Biomedical subjects

Eija Stengård

Publications and source records attributed to Eija Stengård.

9 recordsLinked to original sources

PubMed2006

Body mass index and functioning in long-term schizophrenia. Results of the DSP project.

OBJECTIVE: The study evaluates the association of body mass index (BMI) with functioning in male and female patients with long-term schizophrenia. METHOD: 722 long-term schizophrenia patients were interviewed three years after discharge from hospital. Their weight and height were recorded and data on their background, illness history, psychosocial functioning (Global Assessment Scale; GAS), health behaviour, daily doses of neuroleptics, and psychiatric symptoms were collected. RESULTS: BMI correlated significantly with GAS scores in male (r=0.202, p=0.000) but not in female patients. In male patients, BMI associated significantly (p=0.005) with GAS scores even when the effects of psychiatric symptoms and other confounding variables were taken into account. CONCLUSIONS: In male but not in female long-term patients with schizophrenia, low BMI associates with poor functioning. It is suggested that among male schizophrenia patients, low BMI may be an indicator of poor functioning.

Adult↗

PubMed2006

Subjective life satisfaction and living situations of persons in Finland with long-term schizophrenia.

OBJECTIVE: This study measured subjective life satisfaction among patients with long-term schizophrenia who were living in the community. METHODS: A representative national sample of 2,221 persons with schizophrenia who were discharged from psychiatric hospitals in Finland in 1986, 1990, and 1994 were interviewed three years after discharge. Subjective life satisfaction was measured; patients were asked about their current level of satisfaction and the level of satisfaction they recalled having at the time of discharge. RESULTS: Patients tended to report more satisfaction at follow-up if they were female, had good psychosocial functioning, had several confidants, or were living in group homes or dormitories. Patients tended to be less satisfied at follow-up if they were divorced or had mental and physical symptoms. Patients with depressive symptoms or with low psychosocial functioning and those who were currently hospitalized reported the smallest changes in levels of satisfaction between the two time points. Patients with low psychosocial functioning who were living with their parents, in group homes or dormitories, or in institutions were relatively satisfied, whereas patients with good psychosocial functioning were more satisfied if they lived with their spouse or partner. CONCLUSIONS: Being female and having good psychosocial functioning, confidants, good physical health, and living arrangements in the community that offer support corresponding to the patient's psychosocial state are important factors of life satisfaction among patients with long-term schizophrenia.

Adaptation, Psychological↗

PubMed2004

Violent victimization in schizophrenia.

BACKGROUND: We investigated the 3-year prevalence, and the sociodemographic and clinical correlates of violent victimization in a large and unselected nationwide sample of deinstitutionalized patients with schizophrenia. METHODS: The sample comprised 670 schizophrenic patients aged 15-64 years, who had been discharged from psychiatric hospitals in Finland in 1994. Comprehensive data were collected from psychiatric case records on the patients' sociodemographic factors and psychiatric history, as well as the patients' overall level of functioning. The patients were interviewed 3 years after discharge by each district's psychiatric professionals using a structured interview schedule specifically designed for the purposes of the present study project. RESULTS: The prevalence of self-reported violent victimization during the 3-year follow-up was 5.6%. In the multivariate analysis, a poor financial situation, alcohol abuse and being a perpetrator of a violent or some other crime were associated with violent victimization. CONCLUSIONS: The prevalence of violent victimization among schizophrenic patients in Finland was markedly lower than that reported on patients in the United States or Great Britain, but correlates were similar. Patients with a poor financial situation and a history of alcohol misuse, as well as of violent behaviour, seem to have an increased risk for violent victimization, and constitute a vulnerable subgroup in this respect. This subgroup of deinstitutionalized patients with schizophrenia may need additional care and protection from the danger posed to them from other members of the society.

Adolescent↗

PubMed2003

Negative symptoms and neuroleptics in catatonic schizophrenia.

The association between neuroleptic treatment and the negative symptom dimension (ND) was evaluated in 1528 schizophrenia patients. In patients receiving more than 820 mg chlorpromazine (CPZ), those with catatonic-type disorder had significantly (p<0.05) higher ND scores than those in any of the other diagnostic subtypes. Even in patients receiving 450 mg CPZ or more, catatonic patients had significantly (p=0.046) higher ND scores than other patients. Patients with catatonic schizophrenia are highly vulnerable to negative symptoms related to neuroleptic drugs, probably because of a defect in their dopaminergic neuronal pathways.

Adolescent↗

PubMed2003

Schizophrenic patients in different treatment settings during the era of deinstitutionalization: three-year follow-up of three discharge cohorts in Finland.

OBJECTIVE: We investigated differences in psychosocial and clinical characteristics, as well as the use of services, of schizophrenic patients in different treatment settings three years after their discharge from a psychiatric hospital. Furthermore, we examined secular changes in these phenomena during the era of rapid deinstitutionalization in Finland. METHOD: Three nationally representative samples comprised 3257 schizophrenic patients who had been discharged in 1986, 1990 and 1994. The patients were interviewed three years after discharge by each district's psychiatric professionals using a structured interview schedule specifically designed for the purposes of the present study. Psychosocial functioning was assessed on the Global Assessment Scale and on a modified version of the Medical Research Council Practices Profile. RESULTS: In the 1990s, more patients with a poor clinical and psychosocial state were transferred from hospital to alternative outpatient facilities, such as sheltered workshops or supported residences. In successive cohorts, the proportion of patients who had dropped out of treatment decreased and the psychiatric and somatic state of the drop-outs improved. CONCLUSION: In general, the psychiatric treatment system has worked well for most deinstitutionalized patients. In the future, however, it is important that the quality of care and adequate resources in the alternative outpatient facilities are ensured.

Adolescent↗

PubMed2003

Educational intervention for the relatives of schizophrenia patients in Finland.

Two methods of providing an educational intervention for families of patients with schizophrenia in Finland were compared. The aims of the intervention were to improve relatives' level of knowledge about the illness, and change the level of expressed emotion (EE), objective burden and psychological distress. Sixty-nine persons participated in the oral presentation groups comprising eight sessions and 128 persons participated in the video education comprising six sessions. The education led to significant knowledge gains and to an increase in the psychological well-being of the participants, but there were no significant changes in objective burden or EE status after intervention. Furthermore, there was only one difference between the two methods of information delivery. The participants in the video groups felt more often that the lessons were useful to them than did the participants in the oral presentation groups. The evidence suggests that brief educational intervention can yield significant benefits in meeting the needs of family members. Better designed, randomized studies investigating the efficacy of brief educational interventions are needed.

Adult↗

PubMed2002

Mortality in chronic schizophrenia during decreasing number of psychiatric beds in Finland.

Mortality, especially mortality due to suicides, is higher among patients suffering from schizophrenia than among the general population. Little is known about the factors predicting the mortality of schizophrenia patients. It has also been suggested that mortality among psychiatric patients increases as the number of beds in mental hospitals decreases. These questions were studied in 4338 schizophrenia patients discharged in 1982, 1986, 1990 and 1994 from mental hospitals in Finland. During this period, the number of beds in mental hospitals in Finland decreased from 3.8 to 1.3 per 1000 inhabitants. During the three-year follow-up, 226 patients or 5.2% died. There were no statistically significant differences in mortality between the cohorts. The total mortality was higher in males than in females. Age, physical illness and number of hospital days predicted increased mortality due to natural causes. Mortality due to unnatural causes (suicides and accidents) was predicted by number of prescribed psychosedatives, number of hospitalisations and short duration of illness. Mortality due to unnatural causes was higher in the first year after index discharge from hospital. The reduction in number of beds in mental hospitals does not seem to be associated with increased mortality in chronic schizophrenia. The high mortality of schizophrenia patients indicates the need for careful medical examinations and treatment of physical illnesses, as well as counselling for a healthy lifestyle. Need for psychosedative medication at discharge from hospital and multiple previous hospitalisations may indicate an increased suicide risk and thus requires special attention. In outpatient treatment, it is important to remember that the risk of unnatural death increases during the first years after discharge from hospital.

Adolescent↗

PubMed2002

Symptom dimensions and their association with outcome and treatment setting in long-term schizophrenia. Results of the DSP project.

National representative samples of 1571 schizophrenia patients discharged from mental hospitals in Finland in 1990 and 1994 were interviewed 3 years after discharge. The symptom items assessed by the PANSS were factorized and orthogonal rotations were performed. Five factor dimensions, negative, positive, depressive, hostile and disorganization dimension, were obtained and correlated with data of patients' socio-demographic background, clinical history, condition and outcome. The negative dimension was more prominent in male and single patients, the depressive dimension in female and divorced patients. Patients with early onset and long duration of illness had high disorganization scores. Patients with disorganized subtype of schizophrenia had high scores in positive and disorganization dimensions. High scores in all, especially in negative and positive dimensions, were associated with poor psychosocial situation. Symptom dimensions varied also according to treatment setting at follow-up. Symptom dimensions of long-term schizophrenia patients in the community are closely associated with patients' socio-demographic background, clinical history and conditions, as well as with outcome and the treatment patients receive. A dimensional approach, instead of a categorical one, seems to be important in assessing symptomatology and its relation to outcome and interventions in schizophrenia.

Adolescent↗

PubMed2002

Caregiving types and psychosocial well-being of caregivers of people with mental illness in Finland.

The burden on caregivers of the mentally ill and their need for information and support have been well documented. The present study aimed to describe how different types of caregivers cope with the demands imposed by a family member's mental illness. Five distinct types of caregivers were identified according to the caregiving dimensions: supervising, anxious, coping, resigned, and activating. The results of this study show that mental health professionals should be aware of the caregiving consequences, personal meaning in caregiving, and coping strategies used in order to be able to offer appropriate interventions that optimally meet caregivers' needs.

Adaptation, Psychological↗