Biomedical subjects

M Scazufca

Publications and source records attributed to M Scazufca.

6 recordsLinked to original sources

PubMed2002

[Epidemiological research on dementia in developing countries].

As the world population is ageing, dementia becomes an important public health problem, particularly in developing countries. Epidemiological research in these settings is scarce and present additional methodological difficulties, mainly regarding the socio-cultural adequacy of instruments used to identify cases of dementia. As a result of these concerns the 10/66 Dementia Research Group was founded to fill this gap. This is an international network of investigators, mostly from developing countries, and the group's name was based on the paradox that less than 10% of the population-based studies on dementia are directed to 2/3 or more cases of people with dementia living in developing countries. The aim of the paper is to update data in the literature regarding the differences in dementia prevalence and incidence seen in developed and developing countries.

Dementia↗

PubMed2001

Perception of negative emotions in close relatives by patients with schizophrenia.

OBJECTIVES: The perception of negative emotions in close relatives may play an important role in explaining how external stressors can affect vulnerable individuals with schizophrenia. However, there is considerable debate about the ability of people with schizophrenia to perceive emotions in others. The present study aimed to examine the reliability of patients' perception of relatives' criticism. Secondly, it aimed to investigate whether patients' judgement about relatives' criticism agreed with an independent assessment of relatives' criticism towards patients. METHOD: Forty-three patients with a DSM-III-R diagnosis of schizophrenia and their relatives were assessed soon after patients' admission to a psychiatric hospital and again 9 months after their discharge from hospital. Test-retest reliability of patients' answers to a question about patients' perception of relatives' criticism towards them was carried out. The association between patients' perception of relatives' criticism and the expressed emotion (EE) measure of relatives' criticism was examined at inclusion and follow-up. Patients' symptomatology was examined at both assessments. RESULTS: Reliability of the measurement of patients' perception of relatives' criticism was moderate to good. Patients' judgement of relatives' criticism towards them was associated with the number of critical comments and presence of hostility at inclusion. At follow-up, this association became weaker. CONCLUSION: The ability to judge and describe reliably negative emotions in close relationships may help to explain how perception of the external environment may act as a stressor in people who are vulnerable to schizophrenia.

Adolescent↗

PubMed2000

Household crowding and compliance with outpatient treatment in patients with non-affective functional psychoses in São Paulo, Brazil.

BACKGROUND: Compliance with outpatient treatment can reduce the use of psychiatric inpatient services by people with severe mental disorders. In developing countries, socio-economic factors may be associated with compliance with outpatient treatment. METHODS: A 2-year prospective cohort study was conducted of 99 patients with non-affective functional psychoses who were discharged from hospital. Standardized assessments were used for psychopathology, social functioning and use of psychiatric services. RESULTS: Forty-two patients (42.4%) missed all outpatient appointments for at least 2 consecutive months. Household crowding was the only variable associated with poor compliance, patients living in very crowded homes being more than twice as likely to show poor compliance as those living in less crowded homes. CONCLUSIONS: In large urban centres in developing countries, strategies to improve compliance with outpatient treatment targeted towards those living in overcrowded households may reduce use of psychiatric beds.

Adolescent↗

PubMed1999

Coping strategies in relatives of people with schizophrenia before and after psychiatric admission.

BACKGROUND: Most research on expressed emotion (EE) has used an empirical approach to describe relatives' ways of coping with people with schizophrenia. AIMS: To use the stress and coping model proposed by Lazarus and Folkman to examine how relatives coped with patients. METHOD: Patients with DSM-III-R schizophrenia and their relatives were assessed just after hospitalisation of the patients and nine months after discharge. Both assessments included the symptoms of the patients and the coping strategies, burden, distress and levels of EE of the relatives. RESULTS: Fifty patients and 50 relatives were assessed at inclusion, and 31 patients and 36 relatives at follow-up. Coping strategies were used more frequently at inclusion than at follow-up. Problem-focused coping was the strategy used more often at both assessments. Avoidance coping was strongly associated with burden, distress and high EE at both assessments. CONCLUSIONS: Ways of coping are influenced by relatives' perceptions of the situation with patients. Avoidance strategies seem to be less effective in regulating the distress of care-givers than problem-focused strategies.

Adaptation, Psychological↗

PubMed1998

Stability of expressed emotion in relatives of those with schizophrenia and its relationship with burden of care and perception of patients' social functioning.

BACKGROUND: There is evidence that high expressed emotion (EE) in relatives of patients with schizophrenia is associated with higher levels of burden of care, and with worse perception of patient's social functioning. However, it is not clear whether changes in EE levels over time are associated with changes in relatives' burden of care and their perception of patients' social functioning. METHODS: Fifty patients with a diagnosis of schizophrenia and 50 relatives were included in the study soon after patients' admission to hospital. Thirty-six relatives and 31 patients were re-assessed 9 months after patients' discharge. Both assessments included patients' symptomatology and relatives' EE levels, burden of care, and perception of patients' social functioning. RESULTS: Twenty-three relatives (64%) had the same EE level in both assessments, nine (25%) had changed from high to low EE, and four (11%) from low to high EE. Improvement in burden and perception of patients' social role performance were significantly more accentuated among relatives who changed from high to low EE than among relatives who had a stable EE level. Variables that best predicted changes in EE levels were changes in burden scores and number of hours of contact between patients and relatives at follow-up. CONCLUSIONS: Change in EE is associated with change in circumstances and burden. Findings support the idea that EE is better understood in an integrative model.

Adolescent↗

PubMed1996

Links between expressed emotion and burden of care in relatives of patients with schizophrenia.

BACKGROUND: Findings that the EE level of a relative may change over time support the idea that EE may represent the circumstances of the relationship between patient and caregiver. The present study examines to what extent EE levels in relatives are related to relatives' burden of care and their perceptions of patients' deficits in social role performance. METHOD: Fifty patients recently admitted to hospital with DSM-III-R diagnoses of schizophrenia or schizophreniform disorder were assessed for positive and negative symptoms. Fifty relatives who were living or were in close contact with these patients were interviewed for the assessment of EE and burden or care, and to provide information about patients' social role performance and social and behaviour problems. RESULTS: High-EE relatives had considerably higher mean scores for burden of care then low-EE relatives relatives (12.5 v. 6.8, respectively, P = 0.002), and perceived more deficits in patients' social functioning than low-EE relatives (means: 16.2 v. 6.9, respectively, P = 0.004). The employment status of relatives was the only socio-demographic characteristic of relatives and patients associated with EE levels, those who were working being less likely to be high EE. Patients' psychopathology was not associated with EE levels and burden of care. CONCLUSIONS: This study shows that EE and the burden of care are related. EE and burden both measure aspects of the relationship between relatives and patients. These findings suggest that EE and burden of care are more dependent on relatives' appraisal of the patient condition than on patients' actual deficits.

Activities of Daily Living↗