Both psychiatric patients and their relatives benefit from learning about mental illness and how to cope with it, but the specific interests of these consumers remain unclear. To determine specific educational needs and to compare the needs of different consumers, a questionnaire survey was conducted with a sample of patients with schizophrenia and affective disorder and their relatives. Both patients and relatives reported strong interest in learning more about psychiatric illness and strategies for coping with common problems, but patients with schizophrenia were less interested than patients with affective disorder and both sets of relatives. Discriminant analyses revealed that needs differed as a function of patient diagnosis, patient/relative status, and relatives' membership of a self-help and advocacy organisation. Consumers of mental health services are capable of specifying their own educational needs, and educational programmes should be tailored to meet these.

Thirty-four schizophrenic patients in an acute in-patient hospital were compared with 24 in-patients with major affective disorder and 19 non-patient controls on a role-play test of social skills and a test of affect perception. The role-play test consisted of 12 simulated conversations in which the subject was confronted by parents and friends expressing high-EE criticism or non-critical dissatisfaction. Schizophrenic patients lacked assertiveness and social skills in all conditions, but they did not show any differential impairment when presented with high EE. They consistently lied and denied errors rather than responding assertively or apologising, whether confronted with high-EE or benign criticisms. On the affect perception test, schizophrenic patients consistently underestimated the intensity or negativeness of negative emotions, but they were not deficient in perception of positive emotional displays. The data do not support the hypothesis that schizophrenic patients are poor at dealing with high-EE behaviours, but do indicate that their ability to cope with even mild negative affect is impaired. Possible explanations for this impairment include limited attentional capacity, a neurologically based perceptual deficit, and a self-protective mechanism to reduce or avoid stress.

Twenty-one schizophrenics with prominent negative symptoms were compared with 37 schizophrenics without them, 33 patients with major affective disorder and 20 non-patient controls on a battery of measures including a role-play test of social skills, the Social Adjustment Scale, and the Quality of Life Scale. The negative schizophrenics were most impaired on every subscale of each measure, followed in order by the non-negative schizophrenics, affective disorder patients, and non-patient controls. The social skill measures were not correlated with positive symptom levels, but were highly correlated with measures of community functioning. The results are consistent with the hypothesis that social dysfunction results from focal deficits in social skills.