Berta Moreno Küstner

Schizophrenia and quality of life: a one-year follow-up in four EU countries.

BackgroundThis article systematically monitors the quality of life (QOL) of patients with schizophrenia from seven different sites across four European countries: France, Ireland, Portugal and Spain.MethodsA one-year prospective cohort study was carried out. Inclusion criteria for patients were: a clinical lifetime diagnosis of schizophrenia according to ICD-10 (F20) diagnostic criteria for research, age between 18 and 65 years and at least one contact with mental health services in 1993. Data concerning QOL were recorded in seven sites from four countries: France, Portugal, Ireland and Spain, and were obtained using the Baker and Intagliata scale. At baseline, 339 patients answered the QOL questionnaire. At one-year follow-up, Spain could not participate, so only 263 patients were contacted and 219 agreed to take part. QOL was compared across centres by areas and according to a global index. QOL was correlated with presence of clinical and social problems, needs for care and interventions provided during the one-year follow-up.ResultsWe did not find any link between gender and QOL. There were some significant differences between centres concerning many items. What is more, these differences were relative: in Lisbon where the lowest level of satisfaction was recorded, people were satisfied with food but highly dissatisfied with finances, whereas in St Etienne, where the highest level of satisfaction was recorded, people were less satisfied with food when they were more satisfied with finances. The evolution in one year among those respondents who took part in the follow-up (excluding the subjects from Granada) showed different patterns depending on the items.ConclusionThe four countries have different resources and patients live in rather different conditions. However, the main differences as far as their QOL is concerned very much depend on extra-psychiatric variables, principally marital status and income.

Needs for care among patients with schizophrenia in six European countries: a one-year follow-up study

BackgroundThis article compares needs for care among patients with schizophrenia across six European countries and examines how this relates to the diversity of psychiatric systems in Europe.MethodsA one-year prospective cohort study was set up. Inclusion criteria for patients were: a clinical lifetime diagnosis of schizophrenia according to ICD-10 (F20) diagnostic criteria for research, age between 18 and 65 years and at least one contact with mental health services in 1993. The patients were assessed for their clinical diagnosis and symptoms using the SCAN interview (Schedules for Clinical Assessment in Neuropsychiatry) and the interventions proposed to them were recorded through the systematic use of the NFCAS (Needs For Care Assessment Schedule).Results438 patients were included and 391 were followed up. The mean age was 38 years, the mean age at onset was 22 years, and 59% were out-patients, 24% in day care and 15% hospitalized. The populations in the different centres were significantly different for almost all the variables: sociodemographic, clinical and social, and the problems identified remained relatively stable over the year. Comparisons highlighted cultural differences concerning the interventions that were proposed. Centres in Italy, Spain and Portugal proposed many interventions even though they were relatively deprived in terms of resources, and the tendency seems to be the reverse for the Northern European countries. On average, one in four patients suffered from needs that were not adequately met by the mental health service in their region. These needs (on average 6 per patient) varied from psychotic symptoms to managing their own affairs. The number of interventions was not correlated to the need status. The availability of community-based treatment, rehabilitation and residential care seems to predict smaller proportions of patients with unmet needs.ConclusionThere appeared to be a systematic relationship between the availability of community-based mental health care and the need status of schizophrenic patients: the fewer out-patient and rehabilitation services available, the more unmet needs there were.

The Goals and Method of the Andalusian Case Register for Schizophrenia

Background: Psychiatric case registers have been acknowledged as a valuable source of data, a long time ago. However, a growing interest exists in data on service utilization by patients belonging to groups with a related diagnosis to enable adequate planning of health resources. Aims: The aims of the Andalusian Case Register for Schizophrenia are to determine the prevalence of schizophrenia of those cared for by the public network of mental health services and to describe their pattern of care. Methods: Cases included on the Register are those persons resident in South Granada area with a diagnosis of schizophrenia and related disorders. The agencies which sent the information to the Register are all the mental health facilities in the catchment area. Conclusions: The Register is a flexible instrument to use for epidemiological research and mental health care planning.

Creación y funcionamiento del Registro Andaluz de Esquizofrenia.

El Registro Andaluz de Esquizofrenia tiene como objetivo principal conocer la prevalencia de la esquizofrenia asistida en el area sur de la provincia de Granada.