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Burr C, Richter D. Predictors of community mental health nursing services use in Switzerland: Results from a representative national survey. Int J Ment Health Nurs 2021; 30:1640-1648. [PMID: 34328258 DOI: 10.1111/inm.12917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/05/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023]
Abstract
Community mental health services are the service of choice in the mental health field. In recent years, demand for these services has increased significantly. Nurses play a central role in community mental health services. Nevertheless, predictive factors of the use of such services are unclear, especially in Switzerland. This study aimed to examine relevant predictors of persons with mental health problems' use of community mental health nursing services in Switzerland. Swiss Health Survey 2017 data were used to compare those who use community mental health nursing services with those who do not. We found that age, number of doctor visits, problems with instrumental activities of daily life, use of informal help, use of emergency services, taking psychotropic medication, being female, and living without a partner were positive predictors, while experiencing severe physical symptoms was a negative predictor. Several of our findings confirm the similarity between the utilization of community mental health nursing services and the use of community mental health services in general. Our results suggest that community mental health nursing services deserve the same prominent place in the mental health system and its corresponding policies. This should be taken as an argument for policy development and better reimbursement. In research, health surveys should focus on nursing and need-related questions. Additionally, it is necessary to develop community mental health nursing services from an add-on service into independent nursing services and evaluate these services.
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Affiliation(s)
- Christian Burr
- University Hospital of Psychiatry and Psychotherapy, Bern University Hospital for Mental Health, Bern, Switzerland
| | - Dirk Richter
- Centre for Psychiatric Rehabilitation, Bern University Hospital for Mental Health, Bern, Switzerland.,Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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Tian Y, Liu D, Wang D, Wang J, Xu H, Dai Q, Andriescue EC, Wu HE, Xiu M, Chen D, Wang L, Chen Y, Yang R, Wu A, Wei CW, Zhang X. Obesity in Chinese patients with chronic schizophrenia: Prevalence, clinical correlates and relationship with cognitive deficits. Schizophr Res 2020; 215:270-276. [PMID: 31653580 DOI: 10.1016/j.schres.2019.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 12/18/2022]
Abstract
The prevalence of obesity in schizophrenia patients is high, especially in chronic and medicated patients. Few studies have explored the relationships between obesity, cognition and clinical correlates in patients with schizophrenia. This study was designed to assess the prevalence and clinical correlates of obesity and its relationship to cognitive impairment in Chinese patients with schizophrenia. We recruited 633 inpatients and collected clinical, demographic data and lipid parameters. The Positive and Negative Syndrome Scale (PANSS) and its five-factor model were adopted for psychopathological symptoms. The prevalence of comorbid obesity in schizophrenia patients was 16.4%. The plasma levels of glucose, triglyceride, low density lipoprotein (LDL), apolipoprotein B, and cholesterol were higher, but high density lipoprotein (HDL) levels were lower in obese patients than those in non-obese patients (all p < 0.05). Furthermore, obese patients had lower PANSS negative symptom, cognitive factor and total scores than non-obese patients (all p < 0.05). Correlation analysis showed a significant correlation between BMI and the following variables: age, marriage, gender, negative symptoms, general psychopathological symptoms, cognitive factor, PANSS total score, glucose, triglycerides, HDL, LDL, cholesterol and apolipoprotein B (all p < 0.05). Further multiple regression showed that PANSS cognitive factor, PANSS total score, and triglyceride were important independent predictors of obesity. Our results indicate a high prevalence of obesity in Chinese patients with chronic schizophrenia. Multiple demographics, clinical variables, and lipid parameters are associated with obesity in schizophrenia. Moreover, obesity appears to be a protective factor for psychological symptoms. However, not having objective assessments for cognition in this study is a limitation.
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Affiliation(s)
- Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dianying Liu
- Departtment of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, Jiangxi Province, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiesi Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hang Xu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qilong Dai
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Elena C Andriescue
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hanjing E Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Meihong Xiu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dachun Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yiwen Chen
- Departtment of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, Jiangxi Province, China
| | - Ruilang Yang
- Departtment of Psychiatry, The Third People's Hospital of Ganzhou City, Ganzhou, Jiangxi Province, China
| | - Anshi Wu
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Chang Wei Wei
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Li Q, Du X, Zhang Y, Yin G, Zhang G, Walss-Bass C, Quevedo J, Soares JC, Xia H, Li X, Zheng Y, Ning Y, Zhang XY. The prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia. Psychiatry Res 2017; 251:131-136. [PMID: 28199911 DOI: 10.1016/j.psychres.2016.12.041] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 10/17/2016] [Accepted: 12/26/2016] [Indexed: 01/04/2023]
Abstract
Obesity is a common comorbidity in schizophrenia. Few studies have addressed obesity in Chinese schizophrenia patients. The aims of this current study were to evaluate the prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia. A total of 206 patients were recruited from a hospital in Beijing. Their clinical and anthropometric data together with plasma glucose and lipid parameters were collected. Positive and Negative Syndrome Scale (PANSS) was rated for all patients. Overall, 43 (20.9%) patients were obese and 67 (32.5%) were overweight. The obese patients had significantly higher glucose levels, triglyceride levels than non-obese patients. Females and patients with type 2 diabetes mellitus had increased risk for obesity. Correlation analysis showed that BMI was associated with sex, education levels, negative symptoms, total PANSS score, triglyceride levels and type 2 diabetes mellitus. Further stepwise regression analysis showed that sex, type 2 diabetes, education level, triglyceride and amount of smoking/day were significant predictors for obesity. Our study showed that the prevalence of obesity in Chinese patients with schizophrenia is higher than that in the general population. Some demographic and clinical variables are risk factors for obesity in schizophrenia.
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Affiliation(s)
- Qiongzhen Li
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xiangdong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Yingyang Zhang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Guangzhong Yin
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Guangya Zhang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Consuelo Walss-Bass
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - João Quevedo
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Haishen Xia
- Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Xiaosi Li
- Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Yingjun Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xiang Yang Zhang
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA; Psychiatry Research Center, Beijing HuiLongGuan Hospital, Beijing, China.
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Petkari E, Mayoral F, Moreno-Küstner B. Gender matters in schizophrenia-spectrum disorders: Results from a healthcare users epidemiological study in Malaga, Spain. Compr Psychiatry 2017; 72:136-143. [PMID: 27816847 DOI: 10.1016/j.comppsych.2016.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/28/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Women suffering from schizophrenia-spectrum disorders may differ from men in clinical course and outcome. Still, those differences can only be portrayed accurately by means of studies that derive information from multiple sources. One such study was performed in a well-defined area supported by a Mental Health Clinical Management Unit in Malaga, Spain. METHODS Data from 1640 patients (1048 men and 592 women) that were in contact with services during 2008 were examined for the purpose of the present analysis. Gender differences in sociodemographic and clinical characteristics and the role of gender for explaining clinical characteristics (diagnosis, disease severity and service use) beyond potential sociodemographic confounders were explored. RESULTS The chi-squared analysis results revealed that in comparison to men, women were older, married or widowed/divorced and living as housewives with their families in cities. Genders also differed across diagnoses, with men being at higher risk for suffering from paranoid schizophrenia, while women being at higher risk for persistent delusional, acute/transitory and schizoaffective disorders. Furthermore, men had greater disease severity and higher chances to visit the mental health rehabilitation unit (MHRU). Further regression analyses revealed that after controlling for confounders, gender differences remained significant across diagnoses and severity. However, they lost their significance under the influence of marital, living and occupational status when predicting the use of MHRU. CONCLUSION Results confirm the existence of gender differences and highlight the importance of other factors for designing effective psychosocial services that are tailor-made to the patients' needs.
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Affiliation(s)
- Eleni Petkari
- Department of Psychology, School of Humanities and Social Sciences, European University of Cyprus, Nicosia, Cyprus; Department of Psychology, School of Science and Technology, Middlesex University Dubai, Dubai, United Arab Emirates; International Maristan Network.
| | - Fermín Mayoral
- Regional Hospital of Malaga, Spain, Galvez Ginachero Avenue s/n, Malaga 29009, Spain; Biomedicine Institute of Malaga-IBIMA, Avda Jorge Luis Borges, 15, 3,3ª, Malaga, 29019, Spain; International Maristan Network.
| | - Berta Moreno-Küstner
- Biomedicine Institute of Malaga-IBIMA, Avda Jorge Luis Borges, 15, 3,3ª, Malaga, 29019, Spain; Department of Personality, Assessment and Psychological Treatment, University of Malaga, Campus Teatinos s/n, Malaga 18071, Spain; Andalusian Psychosocial Research Group-GAP, Malaga, Spain; International Maristan Network.
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Moreno-Küstner B, Mayoral F, Navas-Campaña D, García-Herrera JM, Angona P, Martín C, Rivas F. Prevalence of schizophrenia and related disorders in Malaga (Spain): results using multiple clinical databases. Epidemiol Psychiatr Sci 2016; 25:38-48. [PMID: 25315825 PMCID: PMC6998667 DOI: 10.1017/s2045796014000614] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 07/21/2014] [Accepted: 08/20/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To calculate the 1-year prevalence of schizophrenia and related disorders in a catchment area of Malaga (Spain) and determine the prevalence by gender, dwelling (rural or urban) and socioeconomic area (deprived or non-deprived area). METHOD This cross-sectional study comprised the mental health area covered by Carlos Haya Hospital. We used multiple large clinical databases and key informants to identify cases. RESULTS The mean 1-year prevalence of schizophrenia and related disorders was 6.27 per 1000. It was nearly double in men (8.45 per 1000) than in women (4.26 per 1000) (p < 0.001), with a male-to-female ratio of 1.98. The rate was higher in urban (6.64 per 1000) than rural areas (3.95 per 1000) (p < 0.0001) and in socioeconomic deprived areas (7.56 per 1000) than non-deprived areas (6.12 per 1000) (p = 0.005). For the subgroup of schizophrenia, the rates were: men, 5.88 per 1000 and women, 2.2 per 1000 (p < 0.0001), with a male-to-female ratio of 2.67. The rate was also higher in urban (4.2 per 1000) than rural areas (2.49 per 1000) (p < 0.0001) and in socioeconomic deprived areas (4.49 per 1000) than non-deprived areas (3.9 per 1000) (p = 0.149). CONCLUSIONS The use of multiple clinical sources of information not only from mental health services, but also from emergency departments, primary care and private settings revealed high prevalence rates of schizophrenia and related disorders. This diagnosis is more common in men and in cities. Such precise estimates of the prevalence of schizophrenia have important repercussions for resource allocation and policy planning.
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Affiliation(s)
- B. Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
| | - F. Mayoral
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
| | - D. Navas-Campaña
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
| | - J. M. García-Herrera
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
| | - P. Angona
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
| | - C. Martín
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
| | - F. Rivas
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Spain
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Torres-González F, Ibanez-Casas I, Saldivia S, Ballester D, Grandón P, Moreno-Küstner B, Xavier M, Gómez-Beneyto M. Unmet needs in the management of schizophrenia. Neuropsychiatr Dis Treat 2014; 10:97-110. [PMID: 24476630 PMCID: PMC3897352 DOI: 10.2147/ndt.s41063] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Studies on unmet needs during the last decades have played a significant role in the development and dissemination of evidence-based community practices for persistent schizophrenia and other severe mental disorders. This review has thoroughly considered several blocks of unmet needs, which are frequently related to schizophrenic disorders. Those related to health have been the first block to be considered, in which authors have examined the frequent complications and comorbidities found in schizophrenia, such as substance abuse and dual diagnosis. A second block has been devoted to psychosocial and economic needs, especially within the field of recovery of the persistently mentally ill. Within this block, the effects of the current economic difficulties shown in recent literature have been considered as well. Because no patient is static, a third block has reviewed evolving needs according to the clinical staging model. The fourth block has been dedicated to integrated evidence-based interventions to improve the quality of life of persons with schizophrenia. Consideration of community care for those reluctant to maintain contact with mental health services has constituted the fifth block. Finally, authors have aggregated their own reflections regarding future trends. The number of psychosocial unmet needs is extensive. Vast research efforts will be needed to find appropriate ways to meet them, particularly regarding so-called existential needs, but many needs could be met only by applying existing evidence-based interventions. Reinforcing research on the implementation strategies and capacity building of professionals working in community settings might address this problem. The final aim should be based on the collaborative model of care, which rests on the performance of a case manager responsible for monitoring patient progress, providing assertive follow-up, teaching self-help strategies, and facilitating communication among the patient, family doctor, mental health specialist, and other specialists.
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Affiliation(s)
- Francisco Torres-González
- Centro de Investigación Biomédica en Red de Salud Mental, University of Granada, Spain ; Maristán Network, University of Granada, Granada, Spain
| | - Inmaculada Ibanez-Casas
- Centro de Investigación Biomédica en Red de Salud Mental, University of Granada, Spain ; Maristán Network, University of Granada, Granada, Spain
| | - Sandra Saldivia
- Department of Psychiatry and Mental Health, Faculty of Medicine, University of Concepcion, Chile ; Maristán Network, University of Granada, Granada, Spain
| | - Dinarte Ballester
- Sistema de Saúde Mãe de Deus, Escola Superior de Saúde, Universidade do Vale do Rio dos Sinos, Brazil ; Maristán Network, University of Granada, Granada, Spain
| | - Pamela Grandón
- Department of Psychology, Faculty of Social Sciences, University of Concepcion, Chile ; Maristán Network, University of Granada, Granada, Spain
| | - Berta Moreno-Küstner
- Andalusian Psychosocial Research Group and Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Malaga, Spain ; Maristán Network, University of Granada, Granada, Spain
| | - Miguel Xavier
- Department of Mental Health, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal ; Maristán Network, University of Granada, Granada, Spain
| | - Manuel Gómez-Beneyto
- Centro de Investigación Biomédica en Red de Salud Mental, University of Valencia, Spain ; Maristán Network, University of Granada, Granada, Spain
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Moreno-Küstner B, Mayoral F, Rivas F, Angona P, Requena J, García-Herrera JM, Navas D, Moreno P, Serrano-Blanco A, Bellón JA. Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis. BMC Health Serv Res 2011; 11:257. [PMID: 21982430 PMCID: PMC3210099 DOI: 10.1186/1472-6963-11-257] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 10/07/2011] [Indexed: 11/10/2022] Open
Abstract
Background Persons with schizophrenia and related disorders may be particularly sensitive to a number of determinants of service use, including those related with illness, socio-demographic characteristics and organizational factors. The objective of this study is to identify factors associated with outpatient contacts at community mental health services of patients with schizophrenia or related disorders. Methods This cross-sectional study analyzed 1097 patients. The main outcome measure was the total number of outpatient consultations during one year. Independent variables were related to socio-demographic, clinical and use of service factors. Data were collected from clinical records. Results The multilevel linear regression model explained 46.35% of the variance. Patients with significantly more contacts with ambulatory services were not working and were receiving welfare benefits (p = 0.02), had no formal education (p = 0.02), had a global level of severity of two or three (four being the most severe) (p < 0.001), with one or more inpatient admissions (p < 0.001), and in contact with both types of professional (nurses and psychiatrists) (p < 0.001). The patients with the fewest ambulatory contacts were those with diagnoses of persistent delusional disorders (p = 0.04) and those who were attended by four of the 13 psychiatrists (p < 0.001). Conclusions As expected, the variables that explained the use of community service could be viewed as proxies for severity of illness. The most surprising finding, however, was that a group of four psychiatrists was also independently associated with use of ambulatory services by patients with schizophrenia or related disorders. More research is needed to carefully examine how professional support networks interact to affect use of mental health.
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Affiliation(s)
- Berta Moreno-Küstner
- Research Unit Distrito Sanitario Malaga, IMABIS Fundation, Department of Personality, Evaluation and Psychological Treatment, University of Malaga, Spain.
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Moreno-Küstner B, Mayoral F, Pérez O, García-Herrera JM, Algarra J, Rivas F, Pérez R, Becerra F, Gornemann I. The Malaga schizophrenia case-register (RESMA): overview of methodology and patient cohort. Int J Soc Psychiatry 2009; 55:5-15. [PMID: 19129322 DOI: 10.1177/0020764008092237] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Little information has become available after psychiatric reforms regarding outcomes of persons with schizophrenia and related disorders cared for in community-based mental health facilities. AIMS The aim of this study was to determine the consequences of psychiatric services in the users of mental health services in Malaga. METHOD We describe the cohort and methods involved in the Schizophrenia Case Register (RESMA) in Malaga, Spain. All cases (n = 1,022) were users of public mental health services provided in the catchment area over one year. The majority were male (65%), single (68%), living with their original family (50%), with primary education (41%) and living on disability benefits (52%). RESULTS Concerning use of services, the majority had out-patient contacts (89%). RESULT s show a substantial overlap in the use of different services during the study period. CONCLUSION The Malaga Schizophrenia Case Register provides sociodemographic, clinical and service use information for a large sample of patients with schizophrenia or related disorders. Results obtained from the cohort studied will be instrumental for the follow-up and evaluation of the mental health care reform.
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Affiliation(s)
- Berta Moreno-Küstner
- Faculty of Psychology, University of Málaga, IMABIS Foundation Avda Principal del Candado, 15 degrees C-1, 29018 Málaga, Spain.
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Abstract
PURPOSE OF REVIEW To follow up on reviews of case register research. Literature searches over a 2-year period were conducted to determine whether psychiatric case registers still have a role for research and service monitoring. RECENT FINDINGS Case register research covers a wide range of topics, and is most often found in Denmark where national databases support all kinds of record linkage studies. Typically, case registers are used in studies of treated prevalence and incidence of psychiatric disorders, in research on patterns of care, as sampling frames in epidemiological studies, and in studies on risk factors and treatment outcome. SUMMARY Despite a wide range of research based on administrative data, stakeholders in most countries are probably not well served by current priorities. Few studies investigate longitudinal patterns of service use to evaluate healthcare policies. There is a lack of comparative record linkage studies to inform local authorities on the cooperation between mental healthcare and public services. Implementing standard tools and procedures for routine outcome assessment seems still to be in an early phase in most register areas. When case register staff can capitalize on new opportunities, old and new case registers will continue to be important for research and service monitoring.
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