Experiences of victimisation and depression are associated with community functioning among men with schizophrenia.
OBJECTIVE
The present study aimed to identify proximal and distal factors associated with real life community functioning among men with schizophrenia. Real life community functioning was defined to include: independent living, occupational functioning, social and leisure activities, and substance misuse, self-harm, and aggressive behaviour.


METHODS
225 men with schizophrenia or schizo-affective disorder were assessed at discharge from hospital and at six-monthly intervals during a two-year period. Information was available from structured interviews with the participants, family members and treatment staff, records of psychiatric treatment, social service files, and official criminal records. Symptoms were assessed using the Positive and Negative Symptom Scale and the Hamilton Rating Scale for Depression. Substance misuse was measured by self-report and hair and urine analyses. Predictors of outcome were divided into four categories: childhood, adulthood, year prior to functional outcome assessment, and con-current.


RESULTS
In a final regression model, five predictors were significantly associated with patients' real life functioning: two adult life-time variables-a diagnosis of drug abuse/dependence and level of education and three current variables-victimisation, depression, and medication non-compliance. Most of the variance in the final outcome scores was explained by current predictors.


CONCLUSIONS
In order to elevate levels of psychosocial functioning among men with schizophrenia, clinicians need to assess victimisation experiences, and, when present, design and implement interventions to help patients protect themselves. In addition, depression needs to be identified and treated, and compliance with antipsychotic medication assured.
Hodgins
Sheilagh
S
Institute of Psychiatry, King's College London, PO23, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK. s.hodgins@iop.kcl.ac.uk
Lincoln
Tania
T
Mak
Tim
T
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000374:Aggression / Q000523:psychology; D014150:Antipsychotic Agents / Q000627:therapeutic use; D019548:Crime Victims / Q000523:psychology* / Q000706:statistics & numerical data; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011336:Probability; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D012565:Schizophrenic Psychology; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology; D012720:Severity of Illness Index; D012917:Social Adjustment; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology
D014150:Antipsychotic Agents