DAily time use, Physical Activity, quality of care and interpersonal relationships in patients with Schizophrenia spectrum disorders (DiAPASon): an Italian multicentre study

Abstract

Background Schizophrenia spectrum disorders (SSD) are ranked among the leading causes of disabilities worldwide. Many people with SSD spend most of their daily time being inactive, and this is related to the severity of negative symptoms. Here, we present the 3-year DiAPAson project aimed at (1) evaluating the daily time use among patients with SSD living in Residential Facilities (RFs) compared to outpatients with SSD and to the general population (Study 1); (2) evaluating the quality of staff-patient relationships, its association with specific patient outcomes and the quality of care provided in RFs (Study 2); and (3) assessing daily activity patterns in residential patients, outpatients with SSD and healthy controls using real-time methodologies (Study 3). Methods Study 1 will include 300 patients with SSD living in RFs and 300 outpatients; data obtained in these clinical populations will be compared with normative data obtained by the National Institute of Statistics (ISTAT) in the national survey on daily time use. Time use assessments will consist of daily diaries asking participants to retrospectively report time spent in different activities. In Study 2, a series of questionnaires will be administered to 300 residential patients (recruited for Study 1) to evaluate the quality of care and staff-patient relationships, level of well-being and burnout of RFs’ staff, and quality of RFs using a European standardized questionnaire (QuIRC-SA). In Study 3, the daily time use will be evaluated in a subgroup of 50 residential patients, 50 outpatients and 50 healthy controls using the Experience Sampling Method approach (participants will complete a brief questionnaire -about time use, mood and perceived energy- on a smartphone 8 times a day for 1 week) to compare retrospective and real-time reports. Moreover, their level of physical activity, sleep patterns, and energy expenditure will be monitored through a multi-sensor device. Discussion This project is highly innovative because it combines different types of assessments (i.e., retrospective and real-time reports; multi-sensor monitoring) to trace an accurate picture of daily time use and levels of physical activity that will help identify the best therapeutic options promoting daily activities and physical exercise in patients with SSD. Trial registration ISRCTN registry ID ISRCTN21141466.

Needs for care of residents with schizophrenia spectrum disorders and association with daily activities and mood monitored with experience sampling method: the DIAPASON study

“…This study is part of the national project ‘DAily time use, Physical Activity, quality of care and interpersonal relationships in patients with Schizophrenia spectrum disorders (DIAPASON)’ (de Girolamo et al ., 2020 ).…”

“…Therefore, based on the total number of occupied beds, we recruited approximately 27% of the patients from each participating RF. The sample size calculation is described in detail in the study protocol (de Girolamo et al ., 2020 ).…”

“…A growing body of evidence has shown that mental health professionals and users may have different perceptions of needs for care (Slade et al ., 1998 ; Brunt and Hansson, 2002 ; Ochoa et al ., 2003 ). Patients and staff may disagree on both the presence of a need for care and on whether a need has or has not been met (Lasalvia et al ., 2000 ; Cleary et al ., 2006 ; Grinshpoon et al ., 2008 ; Wiersma et al ., 2009 ; Eklund and Ostman, 2010 ; de Girolamo et al ., 2020 ). The disagreement between patients and professionals is a critical issue for service delivery, and any effort should be made to improve strategies aimed at increasing consensus between staff and patients, as a better staff–patient agreement may help improve treatment outcomes (Lasalvia et al ., 2008 ).…”

Patterns of antipsychotic prescription and accelerometer-based physical activity levels in people with schizophrenia spectrum disorders: a multicenter, prospective study

“…From October 2020 to October 2021, 620 patients (i.e. 313 residential patients (RPs) and 307 outpatients) with a diagnosis of an SSD were recruited in 37 Departments of Mental Health (DMH) or psychiatric residential treatment facilities across Italy as part of the DAily time use, Physical Activity, quality of care and interpersonal relationships in patients with Schizophrenia spectrum disorders (DiAPASon) project ( de Girolamo et al , 2020 ). We included patients with a Diagnostic and Statistical Manual of mental disorders (DSM)-5-based diagnosis of any SSDs (American Psychiatric Association, 2013) who were 20–55 years old and able to speak and write in Italian.…”

“…For each recruited patient, we completed a sociodemographic and clinical assessment, and several validated clinical scales were administered; for details see the study protocol ( de Girolamo et al , 2020 ). The 24-item Brief Psychiatric Rating Scale (BPRS) ( Overall and Gorham, 1962 ; Morosini and Casacchia, 1995 ) was used to assess the presence and severity of psychopathology; BPRS items were rated on a seven-point scale ranging from 1 (not present) to 7 (extremely severe).…”