The chronic phase of schizophrenia is characterized by illness progression and patients encountering difficulties to return to premorbid level of functioning. The objective of this study was to describe the characteristics of a sample of patients with chronic schizophrenia, as well to assess differences between patients under and over 45 years of age. In a clinical sample of 77 chronic schizophrenia patients, we assessed basic symptoms, cognitive performance, social functioning and quality of life. All participants obtained very high scores in residual symptoms, and no differences in sociodemographic or clinical characteristics between the age groups were found. Younger patients had better cognitive performance and older patients obtained better scores for social functioning and quality of life. Number of psychotropic drugs, verbal learning delayed of SCIP, errors in WCST, Similarities and Digit Symbol Coding of WAIS were the most important variables to predict global functioning of patients over 45 years old. Increasing our understanding of differences in characteristics of the chronic phase of the illness and the profile of functioning at different ages, may help us design intervention strategies to improve adaptation in young and middle-aged patients with chronic schizophrenia.
The Quality of Life (QoL) in psychiatric patients is currently of great relevance. This study aims to examine, through a multi-informant approach, the QoL perception in schizophrenic patients, analyzing differences between the informants, as well as the relationship between negative symptoms and QoL. Participants were 32 schizophrenic patients, their caregivers (relatives or psychosocial educators; 25 and 3, respectively), and a team of four professionals of Outpatient Centers of Mental Health in Guipuzcoa, Spain. The assessment of patients’ QoL was obtained with application of Satisfaction with Life Domains Scale and Karnofsky Performance Status Scale. Self-informant QoL was assessed with Seville Quality of Life Questionnaire and Social Adjustment Scale Self-reported. The negative symptoms were measured with the Brief Psychiatric Rating Scale and the Scale for Assessment of Negative Symptoms. Patients showed an average high life satisfaction. There were significant discrepancies among informants’ reports, with the lowest evaluation given by the professional team and the highest by the patients. Evaluations made by caregivers and patients yielded similar results. These findings suggest that patients and their caregivers present a more optimistic perception of their QoL.
The aim of this study was to explore differential psychological profiles among patients with chronic pain with and without fibromyalgia, and to determine the results of the cognitive behavioral therapy (CBT) for pain. Thirty patients with chronic pain and 60 patients with fibromyalgia were referred to 10 weekly sessions of CBT in a general hospital and were evaluated in pain‐related variables, psychopathological symptoms, coping strategies, resilience, and quality of life. The program was implemented in specific groups for patients with fibromyalgia and nonfibromyalgia chronic pain. After the intervention, patients with fibromyalgia showed higher levels of psychopathology, rated their health status as poorer, and presented larger amplification of symptoms, higher levels of somatization, a more ruminating style of thinking and greater distress. Patients without fibromyalgia achieved better therapeutic results in both pain intensity (d = 0.39 vs. d = 0.12) and psychopathological distress (d = 0.77 vs. d = 0.11) compared to patients with fibromyalgia. Therefore, differential profiles and limited therapeutic results in fibromyalgia patients suggest the need to outline differentiated treatments and include other therapeutic strategies.
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