Psychiatrists-perceptions of the clinical importance, assessment and management of patient functioning in schizophrenia in Europe, the Middle East and Africa

详细信息    查看全文

• 作者：Philip Gorwood (1) (2)
  Tom Burns (3)
  Georg Juckel (4)
  Alessandro Rossi (5)
  Luis San (6)
  Ludger Hargarter (7)
  Andreas Schreiner (7)
  
• 关键词：Assessment ; Functioning ; Management ; Psychiatrist ; Schizophrenia ; Survey
• 刊名：Annals of General Psychiatry
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：12
• 期：1
• 全文大小：317KB
• 参考文献：1. Falkai P, Wobruck T, Lieberman J, Glenthoj B, Gattaz WF, M?ller HJ, WFSBP Task Force on Treatment Guidelines for Schizophrenia: World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 1: acute treatment of schizophrenia. / World J Biol Psychiatry 2005, 6:132-91. CrossRef
  2. Awad AG, Voruganti LN: The burden of schizophrenia on caregivers: a review. / Pharmacoeconomics 2008, 26:149-62. CrossRef
  3. American Psychiatric Association: / Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Arlington: American Psychiatric Association; 1994:297-13.
  4. Harvey PD, Green MF, Keefe RS, Velligan DI: Cognitive functioning in schizophrenia: a consensus statement on its role in the definition and evaluation of effective treatments for the illness. / J Clin Psychiatry 2004, 65:361-72. CrossRef
  5. Harvey PD, Bellack AS: Toward a terminology for functional recovery in schizophrenia: is functional remission a viable concept? / Schizophr Bull 2009, 35:300-06. CrossRef
  6. Priebe S: Social outcomes in schizophrenia. / Br J Psychiatry 2007,191(Suppl 50):s15-s20. CrossRef
  7. Burns T, Patrick D: Social functioning as an outcome measure in schizophrenia studies. / Acta Psychiatr Scand 2007, 116:403-18. CrossRef
  8. / NICE: CG82 Schizophrenia (update): full guideline. [http://guidance.nice.org.uk/CG82/Guidance] []
  9. Wiersma D, Wanderling J, Dragomirecka E, Ganev K, Harrison G, An Der Heiden W, Nienhuis FJ, Walsh D: Social disability in schizophrenia: its development and prediction over 15 years in incidence cohorts in six European centres. / Psychol Med 2000, 30:1155-167. CrossRef
  10. Bellack AS, Green MF, Cook JA, Fenton W, Harvey PD, Heaton RK, Laughren T, Leon AC, Mayo DJ, Patrick DL, Patterson TL, Rose A, Stover E, Wykes T: Assessment of community functioning in people with schizophrenia and other severe mental illnesses: a white paper based on an NIMH-sponsored workshop. / Schizophr Bull 2007, 33:805-22. CrossRef
  11. Bond GR, Drake RE: Predictors of competitive employment among patients with schizophrenia. / Curr Opin Psychiatry 2008, 21:362-69. CrossRef
  12. Rosenheck R, Leslie D, Keefe R, McEvoy J, Swartz M, Perkins D, Stroup S, Hsiao JK, Lieberman J, CATIE Study Investigators Group: Barriers to employment for people with schizophrenia. / Am J Psychiatry 2006, 163:411-17. CrossRef
  13. Juckel G, Morosini PL: The new approach: psychosocial functioning as a necessary outcome criterion for therapeutic success in schizophrenia. / Curr Opin Psychiatry 2008, 21:630-39. CrossRef
  14. Nasrallah HA, Lasser R: Improving patient outcomes in schizophrenia: achieving remission. / J Psychopharmacol 2006,20(Suppl 6):57-1. CrossRef
  15. Ventura J, Subotnik KL, Guzik LH, Hellemann GS, Gitlin MJ, Wood RC, Nuechterlein KH: Remission and recovery during the first outpatient year of the early course of schizophrenia. / Schizophr Res 2011, 132:18-3. CrossRef
  16. / APA: Practice guideline for the treatment of patients with schizophrenia, second edition; 2004. [http://psychiatryonline.org/index.aspx] []
  17. European Medicines Agency: / Draft Guideline ‘Clinical Investigation of Medicinal Products in the Treatment of Schizophrenia. London: European Medicines Agency; 2011.
  18. Gorwood P, Peuskens J, European Group On Functional Outcomes, Remission in Schizophrenia: Setting new standards in schizophrenia outcomes: symptomatic remission 3 years before versus after the Andreasen criteria. / Eur Psychiatry 2012,27(Suppl 3):170-75. CrossRef
  19. Pandina GJ, Lindenmayer JP, Lull J, Lim P, Gopal S, Herben V, Kusumakar V, Yuen E, Palumbo J: A randomized, placebo-controlled study to assess the efficacy and safety of 3 doses of paliperidone palmitate in adults with acutely exacerbated schizophrenia. / J Clin Psychopharm 2010, 30:235-44. CrossRef
  20. Kahn RS, Fleischhacker WW, Boter H, Davidson M, Vergouwe Y, Keet IP, Gheorghe MD, Rybakowski JK, Galderisi S, Libiger J, Hummer M, Dollfus S, López-Ibor JJ, Hranov LG, Gaebel W, Peuskens J, Lindefors N, Riecher-R?ssler A, Grobbee DE, EUFEST Study Group: Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. / Lancet 2008, 371:1085-097. CrossRef
  21. Olivares JM, Rodriguez-Morales A, Diels J, Povey M, Jacobs A, Zhao Z, Lam A, Villalobos Vega JC, Cuéllar JA, de Castro FJ, Quintero CM, Martíin JF, Domínguez P, Ojeda JL, Cortés SS, Cala FI, Marín CG, Castro LM, Duaso MA, Albarracín JR, Vergara GN, Benítez AF, Cleries FM, Pérez-Brian JM, Aragón AB, Navarro JC, Biedma JA, de Pedro RB, González JF, López ME: Long-term outcomes in patients with schizophrenia treated with risperidone long-acting injection or oral antipsychotics in Spain: results from the electronic Schizophrenia Treatment Adherence Registry (e-STAR). / Eur Psychiatry 2009, 24:287-96. CrossRef
  22. Jang JH, Shin NY, Shim G, Park HY, Kim E, Jang GE, Kwon SJ, Hur JW, An SK, Kwon JS: Longitudinal patterns of social functioning and conversion to psychosis in subjects at ultra-high risk. / Aust NZ J Psychiatry 2011, 45:763-70. CrossRef
  23. Kane J, Canas F, Kramer M, Ford L, Gassmann-Mayer C, Lim P, Eerdekens M: Treatment of schizophrenia with paliperidone extended-release tablets: a 6-week placebo-controlled trial. / Schizophr Res 2007, 90:147-61. CrossRef
  24. Mortimer A, Martin S, L?o H, Peuskens J, SOLIANOL Study Group: A double-blind, randomized comparative trial of amisulpride versus olanzapine for 6 months in the treatment of schizophrenia. / Int Clin Psychopharmacol 2004, 19:63-9. CrossRef
  25. Kern RS, Glynn SM, Horan WP, Marder SR: Psychosocial treatments to promote functional recovery in schizophrenia. / Schizophr Bull 2009, 35:347-61. CrossRef
  26. Roder V, Mueller DR, Schmidt SJ: Effectiveness of integrated psychological therapy (IPT) for schizophrenia patients: a research update. / Schizophr Bull 2011,37(Suppl 2):S71-S79. CrossRef
  27. Grant PM, Huh GA, Perivoliotis D, Stolar NM, Back AT: Randomized trial to evaluate the efficacy of cognitive therapy for low-functioning patients with schizophrenia. / Arch Gen Psychiatry 2012, 69:121-27. CrossRef
  28. Fleischhacker WW, Rabinowitz J, Kemmler G, Eerdekens M, Mehnert A: Perceived functioning, well-being and psychiatric symptoms in patients with stable schizophrenia treated with long-acting risperidone for 1 year. / Br J Psychiatry 2005, 187:131-36. CrossRef
  29. San L, Ciudad A, Alvarez E, Bobes J, Gilaberte J: Symptomatic remission and social/vocational functioning in outpatients with schizophrenia: prevalence and associations in a cross-sectional study. / Eur Psychiatry 2007, 22:490-98. CrossRef
  30. Huppert JD, Weiss KA, Lim R, Pratt S, Smith TE: Quality of life in schizophrenia: contributions of anxiety and depression. / Schizophr Res 2001, 51:171-80. CrossRef
  31. Lambert M, Naber D, Schacht A, Wagner T, Hundemer HP, Karow A, Huber CG, Suarez D, Haro JM, Novick D, Dittmann RW, Schimmelmann BG: Rates and predictors of remission and recovery during 3 years in 392 never-treated patients with schizophrenia. / Acta Psychiatr Scand 2008, 118:220-29. CrossRef
  32. Docherty JP, Bossie CA, Lachaux B, Bouhours P, Zhu Y, Lasser R, Gharabawi GM: Patient-based and clinician-based support for the remission criteria in schizophrenia. / Int Clin Psychopharmacol 2007, 22:51-5.
  33. Lambert M, Schimmelmann BG, Naber D, Eich FX, Schulz H, Huber CG, Karow A: Early- and delayed antipsychotic response and prediction of outcome in 528 severely impaired patients with schizophrenia treated with amisulpride. / Pharmacopsychiatry 2009, 42:277-83. CrossRef
  34. de Haan L, Nimwegen L, Amelsvoort T, Dingemans P, Linszen D: Improvement of subjective well-being and enduring symptomatic remission, a 5-year follow-up of first episode schizophrenia. / Pharmacopsychiatry 2008, 41:125-28. CrossRef
  35. Karow A, Naber D, Lambert M, Moritz S, EGOFORS Initiative: Remission as perceived by people with schizophrenia, family members and psychiatrists. / Eur Psychiatry 2012, 27:401-05. CrossRef
  36. American Psychiatric Association: / Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Text Revision. Arlington: American Psychiatric Association; 2000:817-18. CrossRef
  37. Llorca PM, Lan?on C, Lancrenon S, Bayle FJ, Caci H, Rouillon F, Gorwood P: The “Functional Remission of General Schizophrenia-(FROGS) scale: development and validation of a new questionnaire. / Schizophr Res 2009, 113:218-25. CrossRef
  38. Endicott J, Spitzer RL, Fleiss JL, Cohen J: The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. / Arch Gen Psychiatry 1976, 33:766-71. CrossRef
  39. Morosini PL, Magliano L, Brambilla L, Ugolini S, Pioli R: Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. / Acta Psychiatr Scand 2000, 101:323-29.
  40. Brissos S, Molodynski A, Dias VV, Figueira ML: The importance of measuring psychosocial functioning in schizophrenia. / Ann Gen Psychiatry 2011, 10:18. CrossRef
  41. Balanzá V, Bobes J, Fernando C, García P, Martinez MR, Olivares JM, Rodríguez A, Herrero MS, San L: La funcionalidad en el paciente con trastorno mental grave: una encuesta de opinion entre psiquiatras espa?oles. / Rev Psiquiatr Salud Ment (Barc) 2011,4(Suppl 1):1-.
  42. Helldin L, Kane JM, Karilampi U, Norlander T, Archer T: Remission in prognosis of functional outcome: a new dimension in the treatment of patients with psychotic disorders. / Schizophr Res 2007, 93:160-68. CrossRef
  43. Buckley PF, Harvey PD, Bowie CR, Loebel A: The relationship between symptomatic remission and neuropsychological improvement in schizophrenia patients switched to treatment with ziprasidone. / Schizophr Res 2007, 94:99-06. CrossRef
  44. Peuskens J, Gorwood P, EGOFORS Initiative: How are we assessing functioning in schizophrenia? A need for a consensus approach. / Eur Psychiatry 2011, 27:391-95. CrossRef
  45. Schaub D, Brüne M, Jaspen E, Pajonk FG, Bierhoff HW, Juckel G: The illness and everyday living: close interplay of psychopathological syndromes and psychosocial functioning in chronic schizophrenia. / Eur Arch Psychiatry Clin Neurosci 2011, 261:85-3. CrossRef
  46. Lambert M, Naber D: Current issues in schizophrenia: overview of patient acceptability, functioning capacity and quality of life. / CNS Drugs 2004,18(Suppl 2):5-7. CrossRef
  47. Hunter R, Barry S: Negative symptoms and psychosocial functioning in schizophrenia: neglected but important targets for treatment. / Eur Psychiatry 2012, 27:432-36. CrossRef
  48. Figueira ML, Brissos S: Measuring psychosocial outcomes in schizophrenia patients. / Curr Opin Psychiatry 2011, 24:91-9.
  
• 作者单位：Philip Gorwood (1) (2)
  Tom Burns (3)
  Georg Juckel (4)
  Alessandro Rossi (5)
  Luis San (6)
  Ludger Hargarter (7)
  Andreas Schreiner (7)
  
  1. CMME, Sainte-Anne Hospital, Paris-Descartes University, 100 rue de la Santé, Paris, Cedex 14, 75674, France
  2. INSERM UMR894, Centre of Psychiatry and Neuroscience, 2ter rue d’Alesia, Paris, 75014, France
  3. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK
  4. Psychiatrie, LWL-Universitaetsklinikum der Ruhr-Universitaet Bochum, Bochum, 44791, Germany
  5. Department of Experimental Medicine, University de L’Aquila, Coppito II, L’Aquila, 67100, Italy
  6. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, Barcelona, 08950, Spain
  7. Department of Medical and Scientific Affairs, Janssen EMEA, Johnson & Johnson Platz 1, Neuss, 41470, Germany
  

文摘

Background It has been estimated that as many as two thirds of patients with schizophrenia are unable to perform basic personal and social roles or activities. Occupational functioning and social functioning, as well as independent living, are considered as core domains of patient functioning. Improvement in patient functioning has also been recognized as an important treatment goal in guidelines and an important outcome by regulatory agencies. Nevertheless, information is lacking on how these aspects are being considered by psychiatrists across the world and how they are being assessed and managed. Methods The ‘Europe, the Middle East and Africa functioning survey-was designed to canvas opinions of psychiatrists across these regions to ascertain their perceptions of the clinical importance, assessment and management of functioning amongst their patients with schizophrenia. The survey comprised 17 questions and was conducted from March to April 2011 in 42 countries. Data collected included the demographics of respondents and their opinions regarding personal and social functioning in patients with schizophrenia. Results Results were obtained from 4,163 clinicians. Psychiatrists estimated that more than two thirds (70%) of their patients with schizophrenia showed impaired or very poor levels of functioning. The majority of psychiatrists (92%) believed that personal and social functioning was an important treatment goal for patients with schizophrenia, and 91% believed it was an important goal for patients-families. The majority of psychiatrists (55%) assess the personal and social functioning of their patient at each visit; however, 81% reported that they determine the level of functioning through clinical interview and not by using a specific assessment scale. To manage personal and social functioning in their patients, 26% of psychiatrists prefer pharmacological interventions, whereas 46% prefer psychosocial interventions. Conclusion Psychiatrists recognize that functioning is impaired/very poor in patients with schizophrenia, and there is still an important need to address functioning as a main treatment goal for patients with schizophrenia.