Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-19T09:37:58.537Z Has data issue: false hasContentIssue false
  • English
  • Français

Gender differences in patient and caregiver psychoeducation for schizophrenia

Published online by Cambridge University Press:  16 April 2020

T. Reichhart ,
G. Pitschel-Walz ,
W. Kissling ,
J. Bäuml ,
T. Schuster  and
C. Rummel-Kluge
T. Reichhart*
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen, Universität München, Möhlstrasse, 26 81675München, Germany
G. Pitschel-Walz
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen, Universität München, Möhlstrasse, 26 81675München, Germany
W. Kissling
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen, Universität München, Möhlstrasse, 26 81675München, Germany
J. Bäuml
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen, Universität München, Möhlstrasse, 26 81675München, Germany
T. Schuster
Affiliation:
Institute of Medical Statistics and Epidemiology (IMSE), Technische Universität München, 22, Ismaninger Strasse, 81675München, Germany
C. Rummel-Kluge
Affiliation:
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen, Universität München, Möhlstrasse, 26 81675München, Germany
*
*Corresponding author. Tel.: +0049 89 4140 6465; fax: +0049 89 4140 7339. E-mail address: T.Reichhart@lrz.tum.de (T. Reichhart).
Get access

Abstract

Objective:

The aim of this research is to detect gender-related differences in patients and caregivers regarding knowledge about schizophrenia and attitudes towards drugs as well as gender as predictor for changes in these variables during psychoeducation.

Methods:

Data sets of one randomised-controlled (study 1) and one naturalistic psychoeducation study (study 2) were reanalysed. Main outcome measures (knowledge about schizophrenia, drug attitude, confidence in medication) were assessed at baseline, post-intervention and 12 months after index discharge.

Results:

The reanalysed samples consisted in total of 1002 patients and 176 caregivers. In study 2, baseline knowledge was significantly better in male patients and female caregivers. All participants improved significantly their knowledge. The amount of knowledge gain did not differ between genders in either study or either group. Gender was not a major predictor of baseline knowledge or knowledge gain. Only in study 1 did gender significantly impact the knowledge gain from baseline to follow-up. Regarding improvement of drug attitude, females seemed to benefit significantly better from psychoeducation. In both studies, however, changes in drug attitudes respectively confidence in medication were best explained by lower corresponding baseline scores, not gender. Patients’ gender did not influence outcomes of their caregivers.

Conclusion:

Our findings suggest that psychoeducational programs might be better adapted to males in order to improve their drug attitude. Concerning knowledge, gender-related changes do not seem to be necessary.

Keywords

PsychoeducationGenderSchizophreniaKnowledgeDrug attitude
Type
Original articles
Information
European Psychiatry , Volume 25 , Issue 1 , January 2010 , pp. 39 - 46
Copyright
Copyright © Elsevier Masson SAS 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aleman, A., Kahn, R.S., Selten, J.P.Sex differences in the risk of schizophrenia: evidence from meta-analysis. Arch Gen Psychiatry 2003;60:565–571.CrossRefGoogle ScholarPubMed
Angermeyer, M.C., Goldstein, J.M., Kuehn, L.Gender differences in schizophrenia: rehospitalization and community survival. Psychol Med 1989;19:365–382.CrossRefGoogle ScholarPubMed
Angermeyer, M.C., Kuhn, L., Goldstein, J.M.Gender and the course of schizophrenia: differences in treated outcomes. Schizophr Bull 1990;16:293–307.CrossRefGoogle ScholarPubMed
Argimon, J.M., Limon, E., Vila, J., Cabezas, C.Health-related quality of life in carers of patients with dementia. Fam Pract 2004;21:454–457.CrossRefGoogle ScholarPubMed
Atalay, F., Atalay, H.Gender differences in patients with schizophrenia in terms of sociodemographic and clinical characteristics. Ger J Psychiatry 2006;9:41–47.Google Scholar
Awad, A.G.Subjective response to neuroleptics in schizophrenia. Schizophr Bull 1993;19:609–618.CrossRefGoogle Scholar
Bauml, J., Frobose, T., Kraemer, S., Rentrop, M., Pitschel-Walz, G.Psychoeducation: a basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophr Bull 32(Suppl 1)2006 S1–S9.CrossRefGoogle ScholarPubMed
Bauml, J., Pitschel-Walz, G.Psychoedukation bei schizophrenen Erkrankungen. Schattauer: Stuttgart; 2003.Google Scholar
Bauml, J., Pitschel-Walz, G., Volz, A., Engel, R.R., Kissling, W.Psychoeducation in schizophrenia: 7-year follow-up concerning rehospitalization and days in hospital in the Munich Psychosis Information Project Study. J Clin Psychiatry 2007;68:854–861.CrossRefGoogle ScholarPubMed
Cassidy, E., Hill, S., O’Callaghan, E.Efficacy of a psychoeducational intervention in improving relatives’ knowledge about schizophrenia and reducing rehospitalisation. Eur Psychiatry 2001;16:446–450.CrossRefGoogle ScholarPubMed
Csernansky, J.G., Schuchart, E.K.Relapse and rehospitalisation rates in patients with schizophrenia: effects of second generation antipsychotics. CNS Drugs 2002;16:473–484.CrossRefGoogle ScholarPubMed
De Las, C.C., Sanz, E.J.Attitudes toward psychiatric drug treatment: the experience of being treated. Eur J Clin Pharmacol 2007;63:1063–1067.CrossRefGoogle Scholar
Doering, S., Muller, E., Kopcke, W., Pietzcker, A., Gaebel, W., Linden, M.et al. Predictors of relapse and rehospitalization in schizophrenia and schizoaffective disorder. Schizophr Bull 1998;24:87–98.CrossRefGoogle ScholarPubMed
Donaldson, C., Tarrier, N., Burns, A.Determinants of carer stress in Alzheimer's disease. Int J Geriatr Psychiatry 1998;13:248–256.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
Faraone, S.V., Chen, W.J., Goldstein, J.M., Tsuang, M.T.Gender differences in age at onset of schizophrenia. Br J Psychiatry 1994;164:625–629.CrossRefGoogle ScholarPubMed
Fenton, W.S., Blyler, C.R., Heinssen, R.K.Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 1997;23:637–651.CrossRefGoogle ScholarPubMed
Foldemo, A., Gullberg, M., Ek, A.C., Bogren, L.Quality of life and burden in parents of outpatients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2005;40:133–138.CrossRefGoogle ScholarPubMed
Glick, I.D., Spencer, J.H. Jr., Clarkin, J.F., Haas, G.L., Lewis, A.B., Peyser, J.et al. A randomized clinical trial of inpatient family intervention. IV. Follow up results for subjects with schizophrenia. Schizophr Res 1990;3:187–200.CrossRefGoogle ScholarPubMed
Grossman, L.S., Harrow, M., Rosen, C., Faull, R.Sex differences in outcome and recovery for schizophrenia and other psychotic and nonpsychotic disorders. Psychiatr Serv 2006;57:844–850.CrossRefGoogle ScholarPubMed
Haas, G.L., Glick, I.D., Clarkin, J.F., Spencer, J.H., Lewis, A.B.Gender and schizophrenia outcome: a clinical trial of an inpatient family intervention. Schizophr Bull 1990;16:277–292.CrossRefGoogle ScholarPubMed
Hafner, H.Gender differences in schizophrenia. Psychoneuroendocrinology 28(Suppl 2)2003 17–54.CrossRefGoogle Scholar
Hafner, H., an der, H.W., Behrens, S., Gattaz, W.F., Hambrecht, M., Loffler, W.et al. Causes and consequences of the gender difference in age at onset of schizophrenia. Schizophr Bull 1998;24:99–113.CrossRefGoogle ScholarPubMed
Hafner, H., Riecher, A., Maurer, K., Fatkenheuer, B., Loffler, W., an der, H.W.et al. Sex differences in schizophrenic diseases. Fortschr Neurol Psychiatr 1991;59:343–360.Google ScholarPubMed
Haupt, M., Karger, A., Janner, M.Improvement of agitation and anxiety in demented patients after psychoeducative group intervention with their caregivers. Int J Geriatr Psychiatry 2000;15:1125–1129.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Hogan, T.P., Awad, A.G.Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures. Psychol Med 1992;22:347–352.CrossRefGoogle ScholarPubMed
Hooker, K., Manoogian-O’Dell, M., Monahan, D.J., Frazier, L.D., Shifren, K.Does type of disease matter? Gender differences among Alzheimer's and Parkinson's disease spouse caregivers. Gerontologist 2000;40:568–573.CrossRefGoogle ScholarPubMed
Kampman, O., Lehtinen, K.Compliance in psychoses. Acta Psychiatr Scand 1999;100:167–175.CrossRefGoogle ScholarPubMed
Linden, M., Nather, J., Wilms, H.U.Definition, significance and measurement of disease concepts of patients. The Disease Concept Scale for schizophrenic patients. Fortschr Neurol Psychiatr 1988;56:35–43.CrossRefGoogle ScholarPubMed
Magliano, L., Fiorillo, A., Malangone, C., De, R.C., Maj, M.Patient functioning and family burden in a controlled, real-world trial of family psychoeducation for schizophrenia. Psychiatr Serv 2006;57:1784–1791.CrossRefGoogle Scholar
McWilliams, S., Hill, S., Mannion, N., Kinsella, A., O’Callaghan, E.Caregiver psychoeducation for schizophrenia: is gender important?. Eur Psychiatry 2007;22:323–327.CrossRefGoogle ScholarPubMed
Merinder, L.B., Viuff, A.G., Laugesen, H.D., Clemmensen, K., Misfelt, S., Espensen, B.Patient and relative education in community psychiatry: a randomized controlled trial regarding its effectiveness. Soc Psychiatry Psychiatr Epidemiol 1999;34:287–294.CrossRefGoogle ScholarPubMed
Nasser, E.H., Walders, N., Jenkins, J.H.The experience of schizophrenia: what's gender got to do with it? A critical review of the current status of research on schizophrenia. Schizophr Bull 2002;28:351–362.CrossRefGoogle Scholar
Noh, S., Turner, R.J.Living with psychiatric patients: implications for the mental health of family members. Soc Sci Med 1987;25:263–272.CrossRefGoogle ScholarPubMed
O’Donnell, C., Donohoe, G., Sharkey, L., Owens, N., Migone, M., Harries, R.et al. Compliance therapy: a randomised controlled trial in schizophrenia. BMJ 2003;327:834.CrossRefGoogle Scholar
Ochoa, S., Usall, J., Villalta-Gil, V., Vilaplana, M., Márquez, M., Valdelomar, M.et al. Influence of age at onset on social functioning in outpatients with schizophrenia. Eur J Psychiatr 2006;20:157–163.CrossRefGoogle Scholar
Pekkala, E, Merinder, L.Psychoeducation for schizophrenia. Cochrane Database Syst Rev 2002; CD002831.Google Scholar
Pickett-Schenk, S.A., Lippincott, R.C., Bennett, C., Steigman, P.J.Improving knowledge about mental illness through family-led education: the journey of hope. Psychiatr Serv 2008;59:49–56.CrossRefGoogle Scholar
Pinquart, M., Sorensen, S.Helping caregivers of persons with dementia: which interventions work and how large are their effects?. Int Psychogeriatr 2006;18:577–595.CrossRefGoogle ScholarPubMed
Pitschel-Walz, G.Die Einbeziehung der Angehörigen in die Behandlung schizophrener Patienten und ihr Einfluss auf den Krankheitsverlauf. Peter Lang: Frankfurt am Main; 1997.Google Scholar
Pitschel-Walz, G., Bauml, J., Bender, W., Engel, R.R., Wagner, M., Kissling, W.Psychoeducation and compliance in the treatment of schizophrenia: results of the Munich Psychosis Information Project Study. J Clin Psychiatry 2006;67:443–452.CrossRefGoogle ScholarPubMed
Pitschel-Walz, G., Leucht, S., Bauml, J., Kissling, W., Engel, R.R.The effect of family interventions on relapse and rehospitalization in schizophrenia–a meta-analysis. Schizophr Bull 2001;27:73–92.CrossRefGoogle ScholarPubMed
Pitschel-Walz, G., Rummel-Kluge, C., Reichhart, T., Bauml, J., Kissling, W.Caregiver psychoeducation for schizophrenia: is gender important? Comments on the study by McWilliams et al., 2007. Eur Psychiatry 2007;22:479–480.CrossRefGoogle Scholar
Resnick, S.G., Fontana, A., Lehman, A.F., Rosenheck, R.A.An empirical conceptualization of the recovery orientation. Schizophr Res 2005;75:119–128.CrossRefGoogle ScholarPubMed
Riecher-Rossler, A.Mental diseases in women – some arguments for a gender-sensitive psychiatry and psychotherapy. Z Psychosom Med Psychother 2000;46:129–139.Google Scholar
Rocca, P., Crivelli, B., Marino, F., Mongini, T., Portaleone, F., Bogetto, F.Correlations of attitudes toward antipsychotic drugs with insight and objective psychopathology in schizophrenia. Compr Psychiatry 2008;49:170–176.CrossRefGoogle Scholar
Roter, D.L., Hall, J.A.How physician gender shapes the communication and evaluation of medical care. Mayo Clin Proc 2001;76:673–676.CrossRefGoogle ScholarPubMed
Rummel, C.B., Hansen, W.P., Helbig, A., Pitschel-Walz, G., Kissling, W.Peer-to-peer psychoeducation in schizophrenia: a new approach. J Clin Psychiatry 2005;66:1580–1585.CrossRefGoogle ScholarPubMed
Rummel-Kluge, C., Pitschel-Walz, G., Bauml, J., Kissling, W.Psychoeducation in schizophrenia–results of a survey of all psychiatric institutions in Germany, Austria and Switzerland. Schizophr Bull 2006;32:765–775.CrossRefGoogle ScholarPubMed
Rummel-Kluge, C., Pitschel-Walz, G., Kissling, W.A fast, implementable psychoeducation program for schizophrenia. Psychiatr Serv 2007;58:1226.CrossRefGoogle Scholar
Sajatovic, M., Jenkins, J.H., Strauss, M.E., Butt, Z.A., Carpenter, E.Gender identity and implications for recovery among men and women with schizophrenia. Psychiatr Serv 2005;56:96–98.CrossRefGoogle ScholarPubMed
Sellwood, W., Tarrier, N.Demographic factors associated with extreme non-compliance in schizophrenia. Soc Psychiatry Psychiatr Epidemiol 1994;29:172–177.Google Scholar
Sibitz, I., Katschnig, H., Goessler, R., Unger, A., Amering, M.Pharmacophilia and pharmacophobia: determinants of patients’ attitudes towards antipsychotic medication. Pharmacopsychiatry 2005;38:107–112.CrossRefGoogle ScholarPubMed
Smith, T.E., Hull, J.W., Anthony, D.T., Goodman, M., Hedayat-Harris, A., Felger, T.et al. Post-hospitalization treatment adherence of schizophrenic patients: gender differences in skill acquisition. Psychiatry Res 1997;69:123–129.CrossRefGoogle ScholarPubMed
Sorensen, S., Pinquart, M.Racial and ethnic differences in the relationship of caregiving stressors, resources, and sociodemographic variables to caregiver depression and perceived physical health. Aging Ment Health 2005;9:482–495.CrossRefGoogle ScholarPubMed
Sorensen, S., Pinquart, M., Duberstein, P.How effective are interventions with caregivers? An updated meta-analysis. Gerontologist 2002;42:356–372.CrossRefGoogle ScholarPubMed
Tennakoon, L., Fannon, D., Doku, V., O’Ceallaigh, S., Soni, W., Santamaria, M.et al. Experience of caregiving: relatives of people experiencing a first episode of psychosis. Br J Psychiatry 2000;177:529–533.CrossRefGoogle ScholarPubMed
Vreeland, B., Minsky, S., Yanos, P.T., Menza, M., Gara, M., Kim, E.et al. Efficacy of the team solutions program for educating patients about illness management and treatment. Psychiatr Serv 2006;57:822–828.CrossRefGoogle Scholar
WHO. Gender and health research series. Gender in mental health research. http://www_who_int/gender/documents/en/mentalhealthlowpdf; 2005; access date: 14 November 2007.Google Scholar
Submit a response

Comments

No Comments have been published for this article.