Community integration and associated factors among older adults with schizophrenia.
OBJECTIVE
Community integration has been increasingly recognized as an important element in recovery. There is a paucity of data on community integration for older adults with schizophrenia. This study compared community integration for older persons with schizophrenia with their age peers in the community and examined factors associated with community integration in the schizophrenia group.


METHODS
The schizophrenia group consisted of 198 community-dwelling persons aged 55 and older who developed schizophrenia before age 45. A community comparison group (N=113) was recruited by randomly selected block groups. Wong and Solomon's 2002 conceptual framework was used to develop a 12-item community integration scale with four components: independence, psychological integration, physical integration, and social integration. Moos' ecosystem model was used to examine 15 personal and environmental factors associated with community integration.


RESULTS
Compared with the general community group, the schizophrenia group had significantly lower total community integration scale scores and lower scores on each of the four components. Within the schizophrenia group, regression analysis showed that seven variables were significantly associated with community integration: being female, higher personal income, lower depressive symptoms, lower positive symptoms, lower Abnormal Involuntary Movement Scale score, higher CAGE lifetime scores, and greater control of one's life. The model was significant and explained 49% of the variance.


CONCLUSIONS
The data confirmed that older persons with schizophrenia had a lower level of community integration than their age peers in the community and that the model for community integration can identify potentially ameliorable clinical and social variables that may be targets for intervention research.
Abdallah
Chadi
C
Departmentof Psychiatry, State University of New York Downstate Medical Center, 450Clarkson Ave., Brooklyn, NY 11203, USA. chadi.abdallah@downstate.edu
Cohen
Carl I
CI
Sanchez-Almira
Miguel
M
Reyes
Pia
P
Ramirez
Paul
P
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D004409:Dyskinesia, Drug-Induced / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010379:Peer Group; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000523:psychology / Q000534:rehabilitation*; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use; D012111:Residence Characteristics; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D012928:Social Desirability; D012931:Social Environment; D012959:Socioeconomic Factors
D011619:Psychotropic Drugs