Assessments of needs in schizophrenia patients

Background Deinstitutionalization of people with schizophrenia increases the importance of evaluating their needs. This study set out to identify the most common needs of people with schizophrenia analyze how those needs differ when evaluated by staff or by patients, describe the kind of help patients receive from relatives and communuity mental health services, and find out the sociodemographic and clinical variables that correlate with having needs and unmet needs. Material Methods The present study included 94 patients diagnosed with schizophrenia according to DSM-IV-TR criteria and 94 of their primary caregivers.Those patients in remission were followed-up at the psychiatric outpatient clinics of Celal Bayar University Medical School, and Manisa Mental Health and Disorders Hospital, and Manisa Community Mental Health Center. Both patients and primary caregivers were evaluated with the Camberwell Assessment of Need (questionnaire was used to obtain and report quantitative information on needs) Additionally patients were evaluated with Socio-demographical Data Form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Rating Scale (CDRS), Personal and Social Performance Scale (PSP), Quality of Life Scale for - schizophrenic patients. (QLS).Also primary caregivers were evaluated by Perceived Family Burden Scale (PFBS). Stepwise Multipl Linear Regression analysis was used to identify correlations between needs with sociodemographic and clinical variables. Results Needs that were detected by patients and staff were similarly. Mean number of needs as rated by patients was 6,22±2,38 and staff 6.29± 2,32 (p >0.05). However, Mean number of unmet needs was greater when assessed by patients than by staff: 2,04±1,86 versus 1.63±1,89 (p <0.001).This difference was statistically significant. The most frequently detected needs by patients involved psychotic symptoms, house upkeep,intimate relations, pshlogical stressors .This situation is similarly for caregivers The need areas concerning social and interpersonal functioning demonstrated the highest proportion of unmet to total needs. In a majority of need areas the patients received more help from services than from relatives, but in the areas of social relations the informal network provided substantial help. In a stepwise linear regression model `?Living Area, gender?? as a control variable, `?Calgary depression scale, family burden scale and PANSS positive symptoms?? as a predictor variable were significant predictors of the need status, explaining 45% of the variance in total needs perceived by patient. `?Family burden scale and PANSS general psychopathology were the only predictors that was explaining 23% of the variance in unmet needs perceived by patients. Conclusıons It is concluded that the mental health system fails to detect and alleviate needs in several areas of major importance to schizophrenic patients. Enhanced collaboration between the care system and the informal network to systematically analyze the need profile of the patients seems necessary to minimise the unmet needs. Need assessment is complementary to clinical evaluation in schizophrenia also planning community mental health services. Key words: Schizophrenia, needs assessment, community mental health care, burden of care, prediction