Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-17T01:18:23.018Z Has data issue: false hasContentIssue false

The Nordic Study on schizophrenic patients living in the community. Subjective needs and perceived help

Published online by Cambridge University Press:  16 April 2020

T. Middelboe*
Affiliation:
Community Mental Health Center, Bispebjerg University Hospital, Copenhagen, and Department of Psychiatry, Gentofte University Hospital, Denmark;
T. Mackeprang
Affiliation:
Community Mental Health Center, Bispebjerg University Hospital, Copenhagen, and Department of Psychiatry, Gentofte University Hospital, Denmark;
L. Hansson
Affiliation:
Department of Clinical Neuroscience, Division of Psychiatry, Lund University, Lund, Sweden;
G. Werdelin
Affiliation:
Roskilde County Hospital, Fjorden, Roskilde, Denmark;
H. Karlsson
Affiliation:
Department of Psychiatry, Turku University, Turku, Finland;
O. Bjarnason
Affiliation:
Department of Psychiatry, Landspitallin, Reykjavik, Iceland;
A. Bengtsson-Tops
Affiliation:
Department of Psychiatry, Sector West, Malmö, Sweden;
J. Dybbro
Affiliation:
Department of Psychiatric Demography, Institute for Basic Psychiatric Research, University of Aarhus, Denmark;
L.L. Nilsson
Affiliation:
Department of Psychiatry, Sector North-East, Malmö, Sweden;
M. Sandlund
Affiliation:
Department of Clinical Science, Division of Psychiatry, Umeå University, Sweden;
K.W. Sörgaard
Affiliation:
Nordland Psychiatric Hospital, Bodø, Norway
*
*Correspondence and reprints: Department of Psychiatry, Gentofte University Hospital, DK-2400 Hellerup, Denmark E-mail address: [email protected] (T. Middelboe).
Get access

Summary

In a community sample of 418 persons diagnosed with schizophrenia, subjective needs and perceived help was measured by the Camberwell Assessment of Need (CAN). The mean number of reported needs was 6.2 and the mean number of unmet needs 2.6. The prevalence of needs varied substantially between the need areas from 3.6% (‘telephone’) to 84.0% (‘psychotic symptoms’). The rate of satisfaction estimated as the percentage of persons satisfied with the help provided within an area varied between 20.0% (‘telephone’) and 80.6% (‘food’).

The need areas concerning social and interpersonal functioning demonstrated the highest proportion of unmet to total needs.

In a majority of need areas the patients received more help from services than from relatives, but in the areas of social relations the informal network provided substantial help. In general the patients reported a need for help from services clearly exceeding the actual amount of help received.

In a linear regression model symptom load (BPRS) and impaired functioning (GAF) were significant predictors of the need status, explaining 30% of the variance in total needs and 20% of the variance in unmet needs.

It is concluded that the mental health system fails to detect and alleviate needs in several areas of major importance to schizophrenic patients. Enhanced collaboration between the care system and the informal network to systematically map the need profile of the patients seems necessary to minimise the gap between perceived needs and received help.

Type
Original article
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, DSM-IV 4th ed. Washington DC: American Psychiatric Association; 1994.Google Scholar
Bhui, K., Puffet, A., Herriot, P.A survey of sexual problems amongst psychiatric inpatients. Soc Psychiatry Psychiatr Epidemiol 1995; 30: 7377.CrossRefGoogle ScholarPubMed
Birchwood, M., Smith, J., Cochrane, R.Specific and non-specific effects of educational intervention for families living with schizophrenia. A comparison of three methods. Br J Psychiatry 1992; 160: 806814.CrossRefGoogle ScholarPubMed
Brewin, C.Measuring individual needs for care and services. In: Thornicroft, G., Brewin, C., Wing, J., Measuring mental health ne. London: Gaskell; 1993. p. 220236.Google Scholar
Hansson, L., Bjorkman, T., Svensson, B.The assessment of needs in psychiatric patients. Interrater reliability of the Swedish version of the Camberwell Assessment of Needs instrument and results from a cross-sectional study. Acta Psychiatr Scand 1995; 92: 285293.CrossRefGoogle ScholarPubMed
Hansson, L., Middelboe, T., Merinder, L., Bjarnason, O., Bengtsson-Topps, A., Nilsson, L., et al. Predictors of subjective quality of life in schizophrenic patients living in the community. A Nordic multicenter study. Int J Soc Psychiatry 1999; 45: 247258.CrossRefGoogle Scholar
Herz, M.I., Lamberti, J.S., Mintz, J., Scott, R., O’Dell, S.P., McCartan, L. et al. A program for relapse prevention in schizophrenia: a controlled study. Arch Gen Psychiatry 2000; 57: 277283.CrossRefGoogle ScholarPubMed
Holloway, F.Need in community psychiatry: a consensus is required. Psychiatr Bull 1993; 18: 321323.CrossRefGoogle Scholar
Leese, M., Johnson, S., Slade, M., Parkman, S., Kelly, F., Phelan, M. et al. User perspective on needs and satisfaction with mental health services. PRiSM Psychosis Study. 8. Br J Psychiatry 1998; 173: 409415.CrossRefGoogle ScholarPubMed
Lehtinen, V., Joukamaa, M., Jyrkinen, E., Lahtela, K., Raitasalo, R., Maatela, J. et al. Need for mental health services of the adult population in Finland: results from the Mini Finland Health Survey. Acta Psychiatr Scand 1990; 81: 426431.CrossRefGoogle ScholarPubMed
Miller, L.J.Sexuality, reproduction, and family planning in women with schizophrenia. Schizophr Bull 1997; 23: 623635.CrossRefGoogle ScholarPubMed
Nielsen, L.F., Middelboe, T., Werdelin, G., Petersen, L., Mackeprang, T., Mortensen, E.L. et al. Needs assessment in long-term psychiatric patients. Inter-rater and test-retest reliability of the Danish version of the Camberwell Assessment of Need. Nord J Psychiatry 1999; 53: 371376.CrossRefGoogle Scholar
Overall, J.E., Gorham, D.R.The Brief Psychiatric Rating Scale (BPRS). Psychol Rep 1962; 10: 799812.CrossRefGoogle Scholar
Phelan, M., Slade, M., Thornicroft, G., Dunn, G., Holloway, F., Wykes, T. et al The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. Br J Psychiatry 1995; 167: 589595.CrossRefGoogle ScholarPubMed
Slade, M., Phelan, M., Thornicroft, G., Parkman, S.The Camberwell Assessment of Need (CAN): comparison of assessments by staff and patients of the needs of the severely mentally ill. Soc Psychiatry Psychiatr Epidemiol 1996; 31: 109113.CrossRefGoogle ScholarPubMed
Stein, L.I., Santos, A.B.Assertive community treatment of persons with severe mental illness. New York: Norton; 1998.Google Scholar
Submit a response

Comments

No Comments have been published for this article.