Symtoms and Social Adjustment of Schizophrenic Patients as Evaluated by Their Family Members: A Cross‐Cultural Psychiatric Study between Offshore Islands and an Urban City

Abstract

We conducted a comparative study of symptoms and social adjustment of schizophrenic patients on offshore islands and one urban region in Japan. In the evaluation of symptoms and social behavior by family members, no differences were observed between the two regions. Looking at social adjustment in the two regions, no differences were observed by family members either in the performance level or in the expectation level of socially expected activities. However, on the offshore islands, the expectation level of socially expected activities by family members was significantly higher than the level of self‐accomplishment set by schizophrenic patients themselves. As for leisure activities, both family members and patients on the islands evaluated the level of performance to be significantly higher than in the urban region, and the level of satisfaction of the patients themselves was also higher on the islands. Considering both these findings and Japanese traditional views of work and leisure, it is believed that on the islands patients are required to engage in more productive activities and less leisure activities than in the urban region. Further it seems that patients on the islands compared to patients in the urban region may have greater difficulty in social adjustment.

Symptoms and social adjustment of schizophrenic patients as evaluated by family members

“…Our results also support this conclusion. In a study we conducted on the same subjects 2years ago, we identified that family members in this area expected patients to achieve more in productive activities than leisure activities compared with those in urban areas (33). Considering this together with the results of this study, it is suggested that relatives' over-expectation regarding patients' productive activities and their negative attitude towards patients' leisure activities were expressed as high EE.…”

“…Sappington et al (26) reported that morbid state evaluation by family members estimated outcome more accurately than clinical evaluation, and as such, greater attention should be paid to the threshold of acceptance or refusal of the illness by family members. In our previous studies, we have examined the relationship between family recognition and motivation of visits to psychiatric institutions, relapse of mental symptoms, social outcome of patients (27)(28)(29)(30)(31)(32)(33). In this study we examine the relationship between the recognition modes of family members on patients' symptoms, social adjustment evaluated using the Katz Adjustment Scale (KAS) and the EE of family members.…”