How the inner world is reflected in relation to perceived ward atmosphere among patients with psychosis.
BACKGROUND
This study focused on how cognitive ability, personality traits, self-rated psychiatric symptoms, and social functioning were related to the way in which patients with psychosis perceived supportive aspects of the ward atmosphere.


METHODS
Patients at a psychiatric rehabilitation unit (PRU) in southern Sweden completed a ward atmosphere questionnaire (COPES), rated their psychiatric symptoms (SCL-90), self-image (SASB), and were tested on cognitive functioning (WAIS-R) and global social functioning (GAF). They were diagnosed according to ICD-10. Data were analysed by means of logistic regression analyses.


RESULTS
Self-monitoring and restraining (self-control), one cluster in the SASB, was the strongest factor associated with how the patients perceived the ward atmosphere. A perceived high level of self-control indicated high levels of perceived Support, Practical orientation, and Order and organisation of the ward atmosphere. A high level of self-rated paranoid symptoms (SCL-90) increased the risk of perceiving a high level of Anger and aggression and a low level of Program clarity. Regarding cognitive ability (WAIS-R), two factors were important for predicting perceived ward atmosphere. A low level of social competence was associated with a low level of perceived Order and organisation. Furthermore, a low level of abstract thinking was related to a low level of perceived Anger and aggression, while a high level of abstract thinking was associated with a low level of Program clarity. Patients with schizophrenia exhibited a lower level of Self-monitoring and restraining than patients with other psychoses.


CONCLUSIONS
The results from this study indicate that individual factors such as self-control, paranoid symptoms and social competence may be important for how the ward atmosphere is perceived. This is important knowledge when monitoring the ward atmosphere to better fit a unit's target group.
Jansson
Jan-Ake
JA
Department of Psychology, University Hospital, Lund University, Lund, Sweden. jan-ake.jansson@arb.lu.se
Eklund
Mona
M
D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric / Q000592:standards*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010554:Personality Disorders / Q000175:diagnosis / Q000209:etiology; D011618:Psychotic Disorders / Q000523:psychology* / Q000534:rehabilitation*; D012649:Self Concept; D012931:Social Environment; D012938:Social Perception