Social functioning of patients with schizophrenia in high-income welfare societies

Psychiatr Serv. 2000 Feb;51(2):223-8. doi: 10.1176/appi.ps.51.2.223.

Abstract

Objective: The study assessed the level of reintegration into the community of patients with schizophrenia in Oslo, Norway, a country with a well-developed social welfare system and low unemployment rates.

Methods: Eighty-one patients with a DSM-III-R diagnosis of schizophrenia treated in 1980 and in 1983 in a short-term ward of a psychiatric hospital were followed up after seven years. Seventy-four of 76 patients alive at follow-up agreed to participate. Social functioning was measured by the Strauss-Carpenter Level of Functioning Scale and the Social Adjustment Scale.

Results: At follow-up 78 percent of patients lived independently, 47 percent were socially isolated, and 94 percent were unemployed. Thirty-four percent had lost employment in the follow-up period. A poor outcome in terms of social functioning and community reintegration was associated with loss of employment. A good outcome was predicted by short periods of inpatient hospitalization, high levels of education, being married, male gender, and not having a late onset of psychosis.

Conclusions: The level of homelessness among these patients with schizophrenia was encouragingly low, which may have been expected in a high-income welfare society. However, insufficient efforts were aimed at social and instrumental rehabilitation, and the level of unemployment was alarmingly high.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Chronic Disease
  • Developed Countries / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Ill-Housed Persons / statistics & numerical data
  • Linear Models
  • Male
  • Middle Aged
  • Norway
  • Outcome Assessment, Health Care
  • Sampling Studies
  • Schizophrenia / rehabilitation*
  • Social Adjustment*
  • Social Isolation
  • Social Welfare
  • Unemployment