Service Engagement: Psychopathology, Recovery Style and Treatments

Simone Vender,Cristiano Bonalumi,Camilla Callegari,Francesca Aletti,Nicola Poloni

doi:10.1155/2014/249852

Abstract

The aim of the present study is to evaluate how recovery style, a set of strategies used by patients to interact with services and therapists, and the severity of psychotic symptoms affect the quality/continuity of taking charge of each patient. 156 psychotic patients at different stages of illness were enrolled. Sociodemographic and clinical data were collected and integration/sealing-Over Scale, Recovery Style Questionnaire and Positive and Negative Syndrome Scale were administered. Patients were distinguished into four groups according to the type of treatment received: clinical package, hospital package, day-care package, and residential package. A positive correlation between the cost of psychiatric performance and psychopathological severity (measured with PANSS scores) was identified. No association emerged between ISOS/RSQ total scores and costs. The sanitary expenditure appears to be linked to positive psychotic symptoms while lower performances are given for the treatment of patients with predominant negative symptoms. Recovery style itself has not a direct influence on the quantity/quality of psychiatric services.

Highlights

The turn of the century has seen a number of changes in perceptions of mental disorder, treatment approaches and goals, and mental care systems [1]
Schizophrenia, delusional disorder, schizoaffective disorder, and mood disorders with psychotic symptoms are diseases characterized by a loss of contact with reality, a fracture in experiential continuity, an impairment of ego functions as well in the personal and social functioning
We used a consecutive sampling over a period of 18 months (September 2011–February 2013) and we included patients with diagnosis of psychotic disorders and mood disorders with psychotic symptoms according to the International Classification of Diseases (ICD-10) criteria [23]

Summary

Introduction

The turn of the century has seen a number of changes in perceptions of mental disorder, treatment approaches and goals, and mental care systems [1]. It is crucial to understand whether a patient, in particular if affected by psychotic disorder, will adhere to treatment sufficiently to provide therapeutic benefits. The concept of service engagement emerges in the psychiatric literature in the early 1990s: until the 1980s most work on patients’ engagement with medication regimes was described as compliance. This expression has fallen out of favour in clinical practice because of the increasing concern that the term carries an assumption that patients are passive recipients of the doctors and that the clinician is always in a position of authority. It is important to consider that the patient and the professional may legitimately hold differing ideas about what would be the appropriate treatment intervention and that the management of any symptoms or disorder will require negotiation [2]

Objectives

Methods

Results

Discussion

Conclusion