Patients with schizophrenia and their finances: how they spend their money

Introduction: Although most patients with schizophrenia rely on state financial support, little is known about their expenses and how they use the money at their discretion. However, the ability to budget is a predictive factor in rehabilitation. An assessment of financial management skills could make it possible to develop more appropriate psycho-social assistance. Method: Fifty-seven outpatients with schizophrenia treated in the public sector in Geneva, Switzerland took part in the study. Psychosocial, diagnostic, neurocognitive and symptomatological measures were collected. Data were gathered on patients' incomes and quality of life. A prospective analysis of their expenses during a 1-month period was also performed. Results: Median income was 4,125 Swiss francs per month (i.e., 3,372 US dollars). After paying fixed expenses (which were handled with or without the assistance of a representative payee), a mean of 400 Swiss francs remained at their disposal to use as they wished. Seventy-two percent of this money was devoted to the use of psychoactive substances (e.g., cigarettes, alcohol, cannabis) or various drinks in coffee houses, and 28% on leisure activities (trips, sports and other recreational activities). Eighty-four percent of patients would have liked to have more money for leisure activities. The study was well-accepted and led to modification of the treatment plan in 84% of cases. Conclusion: Most of the discretionary money patients received was used for buying substances with addictive properties; this may hinder the practice of activities favouring recovery. Thus, it appears essential to guide patients in the management of their budget

Religion and Spirituality: How Clinicians in Quebec and Geneva Cope with the Issue When Faced with Patients Suffering from Chronic Psychosis

Spirituality and religion have been found to be important in the lives of many people suffering from severe mental disorders, but it has been claimed that clinicians "neglect” their patients' religious issues. In Geneva, Switzerland and Trois-Rivières, Quebec, 221 outpatients and their 57 clinicians were selected for an assessment of religion and spirituality. A majority of the patients reported that religion was an important aspect of their lives. Many clinicians were unaware of their patients' religious involvement, even if they reported feeling comfortable with the issue. Both areas displayed strikingly similar results, which supports their generalizatio

Evolution of spirituality and religiousness in chronic schizophrenia or schizo-affective disorders: a 3-years follow-up study

Purpose: Spirituality and religiousness have been shown to be highly prevalent in patients with schizophrenia. Religion can help instil a positive sense of self, decrease the impact of symptoms and provide social contacts. Religion may also be a source of suffering. In this context, this research explores whether religion remains stable over time. Methods: From an initial cohort of 115 out-patients, 80% completed the 3-years follow-up assessment. In order to study the evolution over time, a hierarchical cluster analysis using average linkage was performed on factorial scores at baseline and follow-up and their differences. A sensitivity analysis was secondarily performed to check if the outcome was influenced by other factors such as changes in mental states using mixed models. Results: Religion was stable over time for 63% patients; positive changes occurred for 20% (i.e., significant increase of religion as a resource or a transformation of negative religion to a positive one) and negative changes for 17% (i.e., decrease of religion as a resource or a transformation of positive religion to a negative one). Change in spirituality and/or religiousness was not associated with social or clinical status, but with reduced subjective quality of life and self-esteem; even after controlling for the influence of age, gender, quality of life and clinical factors at baseline. Conclusions: In this context of patients with chronic schizophrenia, religion appeared to be labile. Qualitative analyses showed that those changes expressed the struggles of patients and suggest that religious issues need to be discussed in clinical setting

La schizophrénie : chemins de "spiritualité" et adhérence au traitement médical

Ce travail évalue l'importance de la spiritualité et la religion chez les patients souffrant de troubles psychotiques et son influence sur les soins prodigués, notamment l'adhérence au traitement. Le collectif étudié comprend 103 patients souffrant de troubles psychotiques suivis en consultation ambulatoire à Genève. Leurs pratiques et croyances religieuses, moyen de faire face à la maladie et adhérence aux soins proposés ont été évalués par questionnaires aux patients et aux soignants. La dimension religieuse, bien que sous-estimée par les soignants, semble clairement agir pour ces patients tant au niveau de l'image de soi, de la façon de résoudre les problèmes courants, des relations sociales qu'au niveau de la représentation qu'ils ont de la maladie et du traitement, influençant ainsi directement l'adhérence au traitement. Tenir compte de cette dimension dans les soins aux patients permettrait de renforcer l'alliance thérapeutique ainsi que les ressources du patient et son adhérence au traitement

Schizophrenia and beta-thalassemia: a genetic link?

This report of two cases in which schizophrenia and beta-thalassemia occurred simultaneously in several family members may suggest that a genetic link exists between these two disorders. A known genetic disease (beta-thalassemia) could help confirm the presence, on the short arm of chromosome 11, of a genetic susceptibility factor for schizophrenia