Determinants of clinical, functional and personal recovery for people with schizophrenia and other severe mental illnesses: A cross-sectional analysis


Autoři: Bert-Jan Roosenschoon aff001;  Astrid M. Kamperman aff001;  Mathijs L. Deen aff002;  Jaap van Weeghel aff002;  Cornelis L. Mulder aff001
Působiště autorů: ESPRI Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands aff001;  Parnassia Psychiatric Institute, The Hague, the Netherlands aff002;  Faculty of Social and Behavioral Sciences, Institute of Psychology, Leiden University, Leiden, the Netherlands aff003;  Tilburg University, Department of Social and Behavioral Sciences, TRANZO Scientific Center for Care and Welfare, Tilburg, the Netherlands aff004;  Parnassia Psychiatric Institute, Antes/Bavo Europoort, Rotterdam, the Netherlands aff005
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222378

Souhrn

Objective

To analyze the relationships between insight, medication adherence, addiction, coping and social support—components of Illness Management and Recovery (IMR)—as determinants of clinical, functional and personal recovery in patients with schizophrenia and other severe mental illnesses. Our rationale lay in the interrelations between these concepts suggested in a conceptual framework of IMR.

Methods

The cross-sectional design used baseline data of outpatient participants in a randomized clinical trial on IMR (N = 187). We used structural equation modeling (SEM) to describe pathways between degrees of insight, medication adherence, addiction, coping and social support, and degree of clinical, functional and personal recovery. We also explored whether clinical recovery mediated functional and personal recovery.

Results

Our final model showed that coping was associated with clinical, functional and personal recovery. Direct associations between coping and functional and personal recovery were stronger than indirect associations via clinical recovery. Although SEM also showed a significant but weak direct pathway between social support and functional recovery, there were no significant pathways either between social support and clinical or personal recovery, or between insight, medication adherence, addiction and any type of recovery.

Conclusions

Coping may be a determinant of all three types of recovery, and social support a determinant of functional recovery. Clinical recovery appears not to be a prerequisite for functional or personal recovery. While our results also suggest the relevance of improving coping skills and of enhancing social support, they only partially support the conceptual framework of IMR.

Klíčová slova:

Biology and life sciences – Psychology – Addiction – Social sciences – Sociology – Education – Educational attainment – Medicine and health sciences – Mental health and psychiatry – Schizophrenia – Personality disorders – Pharmacology – Drug adherence – Drug research and development – Randomized controlled trials – Clinical medicine – Clinical trials – Physical sciences – Chemistry – Chemical compounds – Organic compounds – Alcohols – Organic chemistry – Research and analysis methods


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