Aims
The purpose was to compare the frequency of needs of patients with schizophrenia in forensic services across five European countries as assessed by both the patients and their care staff.
Methods
Patients with schizophrenia and a history of significant interpersonal violence were recruited from forensic psychiatric services in Austria, Germany, Italy, Poland and England. Participants’ needs were assessed using the Camberwell Assessment of Needs—Forensic Version (CANFOR). Multiple linear regression analyses were used to identify predictors of numbers of needs.
Results
In this sample, (n = 221) the most commonly reported need according to patients (71.0%) and staff (82.8%) was the management of psychotic symptoms. A need for information was mentioned by about 45% of staff and patients. Staff members reported a significantly higher number of total needs than patients (mean 6.9 vs. 6.2). In contrast, staff members reported a significantly lower number of unmet needs than patients (mean 2.0 vs. 2.5). Numbers of total needs and met needs differed between countries. Unmet needs as reported by patients showed positive associations with the absence of comorbid personality disorder, with higher positive symptom scores and lifetime suicide or self-harm history. Significant predictors of unmet needs according to staff were absence of comorbid personality disorder and higher positive as well as negative symptom scores according to PANSS.
Conclusions
Staff rated a significantly higher number of total needs than patients, while patients rated more unmet needs. This indicates that patients’ self-assessments of needs yield important information for providing sufficient help and support.
Zusammenfassung Hintergrund Weltweit und insbesondere im stationärpsychiatrischen Setting weist die emotional instabile Persönlichkeitsstörung (EIPS) hohe Prävalenzen auf, die sich hinsichtlich Alter und Geschlecht unterscheiden. Aufgrund des komplexen Krankheitsbildes, wiederholten Aufnahmen und hohen Kosten, wird das Gesundheitssystem vor große Herausforderungen gestellt. Methoden Für die Berechnungen wurden Statistik Austria-Daten der stationären Aufenthalte von Patienten mit psychischen und Verhaltensstörungen unter besonderer Berücksichtigung der EIPS als Hauptentlassungsdiagnose in Österreich im Zeitraum von 2001-2016 verwendet. Eingeschlossen wurden Patienten mit einem Alter über 14 Jahre, Aufnahme an einer psychiatrischen Klinik in der Akutversorgung und maximale Aufenthaltsdauer von 365 Tagen. Alter, Geschlecht und Aufenthaltsdauer wurden mit SPSS ® analysiert, in deskriptiver Form ausgewertet und zueinander in Bezug gesetzt. Aus Gründen der besseren Lesbarkeit wurde darauf verzichtet, geschlechtsspezifische Formulierungen zu verwenden. Soweit personenbezogene Bezeichnungen nur in männlicher Form angeführt sind, beziehen sie sich auf Männer und Frauen in gleicher Weise.
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