Stability and change in needs of patients with schizophrenic disorders : a 15and 17-year follow-up from first onset of psychosis, and a comparison between'objective'and'subjective'assessments of needs for care.
Need for care was studied in a Dutch incidence cohort of patients with schizophrenic disorders 15 and 17 years from first onset of psychosis.
Long-term course of the disorders varied from complete remission and full community participation to chronic psychosis and long-term hospital stay.
Fifty patients were assessed twice with the Needs For Care Assessment Schedule (NFCAS, Brewin and Wing 1989) ; at the latter follow-up an assessment was also made using the Camberwell Assessment of Need (CAN, Phelan et al. 1995).
The NFCAS is an investigator-or professional-based instrument which provides an'objective'assessment of needs.
Need for care was recorded in 22 areas of clinical and social functioning.
Comparison of the two assessments over a 2-year period demonstrated a high stability on the individual items (mean 88%, mostly concerning the absence of a problem twice), but did not show the expected stability of need status among this group of patients with chronic disorders.
One in five patients (22%) had no needs at all on both occasions and 56% of the patients showed a change in needs.
There was more negative than positive change : 28% suffered from new unmet needs at the 17-year follow-up, while only 12% had improved their status to no needs.
About one-third (36%) had at least one unmet need, mostly regarding psychotic symptoms, dyskinesia or underactivity.
The CAN provides a'subjective'assessment of needs according to the view of patients themselves. (...)
Mots-clés Pascal : Schizophrénie, Evolution, Besoin, Soin, Traitement, Long terme, Etude longitudinale, Etude comparative, Méthode mesure, Adolescent, Homme, Adulte jeune, Adulte, Psychose
Mots-clés Pascal anglais : Schizophrenia, Evolution, Need, Care, Treatment, Long term, Follow up study, Comparative study, Measurement method, Adolescent, Human, Young adult, Adult, Psychosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0121317
Code Inist : 002B18C06A. Création : 22/06/1998.