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:
https://doi.org/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
Zdroje
1. Frese FJ 3rd, Knight EL, Saks E. Recovery from schizophrenia: with views of psychiatrists, psychologists, and others diagnosed with this disorder. Schizophr Bull. 2009;35(2):370–80. Epub 2009/03/24. doi: 10.1093/schbul/sbn175 19304812; PubMed Central PMCID: PMC2659312.
2. Jaaskelainen E, Juola P, Hirvonen N, McGrath JJ, Saha S, Isohanni M, et al. A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull. 2013;39(6):1296–306. Epub 2012/11/23. doi: 10.1093/schbul/sbs130 23172003; PubMed Central PMCID: PMC3796077.
3. Bellack AS. Scientific and consumer models of recovery in schizophrenia: concordance, contrasts, and implications. Schizophr Bull. 2006;32(3):432–42. doi: 10.1093/schbul/sbj044 16461575; PubMed Central PMCID: PMC2632241.
4. Whitley R, Drake RE. Recovery: a dimensional approach. Psychiatr Serv. 2010;61(12):1248–50. Epub 2010/12/03. doi: 10.1176/ps.2010.61.12.1248 21123410.
5. Slade M, Leamy M, Bacon F, Janosik M, Le Boutillier C, Williams J, et al. International differences in understanding recovery: systematic review. Epidemiol Psychiatr Sci. 2012;21(4):353–64. Epub 2012/07/17. doi: 10.1017/S2045796012000133 22794507.
6. Slade M, Amering M, Farkas M, Hamilton B, O'Hagan M, Panther G, et al. Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems. World Psychiatry. 2014;13(1):12–20. Epub 2014/02/06. doi: 10.1002/wps.20084 24497237; PubMed Central PMCID: PMC3918008.
7. Cavelti M, Kvrgic S, Beck EM, Kossowsky J, Vauth R. Assessing recovery from schizophrenia as an individual process. A review of self-report instruments. Eur Psychiatry. 2012;27(1):19–32. Epub 2011/12/02. doi: 10.1016/j.eurpsy.2011.01.007 22130177.
8. Van Eck RM, Burger TJ, Vellinga A, Schirmbeck F, de Haan L. The Relationship Between Clinical and Personal Recovery in Patients With Schizophrenia Spectrum Disorders: A Systematic Review and Meta-analysis. Schizophr Bull. 2017. Epub 2017/10/17. doi: 10.1093/schbul/sbx088 29036720.
9. Harvey PD, Bellack AS. Toward a terminology for functional recovery in schizophrenia: is functional remission a viable concept? Schizophr Bull. 2009;35(2):300–6. Epub 2009/01/08. doi: 10.1093/schbul/sbn171 19126634; PubMed Central PMCID: PMC2659311.
10. Andreasen NC, Carpenter WT Jr., Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005;162(3):441–9. Epub 2005/03/03. doi: 10.1176/appi.ajp.162.3.441 15741458.
11. San L, Ciudad A, Alvarez E, Bobes J, Gilaberte I. Symptomatic remission and social/vocational functioning in outpatients with schizophrenia: prevalence and associations in a cross-sectional study. Eur Psychiatry. 2007;22(8):490–8. Epub 2007/10/02. doi: 10.1016/j.eurpsy.2007.06.005 17904337.
12. Mueser KT, Meyer PS, Penn DL, Clancy R, Clancy DM, Salyers MP. The Illness Management and Recovery program: rationale, development, and preliminary findings. Schizophr Bull. 2006;32 Suppl 1:S32–43. doi: 10.1093/schbul/sbl022 16899534; PubMed Central PMCID: PMC2685197.
13. Slade M. Personal recovery and Mentall Ilness, a guide for Mental Health Professionals. Cambridge, United Kingdom: Cambridge University Press; 2009.
14. Liberman R, Kopelowicz A. Recovery from schizophrenia: a challenge for the 21st century. Int Rev Psychiatry. 2002;(14):245–55.
15. Robinson DG, Woerner MG, McMeniman M, Mendelowitz A, Bilder RM. Symptomatic and f unctional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry. 2004;161(3):473–9. Epub 2004/03/03. doi: 10.1176/appi.ajp.161.3.473 14992973.
16. Wunderink L, Sytema S, Nienhuis FJ, Wiersma D. Clinical recovery in first-episode psychosis. Schizophr Bull. 2009;35(2):362–9. Epub 2008/11/08. doi: 10.1093/schbul/sbn143 18990715; PubMed Central PMCID: PMC2659307.
17. Carrion RE, McLaughlin D, Goldberg TE, Auther AM, Olsen RH, Olvet DM, et al. Prediction of functional outcome in individuals at clinical high risk for psychosis. JAMA Psychiatry. 2013;70(11):1133–42. Epub 2013/09/06. doi: 10.1001/jamapsychiatry.2013.1909 24006090; PubMed Central PMCID: PMC4469070.
18. Patterson TL, Mausbach BT. Measurement of functional capacity: a new approach to understanding functional differences and real-world behavioral adaptation in those with mental illness. Annu Rev Clin Psychol. 2010;6:139–54. Epub 2010/03/26. doi: 10.1146/annurev.clinpsy.121208.131339 20334554; PubMed Central PMCID: PMC3160788.
19. ICF (The International Classification of Functioning DaH. Towards a Common Language for Functioning, Disability and Health. Geneva: World Health Organization (WHO); 2002.
20. Deegan P. Recovery as a Self-Directed Process of Healing and Transformation. Occupational Therapy in Mental Health. 2002;17(3–4):5–21. doi: 10.1300/J004v17n03_02
21. Mead S, Copeland ME. What recovery means to us: consumers’ perspectives. Community mental health journal. 2000;36:315–28. 10933247
22. Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011;199(6):445–52. Epub 2011/12/02. doi: 10.1192/bjp.bp.110.083733 22130746.
23. Mueser K, Gingerich S (eds). Illness Management and Recovery Implementation Resource Kit. Rockville, Md: Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2002.
24. Prochaska JO, DiClemente CC. The Transtheoretical Approach: Crossing the Traditional Boundaries of Therapy. Homewood, Ill: Dow-Jones/Irwin; 1984.
25. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–5. PubMed doi: 10.1037//0022-006x.51.3.390 6863699.
26. Liberman RP, Mueser KT, Wallace CJ, Jacobs HE, Eckman T, Massel HK. Training skills in the psychiatrically disabled: learning coping and competence. Schizophr Bull. 1986;12:631–47. PubMed doi: 10.1093/schbul/12.4.631 3810067.
27. Zubin J, Spring B. Vulnerability—a new view of schizophrenia. Journal of abnormal psychology. 1977;86(2):103–26. PubMed doi: 10.1037//0021-843x.86.2.103 858828.
28. Roosenschoon BJ, Mulder C.L., Deen M.L., van Weeghel J. Effectiveness of Illness Management and Recovery (IMR) in the Netherlands: a randomised clinical trial; Study Protocol. BMC Psychiatry. 2016;16(73):11. doi: 10.1186/s12888-016-0774-0 26995361
29. Hoyle RH. Handbook of Structural Equation Modeling. New York: Guilford Press; 2012.
30. Alessandrini M, Lancon C, Fond G, Faget-Agius C, Richieri R, Faugere M, et al. A structural equation modelling approach to explore the determinants of quality of life in schizophrenia. Schizophr Res. 2016;171(1–3):27–34. Epub 2016/01/20. doi: 10.1016/j.schres.2016.01.012 26781001.
31. Galderisi S, Rossi A, Rocca P, Bertolino A, Mucci A, Bucci P, et al. Pathways to functional outcome in subjects with schizophrenia living in the community and their unaffected first-degree relatives. Schizophr Res. 2016;175(1–3):154–60. Epub 2016/05/23. doi: 10.1016/j.schres.2016.04.043 27209527.
32. Chesney MA, Neilands TB, Chambers DB, Taylor JM, Folkman S. A validity and reliability study of the coping self-efficacy scale. British journal of health psychology. 2006;11:421–37. doi: 10.1348/135910705X53155 16870053; PubMed Central PMCID: PMC1602207.
33. Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. Journal of personality assessment. 1990;55:610–7. doi: 10.1080/00223891.1990.9674095 2280326.
34. Tait L, Birchwood M, Trower P. A new scale (SES) to measure engagement with community mental health services. Journal of mental health. 2002;11(2):191–8. doi: 10.1080/09638230020023570-2 21208145.
35. Birchwood M, Smith J, Drury V, Healy J, Macmillan F, Slade M. A self-report Insight Scale for psychosis: reliability, validity and sensitivity to change. Acta Psychiatr Scand. 1994;89:62–7. PubMed doi: 10.1111/j.1600-0447.1994.tb01487.x 7908156.
36. Tait L, Birchwood M, Trower P. Predicting engagement with services for psychosis: insight, symptoms and recovery style. Br J Psychiatry. 2003;182:123–8. PubMed doi: 10.1192/bjp.182.2.123 12562739.
37. McLellan AT, Luborsky L, Woody GE, O'Brien CP. An improved diagnostic evaluation i nstrument for substance abuse patients. The Addiction Severity Index. The Journal of n ervous and mental disease. 1980;168:26–33. PubMed doi: 10.1097/00005053-198001000-00006 7351540.
38. Hendriks VM, Kaplan CD, van Limbeek J, Geerlings P. The Addiction Severity Index: reliability and validity in a Dutch addict population. Journal of substance abuse treatment. 1989;6:133–41. 2746712.
39. Derogatis LR. BSI Brief Symptom Inventory. Administration, Scoring, and Procedures Manual (4th Ed.). Minneapolis, MN: National Computer Systems; 1993.
40. Derogatis LR, Melisaratos N. The Brief Symptom Inventory: an introductory report. Psychol Med. 1983;13:595–605. 6622612.
41. De Beurs E. Brief symptom inventory; handleiding. Leiden: The Netherlands: PITS BV; 2008.
42. Birchwood M, Smith J, Cochrane R, Wetton S, Copestake S. The Social Functioning Scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. Br J Psychiatry. 1990;157:853–9. PubMed doi: 10.1192/bjp.157.6.853 2289094.
43. Iffland JR, Lockhofen D, Gruppe H, Gallhofer B, Sammer G, Hanewald B. Validation of the German Version of the Social Functioning Scale (SFS) for schizophrenia. PLoS One. 2015;10(4):e0121807. Epub 2015/04/04. doi: 10.1371/journal.pone.0121807 25837711; PubMed Central PMCID: PMC4383577.
44. Young SL, Bullock W. A. The Mental Health Recovery Measure. Toledo, Ohio: University of Toledo, Department of Psychology; 2003.
45. Bullock WA. The Mental Health Recovery Measure. In: Campbell-Orde T CJ, Carpenter J, Leff HS, editor. Measuring the Promise of Recovery: A Compendium of Recovery Measures. Cambridge, MA: Evaluation Center and Human Services Research Institute; 2005.
46. Moradi M, Brouwers E.P.M., Van den Bogaard J., Van Nieuwenhuizen Ch. Authorized translation in Dutch of the Mental Health Recovery Measure (MHRM), University of Tilburg/ Tranzo. Tilburg, the Netherlands: University of Tilburg/ Tranzo; 2007.
47. van Nieuwenhuizen C, Wilrycx G, Moradi M, Brouwers E. Psychometric evaluation of the Dutch version of the mental health recovery measure (MHRM). The International journal of social psychiatry. 2014;60:162–8. doi: 10.1177/0020764012472302 23396286.
48. Cohen J. Statistical Power Analysis for Behavioral Sciences, Second Edition. Mahwah, NJ. 07430 USA: Lawrence Erlbaum Associates; 1988.
49. Savalei V. Small sample statistics for incomplete non-normal data: Extensions of complete data formulae and a Monte Carlo comparison. Structural Equation Modeling: A Multidisciplinary Journal. 2010;17:241–60.
50. Savalei V. Understanding Robust Corrections in Structural Equation Modeling. Structural Equation Modeling: A Multidisciplinary Journal. 2014;21(1):149–60.
51. Satorra A, Bentler, PM. A scaled difference chi-square test statistic for moment structure analysis, Economics Working Papers 412, Department of Economics and Business, Universitat Pompeu Fabra. A scaled difference chi-square test statistic for moment structure analysis. Business DoEa, editor. Universitat Pompeu Fabra.1999.
52. Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990;107(2):238–46. Epub 1990/03/01. 2320703.
53. Tucker L, Lewis C. A reliability coefficient for maximum likelihood factor analysis. Psychometrika. 1973;38(1):1–10.
54. Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives., 6, 1–55. Structural Equation Modeling. 1999;6(1):1–55.
55. Jöreskog K. A general method for analysis of covariance structures. Biometrika. 1970;57:239–51. doi: 10.1093/biomet/57.2.239
56. IBM Corporation. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corporation; 2015.
57. Muthén LM, Muthén BO. Mplus User’s Guide. Seventh Edition ed. Los Angeles, CA: Muthén & Muthén; 1998–2012.
58. Strauss JS, Carpenter WT Jr. The prediction of outcome in schizophrenia. II. Relationships between predictor and outcome variables: a report from the WHO international pilot study of schizophrenia. Arch Gen Psychiatry. 1974;31(1):37–42. Epub 1974/07/01. PubMed doi: 10.1001/archpsyc.1974.01760130021003 4835985.
59. Harding CM, Brooks GW, Ashikaga T, Strauss JS, Breier A. The Vermont longitudinal study of persons with severe mental illness, II: Long-term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. Am J Psychiatry. 1987;144(6):727–35. Epub 1987/06/01. doi: 10.1176/ajp.144.6.727 3591992.
60. Harding CM, Brooks GW, Ashikaga T, Strauss JS, Breier A. The Vermont longitudinal study of persons with severe mental illness, I: Methodology, study sample, and overall status 32 years later. Am J Psychiatry. 1987;144(6):718–26. Epub 1987/06/01. doi: 10.1176/ajp.144.6.718 3591991.
61. Kortrijk HE, Mulder CL, van der Gaag M, Wiersma D. Symptomatic and functional remission and its associations with quality of life in patients with psychotic disorder in Assertive Community Treatment teams. Compr Psychiatry. 2012;53(8):1174–80. Epub 2012/06/29. doi: 10.1016/j.comppsych.2012.05.001 22738674.
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