Department of Mental Health and Drug Abuse, AUSL Modena, Viale L Muratori 201, 41124, Modena, Italy.
Social Point Modena - Centro Servizi Volontariato, Modena, Italy.
BMC Psychiatry. 2018 Jun 7;18(1):179. doi: 10.1186/s12888-018-1728-5.
People with psychotic illness suffer from reduced quality of life and often from an insufficient level of social inclusion. These variables are associated with several negative outcomes, such as higher neuro-cognitive deficits, negative symptoms, internalised stigma, increased cardiovascular risk and, most importantly, excess mortality. To date, only a minority of social interventions in psychosis have been investigated. Since 2011, the Department of Mental Health and Substance Abuse in Modena introduced the "Social Point" program, which provides social inclusion interventions to promote active social participation for patients suffering from severe mental illness. The aim of this study was to assess whether a social inclusion intervention is associated with better outcomes in terms of personal and social recovery, with particular reference to the areas of social functioning and activity, and subjective dimensions such as self-esteem, self-stigma and perceived quality of life.
A cross-sectional design was adopted to compare 30 subjects, selected at the completion of "Social Point" program, with a group of subjects, matched for socio-demographic and clinical features, selected from a wait list for "Social Point". All subjects were evaluated by means of instruments assessing: level of disability, level of functioning, severity of psychopathology, self-esteem, internalised stigma and quality of life.
Overall, the results of the study suggest that social inclusion interventions may be effective in people suffering from non-affective psychosis. A dose-effect relationship was also found between higher number of activities per patient and better outcomes within both social and psychopathological domains. However, due to the cross-sectional design of the study no definitive causality can be inferred.
Psychosocial interventions promoting social inclusion are likely to represent an effective approach to improve personal and social recovery.
患有精神病的人生活质量下降,往往社会融入程度不足。这些变量与多种负面结果相关,如更高的神经认知缺陷、阴性症状、内化的耻辱感、增加心血管风险,最重要的是,死亡率过高。迄今为止,只有少数精神分裂症的社会干预措施得到了研究。自 2011 年以来,摩德纳心理健康和药物滥用署引入了“社会点”计划,该计划提供社会融入干预措施,以促进患有严重精神疾病的患者积极参与社会。本研究的目的是评估社会包容干预措施是否与个人和社会康复方面的更好结果相关,特别是在社会功能和活动领域,以及自尊、自我耻辱感和感知生活质量等主观方面。
采用横断面设计,将完成“社会点”计划的 30 名受试者与一组按社会人口统计学和临床特征匹配的受试者进行比较,后者从“社会点”的候补名单中选择。所有受试者均通过评估残疾程度、功能水平、精神病理学严重程度、自尊、内化耻辱感和生活质量的工具进行评估。
总体而言,研究结果表明,社会包容干预措施可能对非情感性精神病患者有效。还发现,每位患者的活动次数与社会和精神病理学领域的更好结果之间存在剂量-效应关系。然而,由于研究的横断面设计,不能推断出明确的因果关系。
促进社会包容的心理社会干预措施可能是改善个人和社会康复的有效方法。