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Experiences of victimisation and depression are associated with community functioning among men with schizophrenia

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objectives

The present study aimed to identify proximal and distal factors associated with real life community functioning among men with schizophrenia. Real life community functioning was defined to include: independent living, occupational functioning, social and leisure activities, and substance misuse, self-harm, and aggressive behaviour.

Method

225 men with schizophrenia or schizo-affective disorder were assessed at discharge from hospital and at six-monthly intervals during a two-year period. Information was available from structured interviews with the participants, family members and treatment staff, records of psychiatric treatment, social service files, and official criminal records. Symptoms were assessed using the Positive and Negative Symptom Scale and the Hamilton Rating Scale for Depression. Substance misuse was measured by self-report and hair and urine analyses. Predictors of outcome were divided into four categories: childhood, adulthood, year prior to functional outcome assessment, and con-current.

Results

In a final regression model, five predictors were significantly associated with patients’ real life functioning: two adult life-time variables—a diagnosis of drug abuse/dependence and level of education and three current variables—victimisation, depression, and medication non-compliance. Most of the variance in the final outcome scores was explained by current predictors.

Discussion

In order to elevate levels of psychosocial functioning among men with schizophrenia, clinicians need to assess victimisation experiences, and, when present, design and implement interventions to help patients protect themselves. In addition, depression needs to be identified and treated, and compliance with antipsychotic medication assured.

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Acknowledgments

The authors would like to thank the patients and their families who participated in this study. The Comparative Study of the Prevention of Crime and Violence by Mentally Ill Persons is being conducted by S. Hodgins, Institute of Psychiatry, King’s College, London; D. Eaves, Vancouver, Canada; M. Eronen, Vanha Vaasa Hospital and Niuvanniemi Hospital, Finland; S. Hart, Simon Fraser University, Canada; R. Kronstrand, Rättsmedicinalverket and Linköping University, Sweden; S. Levander, University Hospital, MAS, Malmö, Sweden; R. Müller-Isberner, Klinik für forensische Psychiatrie Haina, Germany; J. Tiihonen, University of Kuopio, Finland; C. D. Webster, Simon Fraser University & McMaster University, Canada; R. Freese, Klinik für forensische Psychiatrie Haina, Germany; A. Grabovac, Riverview Hospital, Vancouver, Canada; D. Jöckel, Klinik für forensische Psychiatrie Haina, Germany; A. Kreuzer, Justus Liebig Universität, Germany; A. Levin, Forensic Psychiatric Hospital, British Columbia, Canada; S. Maas, Klinik für forensische Psychiatrie Haina, Germany; E. Repo-Tiihonen, Niuvanniemi Hospital, Finland; D. Ross, Riverview Hospital, Vancouver, Canada; E. Tuninger, M.D., University Hospital, MAS, Malmö, Sweden; I. Kotilainen, University of Kuopio, Finland; K. Väänänen, Vanha Vaasa Hospital, Finland; P. Toivonen, Vanha Vaasa Hospital, Finland; H. Vartiainen, Helsinki Central University Hospital, Finland; A. Vokkolainen, Niuvanniemi Hospital, Finland. Grants to support this study have been awarded by the BIO-MED-II Programme of the European Union; Canada: the Forensic Psychiatric Services Commission of British Columbia, Mental Health, Law and Policy Institute, Simon Fraser University and Riverview Hospital; Finland: Niuvanniemi and Vanha Vaasa State Mental Hospitals; Germany: Deutsche Forschungsgemeinschaft and Institut für forensische Psychiatrie Haina; Sweden: Medicinska Forskningrådet, Vårdalstiftelsen, National Board of Forensic Medicine, Forensic Science Centre, Linköping University and Linköping University. Sheilagh Hodgins is a holder of a Wolfson Merit Award from the Royal Society and member of the NIHR Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust/Institute of Psychiatry, King’s College London.

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Authors and Affiliations

  1. Institute of Psychiatry, King’s College London, PO23, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK

    Sheilagh Hodgins & Tim Mak

  2. University of Marburg, Marburg, Germany

    Tania Lincoln

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  1. Sheilagh Hodgins
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  2. Tania Lincoln
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Correspondence to Sheilagh Hodgins.

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Hodgins, S., Lincoln, T. & Mak, T. Experiences of victimisation and depression are associated with community functioning among men with schizophrenia. Soc Psychiat Epidemiol 44, 448–457 (2009). https://doi.org/10.1007/s00127-008-0460-8

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  • DOI: https://doi.org/10.1007/s00127-008-0460-8

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