLUSIONS: The results of this study suggest that the signs of potential elder abuse are associated with a diminishing social network and poor social functioning, although some characteristics of the older person's health are contributing factors. Improved understanding of the link between those characteristics and potential abuse will help healthcare providers, case managers, and others identify older people at high risk of abuse.

Activities of Daily Living↗
PubMed2003

The influence of fatigue on health-related quality of life in patients with Parkinson's disease.

OBJECTIVE: To examine the correlation between fatigue and health-related quality of life (HRQL) in patients with Parkinson's disease (PD). PATIENTS AND METHODS: Sixty-six patients with idiopathic PD. The patients did not have a depressive mood disorder or cognitive impairment. Fatigue was measured by the Fatigue Severity Scale (FSS). HRQL was measured by the Parkinson's Disease Questionnaire (PDQ-39) and the Short-Form 36 (SF-36). RESULTS: Thirty-three (50%) of the patients had significant fatigue. Patients with fatigue had a more advanced disease than those without fatigue, measured by the UPDRS scale, including a higher Hoehn and Yahr stage and lower Schwab and England score. Patients with fatigue reported more distress in the dimensions of emotional well-being and mobility (PDQ-39) and also had a significantly higher PDQ summary index. On the SF-36 patients with fatigue reported more problems in the areas of physical functioning, role limitation (physical), social functioning and vitality. Correlations between the FSS and the HRQL scales were highest for the summary index of PDQ-39 and in the dimensions of ADL, mobility and emotional well-being (PDQ-39) and physical functioning, role limitation (physical), social functioning, general health and vitality (SF-36). CONCLUSIONS: PD has a substantial negative impact on HRQL. We found a strong correlation between fatigue and high distress scores on HRQL scales in a population of patients with PD who were not depressed or demented. The diversity of symptoms and high prevalence of non-motor features, including fatigue, is important to take into account in our efforts to optimize treatment and care for this patient group.

Activities of Daily Living↗
PubMed2004

[What is the specific importance of therapeutic factors in the psychological treatment of social phobia?].

This article describes the psychological interventions developed or adapted specifically for the treatment of social phobia. Two main strategies have been identified : anxiety reduction and improvement of social functioning. Exposure and cognitive restructuring are the main procedures for anxiety reduction. For the improvement of social functioning, social skills training is the principal procedure. The outcomes on a short and long term basis are analyzed and compared to psychopharmacology. Tasks (homework) to be performed in real-life situations between sessions are considered as an essential element of all interventions. However, these tasks are guided by the different theoretical principles inherent to each approach.

Adaptation, Psychological↗
PubMed2006

Neurocognitive performance and functional disability in the psychosis prodrome.

OBJECTIVE: This study evaluates the pattern of neuropsychological deficits and their association with clinical symptomatology and social functioning in individuals identified as ultra-high-risk (UHR) for psychosis. METHODS: A sample of 45 UHR individuals was identified using the Structured Interview for Prodromal Syndromes (SIPS) from consecutive referrals to the Staglin Music Festival Center for the Assessment and Prevention of Prodromal States (CAPPS) at UCLA. Participants were administered a neurocognitive test battery, as well as measures of global (Strauss-Carpenter Outcome Scale) and social functioning (UCLA Social Attainment Survey). RESULTS: Participants showed significant deficits in speed of processing, verbal learning and memory, and motor speed. Poorer verbal learning and memory performance was significantly associated with poorer social functioning, and there was a trend for poorer performance on reasoning and problem solving to be associated with poorer global functioning. Verbal memory independently predicted social functioning over and above severity of negative symptoms. Cognitive deficits were not associated with severity of clinical symptomatology. CONCLUSIONS: Despite the absence of fully psychotic symptoms, UHR individuals experience significant cognitive deficits, particularly on tasks requiring speeded information-processing and efficient recall from memory, and these deficits appear to be associated with functional disability in a manner parallel to that observed in patients with established psychotic illness.

Adolescent↗
PubMed1997

[Some aspects of reproductive function and social adaptation after comprehensive therapy of childhood Hodgkin's disease].

An analysis of the data available on the reproductive status and social adjustment of 443 children who received three modalities of complex treatment for Hodgkin's disease in 1976-1994 established no impairment of reproductive function or its formation, although full therapeutic effect had been achieved. Nor were their intelligence or professional and social function affected in any way.

Adaptation, Psychological↗
PubMed1992

The psychosocial impact of HIV infection in men with haemophilia: controlled investigation and factors associated with psychiatric morbidity.

The aim of the investigation was to establish the prevalence of psychosocial problems in men with haemophilia and HIV infection, and to identify factors associated with psychological morbidity. A cross-sectional controlled study including 37 HIV seropositive and 36 HIV seronegative men with haemophilia under the care of the Oxford Haemophilia Centre were included in the investigation. The outcome measures included current psychological status (PSE, POMS, Beck Hopelessness Scale and Self-Esteem) and psychiatric history; coping and health beliefs (Self-Control Schedule, Hardiness Scale, Health Locus of Control Scale); social functioning (Modified Social Adjustment Scale); and sexual functioning. The results showed that seropositive individuals, whether symptomatic or not, had significantly worse total PSE scores and had higher levels of hopelessness. In addition, symptomatics had worse depression scores (POMS) than seronegatives. However, levels of psychiatric morbidity were generally low, even in the seropositive group. High levels of psychological morbidity were associated with high levels of hopelessness, unfavourable social adjustment, past psychiatric history and symptomatic HIV disease. Seropositives reported greater negative impact on their sex lives, and sexually active seropositives reported a significantly greater prevalence of sexual dysfunction than seronegatives. The majority of seropositives reported regular condom use during intercourse, and also continuing concerns about infecting their sexual partners in spite of it. In summary, it was found that men with haemophilia an HIV infection have higher levels of psychological distress and sexual problems than seronegatives. The skilled staff involved in their treatment are in a good position to identify their difficulties and ensure that good care is provided.

Adaptation, Psychological↗
PubMed2006

The use of focus groups in the development of the KIDSCREEN HRQL questionnaire.

There is increasing interest in the public health sector in the health-related quality of life (HRQL) of healthy children. However, most HRQL instruments are developed for children with a chronic illness. In addition, existing questionnaires are mostly based on expert opinion about what constitutes HRQL and the opinions and views of healthy children are seldom included. In the European project KIDSCREEN, a generic questionnaire was developed for children between the ages of 8 and 18 on the basis of children's opinions about what constitutes HRQL. Focus group discussions were organised in six European countries to explore the HRQL as perceived by children. There were six groups in each country, stratified by gender and age. The age groups were 8-9 years, 12-13 years, and 16-17 years, with 4-8 children in each group. Experienced moderators guided the discussions. The full discussions were audiotaped, transcribed and content-analysed. The discussions went smoothly, with much lively debate. For the youngest group, the most important aspect of their HRQL was family functioning. For both younger and older adolescents, social functioning, including the relationship with peers, was most important. Children in all groups considered physical and cognitive functioning to be less important than social functioning. These key findings were taken into account when designing the KIDSCREEN HRQL questionnaire for healthy children and adolescents, with more emphasis being placed on drawing up valid scales for family and social functioning. In addition, items were constructed using the language and lay-out preferred by the youngsters themselves. We conclude that focus groups are a useful way of exploring children's views of HRQL, showing that an emphasis should be placed on constructing valid social and family scales.

Adolescent↗
PubMed2004

Functional ability, social support, and depression in rheumatoid arthritis.

OBJECTIVE: First, to investigate the patterns of functional ability, depressive feelings, and social support in early stage rheumatoid arthritis (RA) patients. Second, to demonstrate the stress buffering effect of social support. Social support is thought to reduce the impact of chronic stress on psychological well-being; for patients without social support the impact of functional ability on depressive feelings will be stronger. METHODS: In 4 waves with an intervening period of 1 year, longitudinal data was collected of 264 Dutch RA patients, of which 65% was female. At T1, the mean age of these patients was 53 years, while their mean disease duration was 22 months. In an interview at the patients' homes, data was collected on functional ability, social support en psychological well-being. The buffering effect of social support was examined by testing the significance of the (computed) stressor by social support interaction term in a regression analysis on depressive feelings. RESULTS: Although large differences between subjects existed, the mean scores on functional ability, social support, and depressive feelings barely changed from year to year. Patients who deteriorated in functional ability during one year had the best chances to improve next year, and visa versa. Furthermore, the stress by support interaction terms had no significant effect on depressive feelings in a regression analysis. CONCLUSIONS: This study demonstrated clearly the fluctuating pattern of RA in the first years after onset. The patients' level of depressive feelings was linearly related to the level of functional ability. Like many other studies, also this study could not provide evidence for the stress buffering effect of social support.

Activities of Daily Living↗