Comparison of schizophrenia outpatients in residential care facilities with those living with someone: Study of mental and physical health, cognitive functioning, and biomarkers of aging

Lee, Ellen; Martin, Averria Sirkin; Kaufmann, Christopher N.; Liu, Jinyuan; Kangas, Julie L.; Daly, Rebecca; Tu, Xin; Depp, Colin A.; Jeste, Dilip V.

doi:10.1016/j.psychres.2019.02.067

Cited by 13 publications

(11 citation statements)

References 59 publications

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“…Furthermore, a higher proportion of people living in rental accommodation were smokers, consistent with the literature that smoking is more prevalent in the socioeconomic disadvantaged [70] and people with lower income [71]. Lee et al (2019) showed that residents with schizophrenia in homes smoked more cigarettes, suggesting living arrangements may influence smoking behavior [72].…”

Section: Discussionsupporting

confidence: 85%

Associations of living arrangements with symptoms and functioning in schizophrenia

2021

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Background Living arrangements and accommodation are closely related, but no study had concurrently investigated their associations with outcomes in schizophrenia. This study seeks to describe and compare socio-demographic, clinical and functioning profiles of people with schizophrenia in different living arrangements and accommodation, and to examine the associations of living arrangements and accommodation with symptomatic remission and functioning. Methods Community dwelling outpatients with schizophrenia (n = 276) were inquired on living arrangements, accommodation, socio-demographics and assessed on the Positive and Negative Syndrome Scale (PANSS) and the Social and Occupational Functioning Scale (SOFAS). Socio-demographics, symptoms and functioning of outpatients in different living arrangements and accommodation were compared. Symptomatic remission was investigated using logistic regression with living arrangements, socio-demographics and clinical variables as independent variables. Functioning was investigated using multiple regression with the same set of independent variables and the addition of PANSS factors. The same analyses were conducted with accommodation as independent variable. Results 185 (67.03%) participants lived with family and 195 (70.65%) participants lived in owned accommodation. People living with their spouses had significantly higher SOFAS, lower PANSS Total and PANSS Positive than people living with family, independently, or in rehabilitation centres. They also had lower PANSS Negative than people living with family and a higher likelihood to have achieved symptomatic remission. Types of accommodation was not associated with symptoms, symptomatic remission, and functioning. Conclusion Living arrangements, but not types of accommodation, were associated with symptoms and functioning in schizophrenia. Family education and support is important to help maintain a conducive environment for people with schizophrenia. People living independently may need more support.

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Section: Discussionsupporting

confidence: 85%

Associations of living arrangements with symptoms and functioning in schizophrenia

2021

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“…For example, individuals with schizophrenia or bipolar disorder may be more susceptible to COVID-19 infection 4 , 5 and, if infected, those with schizophrenia appear to be more than three times as likely than persons without schizophrenia to experience a severe clinical course 6 . Reasons for these disparities are many and varied but likely include greater vulnerability to stress 7 , 8 , reduced access to healthcare services 9 , 10 , increased prevalence of high risk factors such as obesity or diabetes 11 , 12 , and/or greater likelihood of communal living situations 13 where rates of transmission could be increased.…”

Section: Introductionmentioning

confidence: 99%

COVID-19-related psychological distress and engagement in preventative behaviors among individuals with severe mental illnesses

et al. 2021

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Individuals with severe mental illnesses (SMIs) may be disproportionately vulnerable to COVID-19 infection and psychological distress. This study investigated the prevalence of engagement in COVID-19 preventative behaviors, predictors of these behaviors, and COVID-19-related psychological distress. One hundred and sixty-three individuals with SMIs (94 with schizophrenia spectrum illnesses and 69 with affective disorders) and 27 psychiatrically healthy comparison participants were recruited from ongoing studies across 3 sites, to complete a phone survey querying implementation of 8 specific COVID-19 preventative behaviors that participants engaged in at least once in the past month as well as standard assessments of depression, anxiety, perceived stress, loneliness, and coping. Data were collected between 3 April 2020 and 4 June 2020. The large majority of our SMI sample, which consisted of outpatients with relatively mild symptom severity, endorsed engaging in multiple preventative behaviors. Relatively few differences were found between groups; however, individuals with SMI were less likely to work remotely than healthy individuals and individuals with schizophrenia spectrum illness were less likely to stay home as a preventative measure, wear face masks, and work remotely than individuals with affective disorders. Differences in staying home remained after controlling for potential confounds. Although individuals with SMI reported more psychological distress related to COVID-19, this distress was largely unrelated to engagement in preventative behaviors. The large majority of individuals with SMI in this outpatient sample, regardless of broad diagnostic category, reported performing multiple behaviors intended to prevent COVID-19 infection at least once a month and reported distress associated with the pandemic. These findings suggest a good level of awareness of COVID-19 among stable outpatients with SMI. The degree to which more acutely ill persons with SMI engage in such preventative behaviors, however, remains to be examined.

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“…However, in residential care facilities, healthcare workers continue to assist severe patients during the process of activities of daily living. This assistance may decrease the capacity-performance discrepancy and improve mental and physical health [ 38 ]. Nevertheless, this cross-sectional study did not determine a causal relationship between the capacity-performance discrepancy and environmental barriers.…”

Section: Discussionmentioning

confidence: 99%

Environmental Barriers and Functional Outcomes in Patients with Schizophrenia in Taiwan: The Capacity-Performance Discrepancy

Lien

Wang

et al. 2021

IJERPH

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Environmental factors are crucial determinants of disability in schizophrenic patients. Using data from the 2014–2018 Certification of Disability and Care Needs dataset, we identified 3882 adult patients (46.78% females; age, 51.01 ± 13.9 years) with schizophrenia. We found that patients with severe schizophrenia had lower capacity and performance than those with moderate schizophrenia. The chances of having an access barrier to environmental chapter 1 (e1) products and technology in moderate schizophrenic patients and in severe schizophrenic patients were 29.5% and 37.8%, respectively. Logistic regression analyses demonstrated that the performance score was related to accessibility barriers in the categories described in e1, with adequate fitness of models in category e110 for personal consumption, e115 for personal usage in daily living activities, and e120 for personal outdoor and indoor mobility and transportation. Furthermore, the capacity-performance discrepancy was higher in moderate schizophrenic patients with accessibility barriers in the e110, e115, and e120 categories than that in moderate schizophrenic patients without accessibility barriers. However, severe schizophrenic patients with category e120 accessibility barriers were prone to a lower discrepancy, with institutional care a potentially decreasing factor. In conclusion, providing an e1 barrier-free environment is necessary for patients with schizophrenia to decrease their disability.

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Comparison of schizophrenia outpatients in residential care facilities with those living with someone: Study of mental and physical health, cognitive functioning, and biomarkers of aging

Cited by 13 publications

References 59 publications

Associations of living arrangements with symptoms and functioning in schizophrenia

Associations of living arrangements with symptoms and functioning in schizophrenia

COVID-19-related psychological distress and engagement in preventative behaviors among individuals with severe mental illnesses

Environmental Barriers and Functional Outcomes in Patients with Schizophrenia in Taiwan: The Capacity-Performance Discrepancy

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