Top

Social Psychiatry and Psychiatric Epidemiology

Published in:

01-12-2013 | Original Paper

Perceived emotional support in remission: results from an 18-month follow-up of patients with early episode psychosis

Authors: Raymond Tempier, Lloyd Balbuena, Marje Lepnurm, Tom K. J. Craig

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 12/2013

Abstract

Purpose

Serious mental illness is known for the damage that it inflicts on the social network and social support of patients. Although many studies have used relapse and rehospitalisation as outcomes, recent research has emphasized the importance of a fuller definition of recovery that includes social function. In this study, our goal is to investigate the association of social support with sustained remission in patients with early episode psychosis.

Methods

A secondary analysis of remission and social support was performed with 123 of 144 patients enrolled in the Lambeth Early Onset randomized clinical trial who ever achieved symptom-free status in 18 months of follow-up. Social support was measured by hours of family contact, perceived support, and network size at 6 months into an early intervention treatment program. Consensus judgments made by clinicians on symptom status at each of 18 months of follow-up were analyzed for consecutive months spent in remission. Direct and mediated effects of social support on remission were calculated using Poisson regression and path analysis, respectively.

Results

114 of 123 patients achieved remission after about 7 months on average [mean 6.81 (SD 4.17)]. In univariate models, perceived emotional support predicted longer time spent in remission, while moderate family contact predicted shorter remission duration. Perceived practical support was not associated with remission. Perceived emotional support mediated the association between family contact and remission and between network size and remission. These results are not totally attributable to a specialized early intervention treatment.

Conclusion

Structural measures of support probably contribute to the maintenance of remission through the patient’s perception of emotional support.

Davidson L et al (2008) Remission and recovery in schizophrenia: practitioner and patient perspectives. Schizophr Bull 34(1):5–8PubMedCrossRef

Bellack AS (2006) Scientific and consumer models of recovery in schizophrenia: concordance, contrasts, and implications. Schizophr Bull 32(3):432–442PubMedCrossRef

Andreasen NC et al (2005) Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 162(3):441–449PubMedCrossRef

Liberman RP, Kopelowicz A (2005) Recovery from schizophrenia: a concept in search of research. Psychiatr Serv 56(6):735–742PubMedCrossRef

Slade M (2010) Mental illness and well-being: the central importance of positive psychology and recovery approaches. BMC Health Serv Res 10:26PubMedCrossRef

Noiseux S, Ricard N (2008) Recovery as perceived by people with schizophrenia, family members and health professionals: a grounded theory. Int J Nurs Stud 45(8):1148–1162PubMedCrossRef

Lieberman JA et al (2003) A typical and conventional antipsychotic drugs in treatment-naive first-episode schizophrenia: a 52-week randomized trial of clozapine versus chlorpromazine. Neuropsychopharmacology 28(5):995–1003PubMed

Robinson DG et al (1999) Predictors of treatment response from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry 156(4):544–549PubMed

Wills T, Shinar O (2000) Measuring perceived and received social support. In: Cohen S, Underwood LG, Gottlieb BH (eds) Social support measurement and intervention: a guide for health and social scientists. Oxford University Press, New York, pp 86–135

10.

Haber MG et al (2007) The relationship between self-reported received and perceived social support: a meta-analytic review. Am J Community Psychol 39(1–2):133–144PubMedCrossRef

11.

Cobb S (1976) Presidential address-1976. Social support as a moderator of life stress. Psychosom Med 38(5):300–314PubMed

12.

Mas-Exposito L, Amador Campos JA, Gomez-Benito J, Lalucat-Jo L (2012) Validation of the modified DUKE-UNC functional social support questionnaire in patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-012-0633-3

13.

Clinton M et al (1998) Perceived social support and community adaptation in schizophrenia. J Adv Nurs 27(5):955–965PubMedCrossRef

14.

Harley EW, Boardman J, Craig T (2012) Friendship in people with schizophrenia: a survey. Soc Psychiatry Psychiatr Epidemiol 47(8):1291–1299PubMedCrossRef

15.

Brekke J et al (2005) Biosocial pathways to functional outcome in schizophrenia. Schizophr Res 80(2–3):213–225PubMedCrossRef

16.

Hultman CM, Wieselgren IM, Ohman A (1997) Relationships between social support, social coping and life events in the relapse of schizophrenic patients. Scand J Psychol 38(1):3–13PubMedCrossRef

17.

Guada J et al (2009) The relationships among perceived criticism, family contact, and consumer clinical and psychosocial functioning for African-American consumers with schizophrenia. Community Ment Health J 45(2):106–116PubMedCrossRef

18.

Guarnaccia PJ, Parra P (1996) Ethnicity, social status, and families experiences of caring for a mentally ill family member. Community Ment Health J 32(3):243–260PubMedCrossRef

19.

Lopez SR et al (2004) Ethnicity, expressed emotion, attributions, and course of schizophrenia: family warmth matters. J Abnorm Psychol 113(3):428–439PubMedCrossRef

20.

Hsiao CY, Van Riper M (2010) Research on caregiving in chinese families living with mental illness: a critical review. J Fam Nurs 16(1):68–100PubMedCrossRef

21.

Garcia JIR et al (2006) Family support predicts psychiatric medication usage among mexican american individuals with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 41(8):624–631CrossRef

22.

Herz MI et al (2000) A program for relapse prevention in schizophrenia: a controlled study. Arch Gen Psychiatry 57(3):277–283PubMedCrossRef

23.

Pitschel-Walz G et al (2001) The effect of family interventions on relapse and rehospitalization in schizophrenia––a meta-analysis. Schizophr Bull 27(1):73–92PubMedCrossRef

24.

Bebbington P, Kuipers L (1994) The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychol Med 24(3):707–718PubMedCrossRef

25.

Cochrane R, Hashemi AH (1999) Expressed emotion and schizophrenia: a review of studies across cultures. International Rev Psychiatry 11(2–3):219–224CrossRef

26.

Hooley JM, Campbell C (2002) Control and controllability: beliefs and behaviour in high and low expressed emotion relatives. Psychol Med 32(6):1091–1099PubMedCrossRef

27.

Barrowclough C, Hooley JM (2003) Attributions and expressed emotion: a review. Clin Psychol Rev 23(6):849–880PubMedCrossRef

28.

Carra G et al (2007) Family interventions for schizophrenia in Italy: randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 257(1):23–30PubMedCrossRef

29.

Bustillo J et al (2001) The psychosocial treatment of schizophrenia: an update. Am J Psychiatry 158(2):163–175PubMedCrossRef

30.

Saunders JC (2003) Families living with severe mental illness: a literature review. Issues Ment Health Nurs 24(2):175–198PubMedCrossRef

31.

Garety PA et al (2006) Specialised care for early psychosis: symptoms, social functioning and patient satisfaction: randomised controlled trial. Br J Psychiatry 188:37–45PubMedCrossRef

32.

Craig TK et al (2004) The Lambeth Early Onset (LEO) team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 329(7474):1067PubMedCrossRef

33.

Kerwin R et al (2001) The Bethlem and Maudsley NHS trust: prescribing guidelines 2001, 6th edn. Martin Dunitz, London

34.

Bebbington PE et al (2006) Remission and relapse in psychosis: operational definitions based on case-note data. Psychol Med 36(11):1551–1562PubMedCrossRef

35.

Power MJ, Champion LA, Aris SJ (1988) The development of a measure of social support: the significant others (SOS) scale. Br J Clin Psychol 27(Pt 4):349–358PubMedCrossRef

36.

Cresswell CM, Kuipers L, Power MJ (1992) Social networks and support in long-term psychiatric patients. Psychol Med 22(4):1019–1026PubMedCrossRef

37.

Neeleman J, Power MJ (1994) Social support and depression in three groups of psychiatric patients and a group of medical controls. Soc Psychiatry Psychiatr Epidemiol 29(1):46–51PubMed

38.

Rubin DB (1987) Multiple imputation for nonresponse in surveys. Wiley series in probability and mathematical statistics applied probability and statistics. Wiley Blackwell, New York

39.

Honaker JH, King G, Blackwell M (2007) Amelia II: a Program for missing data. Harvard University, Cambridge, MA. http://gking.harvard.edu/amelia/

40.

Imai K, King G, Lau O (2008) Toward a common framework for statistical analysis and development. J Computational Graphical Statistics 17(4):892–913CrossRef

41.

R Development Core Team (2011) R: A language and environment for statistical computing. R Foundation for Statistical Computing

42.

Zhang Z, Wang L (2011) BMEM: mediation analysis with missing data using bootstrap. http://CRAN.R-project.org/package=bmem

43.

Roe D, Mashiach-Eizenberg M, Lysaker PH (2011) The relation between objective and subjective domains of recovery among persons with schizophrenia-related disorders. Schizophr Res 131(1–3):133–138PubMedCrossRef

44.

Kawachi I, Kennedy BP, Glass R (1999) Social capital and self-rated health: a contextual analysis. Am J Public Health 89(8):1187–1193PubMedCrossRef

45.

Tempier R et al (2012) Does assertive community outreach improve social support? Results from the lambeth study of early-episode psychosis. Psychiatric Services 63(3):216–222PubMedCrossRef

46.

Evert H et al (2003) The relationship between social networks and occupational and self-care functioning in people with psychosis. Soc Psychiatry Psychiatr Epidemiol 38(4):180–188PubMedCrossRef

47.

Guada J, Hoe M, Floyd R, Barbour J, Brekke J (2012) How family factors impact psychosocial functioning for african american consumers with schizophrenia. Community Ment Health J 48:45–55

48.

Sorgaard KW et al (2001) Predictors of social relations in persons with schizophrenia living in the community: a nordic multicentre study. Soc Psychiatry Psychiatr Epidemiol 36(1):13–19PubMedCrossRef

49.

Townsend W, Glasser N (2003) Recovery: the heart and soul of treatment. Psychiatr Rehabil J 27(1):83–86PubMedCrossRef

50.

Ruesch P et al (2004) Occupation, social support and quality of life in persons with schizophrenic or affective disorders. Soc Psychiatry Psychiatr Epidemiol 39(9):686–694PubMedCrossRef

Title: Perceived emotional support in remission: results from an 18-month follow-up of patients with early episode psychosis
Authors: Raymond Tempier
Lloyd Balbuena
Marje Lepnurm
Tom K. J. Craig
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 12/2013
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-013-0701-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perceived emotional support in remission: results from an 18-month follow-up of patients with early episode psychosis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2013

Trends, correlates, and disease patterns of antipsychotic use among children and adolescents in Taiwan

Serious psychological distress among non-Hispanic whites in the United States: the importance of nativity status and region of birth

Stressful life events severity in patients with first and recurrent depressive episodes

Associations between IQ and alcohol consumption in a population of young males: a large database analysis

Social support and physical activity as moderators of life stress in predicting baseline depression and change in depression over time in the Women’s Health Initiative

The relationship between cognitive ability and depression: a longitudinal data analysis