Psychosocial functioning is one of the most significantly impaired domains in individuals with schizophrenia. Unfortunately, this important aspect of life, which impacts relationships and interpersonal interaction, is also the most critical to the well-being of the individual. People with schizophrenia can benefit greatly from family support and personal relationships. However, without proper care, these relationships can deteriorate and become damaged in the very early stages of the illness. Determining which individuals are most at risk for schizophrenia is difficult at best and presents challenges for early intervention. Therefore, clinicians must work hard to determine how to identify and address unmet medical, physical, and social needs.
Social functioning declines most rapidly in the first several years immediately following the development of schizophrenia. Current diagnostic tools used for needs assessment are helpful at isolating which needs are met and unmet prior to treatment but do not provide direction for which approaches would benefit each individual the most. Therefore, Karin Landolt of the University of Zurich’s Department of General and Social Psychiatry in Switzerland recently conducted a study designed to determine the various classes of schizophrenic needs and how addressing these early on would impact psychosocial functioning.
Landolt evaluated individuals from the European First Episode Schizophrenia Trail (EUFEST) at baseline and again 6 and 12 months posttreatment. She found four specific classifications among the participants, representing four different trajectories of unmet needs from baseline to 12 months. The four classes included “autonomous” and “ordinary” classes, which had the fewest unmet needs at baseline. These groups had the lowest levels of baseline depression, highest levels of psychotherapy, and almost no unmet needs at 6 months. The other two classes, “uncomplicated” and “complicated,” had higher levels of baseline depression and more unmet needs at baseline. Although many needs eventually were met in the uncomplicated group, the complicated group maintained a high level of unmet needs at 6 and 12 months. Landolt said, “It became clear that the first 6 months were of outmost importance to treatment because the largest proportion of change in needs occurred during that period.” However, she added that the most significant gains were seen in those with fewer unmet needs at baseline and those that received therapy in addition to antipsychotic medication.
Landolt, K., Rossler, W., Burns, T., Ajdacic-Gross, V., Galderisi, S. (2012). Unmet needs in patients with first-episode schizophrenia: A longitudinal perspective. Psychological Medicine, 42.7, 1461-1473.
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