4 results
VADO approach efficacy in psychiatric rehabilitation: a controlled study
- Michela Vittorielli, Rosaria Pioli, Luisa Brambilla, Luigina Archiati, Giuseppe Rossi, Charlotte Sleijpen, Lorenza Magliano, Franco Veltro, Pierluigi Morosini, Gruppo Di Lavoro
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- Journal:
- Epidemiologia e Psichiatria Sociale / Volume 12 / Issue 1 / March 2003
- Published online by Cambridge University Press:
- 11 October 2011, pp. 43-52
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Aims – Assessment of the efficacy of the rehabilitation approach that is recommended by the manual VADO (AAOS in English: Abilities Assessment and Objectives Setting) in schizophrenic syndromes. Methods – Controlled trial, partly with individual randomisation. Centres were invited to recruit 10 patients who in most centres were randomly allocated either to the VADO approach or to usual rehabilitation practice. At least two professionals for each centre attended a brief intensive training course. Patients were assessed at baseline and six months later with a) the FPS scale, which is an improvement on the DSMIV SOFAS; b) the BPRS 4.0; c) AR, a clinical tool that is contained in VADO. Results – 55 patients received the experimental interventions and 40 the control one. Six months later greater significant improvements were observed in the experimental group, both in social functioning and in psychopathology. Conclusions – The dissemination of structured rehabilitation approaches that are based on personalized definition of objective, intensive progress monitoring, patient's therapeutic education and validated strategies and do not imply additional costs, may be warranted. A longer follow–up is under way.
Declaration of Interest: this work was partly funded by the National Mental Health Project (PNSM) of the Istituto Superiore della Sanita.
Community attitudes towards mental illness and socio-demographic characteristics: an Italian study
- Chiara Buizza, Rosaria Pioli, Marco Ponteri, Michela Vittorielli, Angela Corradi, Nadia Minicuci, Giuseppe Rossi
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- Journal:
- Epidemiologia e Psichiatria Sociale / Volume 14 / Issue 3 / September 2005
- Published online by Cambridge University Press:
- 11 October 2011, pp. 154-162
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Aim — To assess the association between socio-demographic characteristics and community attitudes towards mentally ill people. Method — We assessed a sample of 280 subjects, stratified for sex and age, which has identified using the electoral registers of Brescia. A letter was sent to everyone in order to introduce the future potential study participant to the topics of the public attitudes towards mental illness and it included an invitation to take part in the study. After, 280 subjects were contacted by telephone. Finally, 174 persons, who expressed their willingness to collaborate, were visited by a team of four trained interviewers. The instruments used were: a semi-structured interview; the Community Attitudes to the Mentally III (CAMI) inven-tory, which is composed by 40 statements, concerning the degree of acceptance of mental health services and mentally ill patients in the community; and the Fear and Behavioural Intentions (FABI) inventory, which is composed by 10 items, concerning fears and behavioural intentions towards mentally ill people. 106 subjects refused to participate. Results — Factor analysis of the CAMI revealed three components Physical distance and fear, Social isolation and Social responsibility and tolerance. Factor 1 is associated with: people >61 years old; people being divorced/widowed/living separated; people who haven't participated in social or volunteer activities. Factor 2 is associated with: people > 41 years old; people being schooled at a level that's higher than elementary level; unemployed people. Factor 3 doesn't present any associations. Conclusions — The results of this study outline the need to: a) promote interventions focused to improve the general attitude towards people with mental illness; b) to favour specific actions in order to prevent or eliminate prejudices in subgroups of the population.
Declaration of Interest: in the last two years the authors have been paid by the IRCCS Centra San Giovanni di Dio Fatebenefratelli in Brescia (Italy), as employees and free professionals.
What people with schizophrenia think about the causes of their disorder
- Lorenza Magliano, Andrea Fiorillo, Heidegret Del Vecchio, Claudio Malangone, Corrado De Rosa, Carla Bachelet, Elisabetta Truglia, Rosa D'ambrogio, Fabrizia Pizzale, Franco Veltro, Paola Zanus, Rosaria Pioli, Mario Maj
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- Journal:
- Epidemiologia e Psichiatria Sociale / Volume 18 / Issue 1 / March 2009
- Published online by Cambridge University Press:
- 11 April 2011, pp. 48-53
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Aims – To describe what users with schizophrenia think about the causes of their disorder. Methods – In each of the 10 participating Italian mental health centres, 25 users with schizophrenia were consecutively recruited and asked to complete the Users' Opinions Questionnaire (UOQ). Results – 150 out of 198 respondents mentioned at least one social cause for their mental disorder, and 114 reported exclusively social causes. Family conflicts were the most frequently reported social cause (21%), followed by traumas (20%), work and study difficulties (17%), and psychological disturbances (17%). Ten percent of the respondents mentioned biological causes. Biological causes were more frequently reported by users who were aware of their diagnosis of schizophrenia, whereas social causes by those who just knew they suffered from a psychosis. Difficulties in social relationships were more frequently pointed out by respondents with an earlier onset of the illness and a higher number of compulsory admissions in the previous 12 months. These users expressed more scepticism about the usefulness of the treatments they received, and perceived a greater social distance. Conclusions – Users' beliefs about the causes of their disorder should be taken into account by psychiatrists in order to improve their working alliance with them.
Declaration of Interest: None of the authors has had any interest or he/she has received any form of support, including that from drug companies and honoraria for lectures and consultancies, potentially in conflict with this scientific work. None of the authors has received any form of fee for his/her participation in this study. This study was supported by a grant received from the “M. Lugli” Foundation (grant no. 2–18–8).
The acceptability of the NICE recommendations for schizophrenia in the Italian Departments of Mental Health. The SIEP-DIRECT's Project on the discrepancy between routine practice and evidence
- Domenico Semisa, Antonio Lasalvia, Maurizio Miceli, Rosa Bruna Dall'Agnola, Cristina Pucci, Sarah Bissoli, Enrico Visani, Carmine Pasquale Pismataro, Michele Vanetti, Rosaria Pioli, Mirella Ruggeri, Antonio Lora
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- Epidemiologia e Psichiatria Sociale / Volume 17 / Issue 4 / December 2008
- Published online by Cambridge University Press:
- 11 April 2011, pp. 291-304
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Aims – This paper aims at presenting the most significant results emerging from the work carried out by the focus groups of the multi-centre Project SIEP-DIRECT's. The Project is aimed at assessing the existing discrepancies between the evidence-based NICE guidelines for schizophrenia and the usual practices of care given by Italian mental health services. Each focus group was requested to give an evaluation on: a) appropriateness of the English NICE guidelines in the context of the Italian mental health services; b) clarity and usefulness of the 103 indicators developed on the basis of the NICE recommendations to measure their level of application within the services. Methods - In each of the 19 mental health departments or psychiatric services participating in the Project there were organized “multidisciplinary” focus groups and “specialistic” focus groups. The former included, amongst others, professional operators of the mental health services, patients, their relatives, representatives of patient organizations and general practitioners. They examined the recommendations and indicators upon which the participants could express their opinion or judgment based on their knowledge, experience or information in their possession. The latter group, composed only of psychiatrists, examined the recommendations and indicators relative to pharmacological treatments that regarded the specific competences of their professional category. Results – Most NICE recommendations seemed appropriate to the working context of the Italian services. However, some perplexity emerged as regards specific organizational models of the services, such as the specific services for psychotic onsets or the assertive outreach teams, which were believed not to be strictly pertinent to the traditional organization of mental health care in our Country. There were also some criticisms regarding the cognitive-behavioural treatments which the NICE Guidelines recommend as the principle psychotherapeutic option for patients with schizophrenia, since in many Italian services, when the use of psychological interventions are needed, the tendency is to prefer interventions based on psychodynamic theories. The SIEP indicators were generally held to be clear and acceptable. Conclusions – In the view of the focus groups, the NICE guidelines are on the whole useful and suitable for orientating the services in the choice of more efficacious practices in the treatment of patients with schizophrenia. Moreover, the results obtained legitimate the use of the set of SIEP indicators for the evaluation of good practices and the quality of care offered by Italian services. Finally, the use of focus groups delines to a different context as well as the verification of the comprehensibility and applicability of SIEP indicators.
Declaration of Interest: None.