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QUALITY OF LIFE IN SCHIZOPHRENIA:
SYMPTOM, INSIGHT AND
NEUROPSYCHOLOGICAL
DETERMINANTS
Ma
rianne
S.
Goodman,
Thomas
E.
Smith,
James
W.
Hull
,
Tracy
E.
Felger
,
Andiea
Hedayat-Harris,
Catherine
A.
Walsh,
Susan
C.
Raymond,
Kim
A. Weiss
Department
of
Psychiatry. Cornell University
Med
ical College.
White Plains.
NY
10605. USA
The theoretical construct
of
quality of life has become an
important outcome measure in mental health. Recently, several
measures have been developed that are applicable to the
chronically
mental1y
i1l
and have been utilized in schizophrenic
populations. Early assessments of quality of lifefound associa-
tions with symptoms, especiallydepression and social circum-
stances. There has been no study which correlates quality
of
life with psychotic symptoms, insight, and neuropsychological
variables. In this study, schizophrenic patients recently dis-
charged from the hospital and recovering from a relapse were
assessed with the SAPS, SANS, a neuropsychological battery
testing attention, memory and executive functioning, and the
Scale for Assessment of Unawareness of Mental Disorder
(SUMD). Quality of life was measured using the Lehman
Quality
of
Life Interview (QOL). In preliminary analyses of 17
subjects, QOL was associated with positive symptoms and
rnisattribution on the SUMD (correlations
of
0.4-0.7). No
significantcorrelations were noted between neuropsychological
deficits and QOL. Further understanding of the relationship
between these variables may offer strategies for improving the
quality of life of individuals with schizophrenia.
"~4
INTENSIVE COGNITIVE-BEHAVIOURAL
THERAPY
FOR
RECENT ONSET
SCHIZOPHRENIA: A PILOT STUDY
G.
Haddock,
R.
Hopkins,
N.
Tarrier,
T.
Morrison,
S. Lewis
School
of
Psychiatry and the Behavioural Sciences, University
of
Manchester
M208LR.
UK
The use of Cognitive-Behavioural Therapy (CBT) with
schizophrenic patients whohave persistent psychotic symptoms,
such as hallucinations and delusions, has been shown to
be
beneficialin terms of reducing the occurrence of symptoms and
the distress and disruption caused by them. Most research has
been carried out with patients experiencing chronic medication
resistant symptoms. However CBT applied early in the illness
may be more effectiveat reducing symptoms which have had
lessopportunity to becomesystematised into patient's livesand
research in this area has become a recent focus of interest.
We have completed a pilot study which examined the effec-
tiveness
of
intensive CBT, compared to supportive counselling,
for patients experiencing recent onset psychotic symptoms.
223
Patients were randomly allocated to treatment groups and
received 3 sessions of therapy per week for 5 weeks or until
discharge (whichever was the shorter). Following discharge,
four monthly booster sessions were offered. All patients had a
discharge diagnosis of DSM-IV schizophrenia, schizoalTective
disorder or schizophreniform disorder. Results indicate that
CBT is applicable for patients experiencing recent onset acute
psychotic symptoms in conjunction with neuroleptic medica-
tion. A multicentre Randomised Control Trial is now underway
to examine further the effectiveness of
CBT in this patient
group.
"J{
THE
DEPENDENCE ON FINANCIAL
SUPPORT
FROM
SOCIAL AGENCIES
EARLY IN
THE
COURSE OF
SCHIZOPHRENIA
Beng-Choon
Ho,
MD,
Michael
Flaum,
MD,
Nancy
Andreasen,
MD,
PhD
Mental Health Clinical Research Center. The University
of
Iowa. College
of
Medicine. Department
of
Psychiatry. Iowa
City, IA 52242. USA
Objective: It is clear that many, if not most, patients with
schizophrenia will require external financial support at some
time during their illness.Wesought to determine ifthey become
dependent upon such support early in the course of the illness.
Method:
48 patients were followed for at least 2 years after
their first hospitalization for schizophrenia (Mean duration of
fol1ow-up=6l months,
SD-23
.S). Sources of primary and
secondary income were recorded.
Results: At the time of first hospitalization, 7 (14.6%) were
already receiving financial assistance from a social agency. A
year later, this number rose to
29 (60.4%), while only 15
(31.3%) of the sample were self-supporting. Further analyses
demonstrate that the percent of patients requiring such support
increases gradually thereafter. The mean time period at which
these patients first became financially dependent on
a social
agency during the
follow-up was 9.2 months after the initial
hospitalization. Once they have begun receiving such support,
all patients except one remained so at their latest follow-up.
Conclusion:
Among patients hospitalized for schizophrenia,
the majority are financiallysupported by a social serviceagency
within the first year of their initial hospitalization and continue
to remain so thereafter.
b3b
DETERMINING
THE
TRUE
COSTS OF
BED-AND-BOARD
FOR
THE
SERIOUSLY
MENTALLY ILL.
1. PSYCHIATRIC
HOSPITALS
Gilbert
Honigfeld,
Ph.D.
Room D-317. Department
of
Psychiatry. Robert Wood Johnson
Medical School, Piscataway, New Jersey 08855. USA
How much is spent in the US on bed-and-board for individ-
uals with schizophrenia and other serious mental illnesses?This
