Schizophrenia in real life: courses, symptoms and functioning in an Italian population

Abstract

BackgroundIn the general belief, schizophrenia is associated with the concepts of seriousness, incurability, dangerousness: this is incorrect. In recent decades, the interest in course studies increased and different trends emerged, not necessarily chronic, with the possibility of remission.The plan of this research was to draw a picture of the schizophrenia syndrome in a specific geographic area, in the past and at present time: this allows to detect needs, weaknesses and strengths, for a better planning of future interventions.MethodsThe course of all cases diagnosed as schizophrenia (N = 1,759) in the period 1978–2008, was retrospectively studied in the entire population of an Italian province by observing, for a mean period of 12 years per person, age at first psychiatric consultation, number and length of admissions for both acute symptoms and residential-rehabilitation programs, number of interventions in outpatients. The cases under treatment (N = 842), were evaluated in terms of symptoms, using the Brief Psychiatric Rating Scale, and in terms of functioning, using the Personal and Social Functioning Scale.ResultsThe disease course differs significantly between genders: males have an earlier age at first consultation (about 7 years earlier), higher admission rates, greater number of outpatient interventions and personal and social functioning significantly worse.Hospitalization resulted often unnecessary: 23.1% of cases were never hospitalized and 67.2% spent less than one week per year in hospital.A quarter of the cases meets the international criteria for remission and more than 75% are asymptomatic or mildly symptomatic; only 5.3% of cases shows severe symptoms. However, Personal and Social Functioning highlights, in about 1/3 of cases, relevant or serious problems mainly in Work and Relationships areas, whilst Aggressiveness is a serious problem only in 9%.ConclusionsIn this population, schizophrenia in real life shows great individual variability in course, symptoms and functioning: in most cases nowadays it appears a less severe and chronic disease than in the past, but further improvements are needed on disability prevention and social inclusion.

Assessment of functioning in patients with schizophrenia and schizoaffective disorder with the Mini-ICF-APP: a validation study in Italy

“…Indeed, the sample was made up prevalently by middle-aged, single, unemployed, fairly well educated males, with a long duration of illness, early age at onset, and continuous course of the disorder; ratings obtained at CGI-SCH, PANSS, MMSE, BACS and MMSE, relating to symptoms, cognition and functioning, denote a fairly stable clinical condition characterized by a low/moderate symptoms’ severity, cognitive impairment and social disability, as expected in a cohort of relatively stable, chronic patients in a community setting. Indeed, approximately 50 % of our patients were in clinical remission, slightly less than one-third in functional remission, and about one quarter viewed as recovered in line with the adopted criteria, a finding largely consistent with previous data published by our group [ 14 , 33 ] and with literature findings [ 34 – 37 ]. Mean and median scores obtained at Mini-ICF-APP were generally comprised between 1 and 2 for the majority of items, thus indicating a low-moderate level of impairment, with only two items (self-care and mobility) showing very low scores (both means and medians lower than one), indicating the absence of, or minimal impairments in these areas; this finding was very similar to that of Balestrieri et al in their validation study of the Italian version of the Mini-ICF-APP [ 13 ].…”

<p>Predictors of achieving remission in schizophrenia patients treated with paliperidone palmitate 3-month formulation</p>

“…However, asking a few specific questions during patient interviews may potentially capture similar information as collected by the PSP. Strong correlations have been demonstrated between the total PSP score and its Work and Socially Useful Activities subscale 28. Therefore, asking routine questions such as “Is the patient working?…”

“…Strong correlations have been demonstrated between the total PSP score and its Work and Socially Useful Activities subscale. 28 Therefore, asking routine questions such as “Is the patient working? …going to school?…”

The Role of Dopamine D3 Receptors, Dysbindin, and Their Functional Interaction in the Expression of Key Genes for Neuroplasticity and Neuroinflammation in the Mouse Brain

“…Schizophrenia is an idiopathic psychiatric disorder occurring in 0.5-1% of the general population [1,2]. Its symptoms include hallucinations, disorganized speech, abnormal motor behavior, and cognitive dysfunctions [3][4][5][6][7].…”