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

Abstract

BackgroundIt 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.MethodsThe ‘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.ResultsResults 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.ConclusionPsychiatrists 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.

Clinical Global Impression-severity score as a reliable measure for routine evaluation of remission in schizophrenia and schizoaffective disorders

“…91%) who were both clinically and functionally unremitted, irrespective of remission criteria adopted. This finding is in line with evidence reported of an incomplete recovery in schizophrenic disorders [ 1 ] and with the opinion generally shared by psychiatrists that patients affected by schizophrenia generally show impaired or very poor levels of functioning [ 31 ]. Furthermore, our data demonstrate that clinical remission is related to a similar degree of functional remission when evaluated by means of CGI-S and RSWG criteria.…”

Barriers, Benefits, and Strategies for Physical Activity in Patients With Schizophrenia

“…In an international perspective, availability of medical and psychosocial treatments for patients with schizophrenia varies among countries. 52,53 Therefore, the results may not reflect important factors related to physical activity in patients with schizophrenia living in countries with a more limited health care or social security system.…”

Relationship between clinical outcomes measures and personal and social performance functioning in a prospective, interventional study in schizophrenia

“…The majority of clinicians recognize that improved personal and social functioning are important treatment goals, and most assess the personal and social functioning of their patient at each visit (Gorwood et al, 2013). Progress made in the pharmacological and nonpharmacological treatment of schizophrenia (including the introduction of atypical antipsychotics) has resulted in clinical attention being focused on improving psychosocial functioning, cognition, and negative symptoms, in addition to controlling positive symptoms of psychosis and improving side-effect profiles (Karow & Naber, 2002).…”