Treatment outcomes in schizophrenia: qualitative study of the views of family carers

Abstract

BackgroundSchizophrenia is a complex, heterogeneous disorder, with highly variable treatment outcomes, and relatively little is known about what is important to patients. The aim of the study was to understand treatment outcomes informal carers perceive to be important to people with schizophrenia.MethodQualitative interview study with 34 individuals and 8 couples who care for a person with schizophrenia/schizoaffective disorder. Interviews were transcribed verbatim and analysed by a thematic framework based approach.ResultsCarers described well-recognised outcomes of importance, alongside more novel outcomes relating to: Safety (of the patient/others); insight (e.g. into non-reality of psychotic phenomena); respite from fear, distress or pain; socially acceptable behaviour; getting out of the house; attainment of life milestones; changes in personality and/or temperament; reduction of vulnerability to stress; and several aspects of physical health.ConclusionsThese findings have the potential to inform the development of patient- or carer- focused outcome measures that take into account the full range of domains that carers feel are important for patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-017-1418-8) contains supplementary material, which is available to authorized users.

The role of life context and self‐defined well‐being in the outcomes that matter to people with a diagnosis of schizophrenia

“…For those who were doing less well, safety as an outcome was articulated as an internal feeling brought about through the stabilizing effects of medication that is a sense of safety by the reduction of symptom behaviours. This notion of safety was more aligned to that expressed by the carers we interviewed, who perceived risk to the individual or others as a consequence of symptoms of illness.…”

“…Satisfaction with medication was perceived as necessary for the achievement of person‐centred outcomes. Reductions in symptoms were also valued by our sample and their carers . However, participants desired reductions in affective symptoms, most notably anxiety.…”

“…The importance of achieving participant‐defined life milestones was an outcome evidenced by the value placed on specific psychosocial and functional/occupational activities such as gaining employment, completing university, achieving residential autonomy or getting married. There was a sense of the importance of these outcomes across both the patient and carer samples . Achieving life milestones was also intertwined with and supported by the direct achievement of other short‐term outcomes such as those related to coping and reducing symptoms.…”

“…Broadly speaking, these outcomes were achieving life milestones, feeling safe, being socially connected, having a positive sense of self, reductions in symptoms and outcomes related to improved physical health. The majority of the sample valued these outcomes, which were also identified as important by family members that we interviewed for our carer study …”

<p>Association Between Glutathione S-Transferase (GST) Polymorphisms and Schizophrenia in a Chinese Han Population</p>

“…1 The costs of this disease to affected individuals, their families, and society are enormous. 2 The 1-month prevalence of SCZ in the Chinese population is 0.78%, according to an epidemiological survey conducted in four Chinese provinces. 3 Despite a greater than 100-year history of SCZ research, its pathogenesis is still not fully understood.…”