Mário César Rezende Andrade1, Mike Slade2, Marina Bandeira3, Sara Evans-Lacko4, Janina Komaroff5, Denise Martin6, Jair de Jesus Mari7, Sérgio Baxter Andreoli6. 1. 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. 2. King's College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK. 3. Department of Psychology, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, Brazil. 4. 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. 5. Centre de Recherche de Montréal sur les Inégalités Sociales et les Discriminations (CREMIS), Montréal, Quebec, Canada. 6. 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. 7. 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.
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). LIMITATION: 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.
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). LIMITATION: 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: Elizabeth C Thompson; Nicole D Andorko; Pamela Rakhshan Rouhakhtar; Zachary B Millman; Kristin Sagun; Susan C Han; Doha Chibani; Gloria M Reeves; Bruce Herman; Jason Schiffman Journal: J College Stud Psychother Date: 2020-09-04
Authors: Nicole D Andorko; John Fitzgerald; Caroline Roemer; Eric Solender; Emily Petti; Pamela Rakhshan Rouhakhtar; Karen E McNamara; Melissa E Smith; Robert W Buchanan; Jason Schiffman; Jordan DeVylder Journal: Early Interv Psychiatry Date: 2021-05-24 Impact factor: 2.732
Authors: M E S B Santos; D L Roza; R E M Barros; J L F Santos; D Razzouk; J M Azevedo-Marques; P R Menezes; C M Del-Ben Journal: Braz J Med Biol Res Date: 2021-07-23 Impact factor: 2.590