March 02, 2006

Targeting Schizophrenia Research to Patient Outcomes

Another APA editorial touches upon the issue of how increasingly research is being targeted to help improve patient outcomes. Following is a short excerpt. A link to the full story is at the bottom.

Targeting Schizophrenia Research to Patient Outcomes
Baltimore, Md.

Mental disorders represent four of the top 10 categories of disease disability worldwide. In schizophrenia this disability is clearly evident in employment. In this issue of the Journal, Rosenheck and colleagues report analyses of data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project, which involved more than 1,400 patient participants and gathered clinical, neuropsychological, quality of life, sociodemographic, psychosocial services, and employment information. The finding that barriers to employment range from clinical to social gives emphasis to the breadth of factors required in a medical model purporting to account for effects of illness and treatment on patients’ lives.

For example, CATIE results are a discouraging reminder that race plays a substantial role in so many aspects of our society; in this instance, being black compounds the negative effect of schizophrenia on competitive employment. Receipt of disability payments also has a negative effect on competitive employment, challenging social policy experts to devise a system that protects the provision of financial support for disabled individuals while avoiding disincentives for work accomplishment. The finding that the availability of psychosocial rehabilitation services increases the probability that an individual will find work is another call for policy action on the organization and delivery of mental health services. The effectiveness of supported employment and other vocational services has been documented (1), but most people with schizophrenia are treated in settings that do not offer these services. It is a shame that psychiatry has not been more aggressive in implementing these services and more successful in winning resources to support this vital element of care.

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