Long‐ and short‐term inpatients with schizophrenia in China: Implications for community‐based service development

Abstract

Introduction There is an increasing interest in the patterns of mental health care of people with serious mental illnesses in China, where outpatient and community‐based care are not fully developed and long‐term hospitalization is still not uncommon. Comparison of sociodemographic and clinical characteristics of long‐term and short‐term inpatients diagnosed with schizophrenia can be informative about pattern of treatment and their relationship to services needs. Methods Seventy‐three long‐term schizophrenia inpatients (current length of stay of more than 5 years) were compared to 116 short‐term schizophrenia inpatients (current length of stay of 30 days or less) assessed with the Individual Background Questionnaire, the Positive and Negative Syndrome Scale (PANSS) and the Social Support Rating Scale (SSRS). Results There was no significant difference between the groups on the total PANSS symptom score but the short‐term inpatients scored significantly higher than their long‐term counterparts on the Positive Syndrome sub‐scale and the SSRS and lower on the Negative Syndrome sub‐scale. Discussion Differences in symptomatology and social functioning may be related to better medication adherence and more extended social isolation among long‐term inpatients while the increased positive symptoms are likely to reflect more acute disease process in short‐term inpatients, and possibly poorer medication adherence. These differences may be especially pronounced in developing countries like China in which community‐based services need to be more fully developed to facilitate medication adherence and prevent relapse, and to support community adjustment of socially isolated patients who otherwise require hospitalization.

Disentangling depression and anxiety in relation to neuroticism, extraversion, suicide, and self‐harm among adult psychiatric inpatients with serious mental illness

“…Furthermore, significant correlations of neuroticism with specific depression and anxiety, on top of general distress, indicate that trait negative affectivity is common across all facets of depression and anxiety, potentially contributing to the expression of depression, anxiety, and depression–anxiety comorbidity in adult inpatients (Bauer et al ., ; Brown et al ., ; Melartin et al ., ; Wu et al ., ). Future research might therefore explore whether elevated trait negative affectivity and its corresponding negative emotions such as anger and guilt (Tellegen, ) predict risk for developing clinically severe depressive and/or anxiety psychopathology in adults prior to hospitalization.…”

“…However, extant data indicate that these syndromes are highly associated and comorbid (Brown, Campbell, Lehman, Grisham, & Mancill, ; Gorman, ; Kessler et al ., ; Pollack, ), possessing similar genotypic heritabilities (Demirkan et al ., ; Kendler, Prescott, Myers, & Neale, ; Wray et al ., ), symptom structures (Watson et al ., ,b), and psychological intervention responsiveness (Borkovec, Abel, & Newman, ; Brown, Anthony, & Barlow, ). Adult psychiatric inpatients with serious mental illness (SMI: Kessler et al ., ) comprise a clinical population characterized by elevated depression and anxiety (Bauer et al ., ; Cosoff & Hafner, ; Frame & Morrison, ; Nakaya, Ohmori, Komahashi, & Suwa, ; Wu et al ., ), high depression–anxiety comorbidity (Clayton, ; Melartin et al ., ; Mulsant, Reynolds, Shear, Sweet, & Miller, ), and heightened risk for suicide and self‐harm (Mann, Waternaux, Haas, & Malone, ; Nijman et al ., ; Powell, Geddes, Hawton, Deeks, & Goldacre, ). Therefore, understanding the structure of depression–anxiety comorbidity symptomology and its associations with suicide/self‐harm behaviours may have important clinical implications for this population.…”

Comparisons of Health-Related Quality of Life and Impact Factors in Patients with Depression and Schizophrenia

“…Given the special characteristics in the two groups, it is urgent to deliver more speci c interventions at multi-level respectively [33,34]. Providing these patients with adequate and continuous interventions at family and community level to improve their poor HRQOL seems to be better than simple clinical and single level intervention strategy [35].…”

Prevalence, Influencing Factors, and Cognitive Characteristics of Depressive Symptoms in Elderly Patients with Schizophrenia

“…For this study, genomic DNA was extracted from blood cells after high-speed centrifugation using a blood genomic DNA extraction kit (Qiagen NV, Venlo, the Netherlands), and multiplex amplification refractory mutation system polymerase chain reaction was used to determine APOE genotype. According to a previously described method, 37 APOE E2 included ε2/ε2, ε2/ε3, and APOE E3 included ε3/ε3, while APOE E4 types included ε3/ε4, and ε4/ε4.…”