title: Subjective distress in a representative sample of outpatients with psychotic disorders.
abstract: BACKGROUND
  The affective burden of psychotic disorder has been increasingly recognised. However, subjective reports of distress and its covariates, especially those related to service use, remain under-investigated in patients with psychosis.
  
  
  METHODS
  This study investigated subjective distress and its covariates in a representative sample of 401 outpatients with a confirmed diagnosis of psychotic disorders in Brazil. Distress was assessed using the corresponding domain of a standardised measure of need - the Camberwell Assessment of Need.
  
  
  RESULTS
  Distress was reported as a need by 165 (41%) patients, being met in 78 (20%) and unmet in 87 (22%). Hierarchical logistic regression showed that the presence of distress as a need was predicted by attendance at psychotherapy (OR=3.49, CI=1.62-7.53), presence of suicidal ideation (OR=2.89, CI=1.75-4.79), non-attendance at psychosocial rehabilitation (OR=2.84, CI=1.31-6.19), and higher psychopathology (OR=1.09, CI=1.06-1.12). An unmet need was predicted by family not accompanying patients to treatment (OR=2.60, CI=1.05-6.44) and higher psychopathology (OR=1.05, CI=1.02-1.09).
  
  
  CONCLUSIONS
  The use of a cross-sectional design and a single questionnaire domain to evaluate distress are the main limitations.
  
  
  CONCLUSIONS
  Subjective distress is a common unmet need in psychosis, and can be treated. The main clinical implication is that subjective distress in psychosis may be impacted on by family engagement and psychosocial interventions.
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa, 570, Vila Clementino, São Paulo 04038-020, Brazil; King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK. Electronic address: mariocesar_cm@hotmail.com.
authors.forename: Mário César Rezende
authors.initials: MC
authors.lastname: Andrade
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Slade
authors.affiliation: Department of Psychology, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, Brazil.
authors.forename: Marina
authors.initials: M
authors.lastname: Bandeira
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK; London School of Economics and Political Science, London, UK.
authors.forename: Sara
authors.initials: S
authors.lastname: Evans-Lacko
authors.affiliation: Centre de Recherche de Montréal sur les Inégalités Sociales et les Discriminations (CREMIS), Montréal, Quebec, Canada.
authors.forename: Janina
authors.initials: J
authors.lastname: Komaroff
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa, 570, Vila Clementino, São Paulo 04038-020, Brazil; Universidade Católica de Santos, Santos, Brazil.
authors.forename: Denise
authors.initials: D
authors.lastname: Martin
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa, 570, Vila Clementino, São Paulo 04038-020, Brazil; King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors.forename: Jair de Jesus
authors.initials: Jde J
authors.lastname: Mari
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Borges Lagoa, 570, Vila Clementino, São Paulo 04038-020, Brazil; Universidade Católica de Santos, Santos, Brazil.
authors.forename: Sérgio Baxter
authors.initials: SB
authors.lastname: Andreoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Distress; Needs assessment; Outcome; Psychological stress; Psychotic disorders