Abstract
The prodromal symptoms of schizophrenia are nonspecific and include social withdrawal, sleeplessness, decreased desire, and loss of concentration. Schizophrenia outcomes might be improved if greater therapeutic effort was focused on people with prodromal symptoms. To hasten help-seeking for schizophrenia, we developed a schizophrenia education program for families of patients. Help-seeking and schizophrenia attitudes and knowledge were analyzed among Japanese parents (666 fathers and 613 mothers) of high school students by using the Social Distance Scale-Japanese version, the Link Devaluation-Discrimination Measure and our own questions on help-seeking and schizophrenia knowledge. Statistical analysis included cross-tabulation, the χ2 test, and multiple regression analysis. Most (97.5%) fathers were aged 40 - 59 years; most (78.3%) mothers were aged 40 - 49 years. There was a significant difference between fathers and mothers in basic knowledge of schizophrenia (P 0.05). When asked what treatment they would seek for a child with sleeplessness or social withdrawal, fathers and mothers significantly differed in seeking help medical care at a department of psychosomatic medicine (P differed between fathers and mothers (P = 0.001). In an analysis of parental response to a child with sleepiness and social withdrawal, multiple regression analysis revealed that fathers and mothers significantly differed in the likelihood of seeking help at a department of psychosomatic medicine and from a school nurse and in the likelihood of not seeking help (P
Highlights
Intervention in schizophrenia is a major focus in mental health care worldwide [1,2,3]
Attitude toward schizophrenia was evaluated by using the Social Distance Scale-Japanese version (SDS-J) [15] and the Link Devaluation-Discrimination Measure [13], individual stigma was evaluated by the Social Distance Scale-Japanese version (SDS-J) [15] and social stigma was evaluated by the Link Devaluation-Discrimination Measure [13]
Fathers and mothers significantly differed in their basic knowledge of schizophrenia (P < 0.001; Table 1) but not in their ability to discriminate prodromal symptoms (P > 0.05)
Summary
Intervention in schizophrenia is a major focus in mental health care worldwide [1,2,3]. Duration of psychosis (DUP) is a critical variable, and the importance of intervention within 5 years of the onset of psychosis is acknowledged [4]. Recent research indicates that longer DUP is directly associated with worsening of functional outcomes, symptoms, quality of life and response to antipsychotic medications [5]. Structural magnetic resonance imaging (MRI) studies showed abnormalities in hippocampus, temporal lobe and prefrontal cortex, as well as gray matter changes that are associated with clinical deterioration, including functional and cognitive declines and increased symptom severity [5]. Studies of treatment delays tend to focus on individual or illness-related factors and family or socio-demographic factors [6]. Some but not all studies found that denial of illness and lack of insight account for long DUP [6]
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