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The assessment of outcome in schizophrenic patients should consider both the response to treatment and the recovery of social skills. The aim was to evaluate the outcome and related psychostructural and clinical factors in schizophrenic patients after they underwent 6 months of residential multimodal treatment.
Methods
Fifty-two schizophrenic patients enrolled in a multimodal treatment program were included in the study. Symptomatology and social functioning were assessed with the Brief Psychiatric Rating Scale (BPRS) and the Social and Occupational Functioning Assessment Scale (SOFAS). The Karolinska Psychodynamic Profile (KAPP) was used for the psychostructural evaluation.
Results
After 6 months there was a significant improvement in the global scores of BPRS, SOFAS, and some areas of KAPP. The personality (KAPP) and social-occupational functioning (SOFAS) at baseline (T0) correlated with the global score of BPRS at 6 months (T6); moreover, SOFAS at T6 correlated with BPRS and KAPP at T0 and with the illness duration.
Conclusions
The better the personality functioning in schizophrenic patients the better seems to be the response to treatment, with regard to symptoms as well as rehabilitation. Personality assessment might be useful for the individualisation of therapies, even within the context of a standardised program.
Anorexia nervosa (AN) is a severe mental disorder. Body shape disturbances are key in the development and maintenance of AN. Only few data are available on inpatients with life-threatening AN. Therefore, we aimed to investigate if body shape difficulties—with a focus on both body checking and avoidance—could improve during hospitalization in both subtypes of AN and to ascertain eventual associations between body shape concerns upon admission and clinical outcome.
Methods.
Upon hospital admission and end of treatment (EOT), 139 inpatients with AN completed Body Shape Questionnaire (BSQ), Body Checking Questionnaire (BCQ), and Body Image Avoidance Questionnaire (BIAQ) in addition to measures of eating and general psychopathology.
Results.
Patients with severe AN reported improved BSQ and BIAQ scores at EOT while BCQ did not significantly change. Diagnostic subtypes differed only in baseline BSQ scores and had an impact on the improvement in BSQ at EOT. Baseline BCQ was associated with patients’ clinical improvement at EOT, even after controlling for age, duration of illness, Body Mass Index, depression, and anxiety scores.
Conclusions.
Data on body shape concerns and their trajectory during hospitalization for severe AN are lacking; our findings provide support to the effectiveness of hospitalization in improving body shape concerns and body avoidance, but not body checking. Also, baseline body shape concerns (especially body checking) impacted on clinical improvement. Future research is needed to identify treatments that could further improve the therapeutic approach to severe patients of AN in the acute setting.
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