To examine the predictive validity of early improvement in a naturalistic sample of inpatients and to identify the criterion that best defines early improvement.

Two hundred and forty-seven inpatients who fulfilled ICD-10 criteria for schizophrenia were assessed with the Positive And Negative Syndrome Scale (PANSS) at admission and at biweekly intervals until discharge from hospital. Remission was defined according to the recently proposed consensus criteria, response as a reduction of at least 40% in the PANNS total score from admission to discharge.

Receiver operating characteristic (ROC) analyses showed that early improvement (reduction of the PANSS total score within the first 2 weeks of treatment) predicts remission (AUC = 0.659) and response (AUC = 0.737) at discharge. A 20% reduction in the PANSS total score within the first 2 weeks was the most accurate cut-off for the prediction of remission (total accuracy: 65%; sensitivity: 53%; specificity: 76%), and a 30% reduction the most accurate cut-off for the prediction of response (total accuracy: 76%; sensitivity: 47%; specificity: 90%).

The findings of clinical drug trials that early improvement is a predictor of subsequent treatment response were replicated in a naturalistic sample. Further studies should examine whether patients without early improvement benefit from an early change of antipsychotic medication.

The objective of the present study was to examine the association of insight into the illness with demographic variables and symptomatology in a sample of 1213 patients with schizophrenia.

Data were collected with the Psychosis Evaluation tool for Common use by Caregivers (PECC), a semi-structured interview evaluating five symptom domains of schizophrenia and the insight items ‘awareness of having a mental disorder’ and ‘attributing symptoms to a mental disorder’.

Insight was positively associated with educational level and inversely with overall symptom severity, and the positive, negative, excitatory and cognitive symptom domains. At symptom level, the items ‘delusions’, ‘grandiosity’, ‘poor rapport’, ‘social withdrawal’ and ‘guilt feelings’ showed the strongest associations with both insight items. Overall, correlations between insight and symptomatology were modest, explaining less than 30% of the variance in insight.

Lack of insight in schizophrenia is partially explained by clinical symptoms and demographic measures.

Schizophrenia is regarded as one of the most stigmatized mental illnesses. Relatively few studies have investigated actual stigma experiences among people with schizophrenia and the factors which may contribute to it.

This cross-sectional study assesses the extent of stigma experienced by patients with schizophrenia and attempts to establish its clinical and sociodemographic predictors.

A total of 153 subjects with schizophrenia (62 outpatients and 91 inpatients) were evaluated with the use of the Stigma section of the Consumer Experiences of Stigma Questionnaire (CESQ) and several instruments measuring their subjective quality of life, social functioning and severity of psychiatric symptoms.

Stigmatization experiences were common among respondents who most frequently reported having concealed their illness (86%), witnessed others saying offensive things about the mentally ill (69%), worried about being viewed unfavorably (63%) and been treated as less competent (59%). Higher levels of stigma were related to lower subjective quality of life and younger age of illness onset. No significant associations were found between stigma and symptoms or level of social functioning.

Our findings point at the reduced life satisfaction as a key aspect of the subjective experience of the stigma of schizophrenia.

The aim of our naturalistic-observational study was to determine the efficacy and utility of electroconvulsive therapy (ECT) in clinical population of individuals with schizophrenia where pharmacological response was suboptimal.

The cohort comprised 27 patients suffering from schizophrenia with refractoriness to antipsychotic agents and with severe, disabling symptoms. They only interventional assessing tool was clinical global impression (CGI-S) performed at the baseline and at the end of the treatment.

The administration of ECT resulted in overall clinical improvement reflected in CGI scales and descriptions in clinical notes. On 12 months follow-up period, 10 patients (37.1%) maintained improvement and were able to continue with pharmacological therapy only, suggesting its rekindling effect, especially with Clozapine. Conversely, 17 patients (62.9%) deteriorated and required an additional course of ECT to maintain improvement. In some cases, maintenance ECT treatment was required. The group who engaged in self-harming behaviour at baseline demonstrated they were more likely to relapse into psychosis at the end of the first course of ECT, their self-harming behaviour abated, especially when maintenance ECT was undertaken.

Although limited by lack of control group, small sample size, heterogeneous symptom profiles and various concurrent neuroleptic agents, the ECT proved as valuable and safe augmentative procedure when unsatisfactory response to pharmacological interventions had been demonstrated prior to interventions. This effect was evident despite the chronicity of the illness.

Higher incidence of mental illnesses and less access to care is previously reported concerning migrants but few studies focus on the needs and care of migrant groups in psychiatry. The aim of this study was to compare differences in needs and care between migrant and nonmigrant groups of severely and persistently mentally ill (SMI) after the 1995 Swedish mental health care reform.

In a Swedish area, inventories were made in 2001 and 2006 of persons considered as SMI. These persons were interviewed and their needs were assessed. In a cross-sectional study in 2006, needs and care were compared between migrants and nonmigrants. In a longitudinal study, migrants and nonmigrants interviewed in both 2001 and 2006 were compared concerning the development of needs and care.

The needs of the migrant group were less taken care of. In 2006, there were more unmet needs in this group concerning accommodation, physical health, psychological distress, basic education and economy.

The improvement of groups considered as SMI concerning functional disability and efforts of care found in the actual area did not seem to include the migrant group, at least not to the same degree.

There is a growing concern about satisfaction with inpatient psychiatric services. There are currently numerous satisfaction instruments available to psychiatric inpatients, but little guidance on which among them to select.

To provide an overview of the psychometric properties and the content of satisfaction instruments available to psychiatric inpatients.

Systematic searches of Medline database to identify inpatient satisfaction questionnaires. Assessment of the instruments according to relevant psychometric properties.

Fifteen satisfaction instruments were identified. The target population differed according to the instrument. Methods used to generate items were heterogeneous. These instruments were based on a mixed approach including patients’ points of view, expert opinions, and literature reviews, causing the content of questionnaires to vary. Reliability and validity were not systematically tested.

The validation of a common inpatient satisfaction instrument is a major challenge. Recommendations for the future development of satisfaction instruments may include: item generation based exclusively on the patient's point of view; a validation process on a large and representative population; and an instrument combining generic (core questionnaire) and specific (additional modules) approaches.