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Patterns of clinical course in persons with mental disorders: which impact on social disability and quality of life? A longitudinal study

Published online by Cambridge University Press:  11 October 2011

Antonio Lasalvia*
Affiliation:
Unità di Valutazione dell'Esito, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Università di Verona, Verona
Chiara Bonetto
Affiliation:
Unità di Valutazione dell'Esito, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Università di Verona, Verona
Katia De Santi
Affiliation:
Unità di Valutazione dell'Esito, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Università di Verona, Verona
Mirella Ruggeri
Affiliation:
Unità di Valutazione dell'Esito, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Università di Verona, Verona
*
Address for correspondence: Dr. A. Lasalvia, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria e Psicologia Clinica Università di Verona, Policlinico G.B. Rossi, P.le L.A. Scuro 10,37134 Verona Fax +39-045-585-871 E-mail: antonio.lasalvia@medicina.univr.it.

Abstract

Summary

Aims — To investigate in persons with mental disorders 1) the patterns of clinical course and their frequencies, 2) the impact of clinical course on two social dimensions of outcome, such as disability and quality of life. Methods — Study conducted with a longitudinal design in the “real world” of community mental health services. Clinical course was retrospectively assessed by using an instrument developed by our group, taking into account previous literature in this area; disability and quality of life were measured, respectively, with the WHO—Disability Assessment Schedule and the Lancashire Quality of Life Profile. Results — In patients with non affective psychosis, continuous and episodic course showed the same tendency to occur, whereas in subjects with affective disorders (either psychotic or neurotic) episodic course was more frequent. Continuous course was associated with higher levels of disability and lower quality of life in psychotic patients, while a poorer quality of life in some areas was associated with episodic course in patients with non psychotic disorders. Conclusions — The impact of clinical course on social disability and quality of life is different depending upon the specific diagnostic category. This suggests that specific and individualised interventions should be provided in order to prevent the negative impact of clinical course on life conditions of persons with mental disorders.

Declaration of Interest

the study has been supported by a Grant from MURST 60% to Prof. Mirella Ruggeri and Fondi 1% per la Ricerca Sanitaria Finalizzata 2001 Ministry of Health, to Professor M. Tansella.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2004

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