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    Analysis of Social Class by LCA in Patients with Schizophrenia: Change in Psychopathology after 12 Month of Treatment
    (Kure Iletisim Grubu A S, 2009) Saylan, Mete; Ucok, Alp; Uguz, Suekrue; Treuer, Tamas; Sir, Aytekin
    Objective: The social factors may contribute to the heterogeneous course of schizophrenia and relationship between these factors and the level of care received is complex. Social factors may influence access to treatment and outcome of the disease. Current diagnostic systems classify longitudinal course of schizophrenia based on symptom patterns. We aimed to identify latent social classes in Turkish patients with schizophrenia who participated to IC-SOHO observational study. Latent class analysis may allow a physician to understand various patient social groups (social casemix) in a very heterogeneous patient data flow seen in everyday practice. Method: 692 outpatients with schizophrenia (ICD-10 or DSM-IV), who were initiated or switched to antipsychotic treatment, were included in this 3-year, non-interventional, prospective, observational study. Information regarding social functioning items including housing (independent, dependent, supervised, or hospitalized), work status (employed paid/unpaid, unemployed able to work/unable to work, or retired), number of social activities in past 4 weeks, and relationship with spouse or partner, were collected by interviewing the patients and relatives. We performed a latent class analysis acording to patient's indicators of social functioning to identify social classes. We compared mean change of psychopathology among social classes for all patients and for patients treated with antipsychotic monotherapy for one year. Results: Data for baseline indicators used in the casemix analysis were available for 614 patients. We identified 5 classes of patients (inactives, 38.9%; in a relationship, 29.5%; no relationship unemployed dependents, 15.3%; no relationship employed dependents, 11.6%; no relationship retirees, 4.8%) that share similar characteristics, (likelihood ratio chi-square=107.1, df=347) with 4 aspects of social functioning items. There was no statistical difference among social classes in the improvement of positive, negative, and overall symptom severity at the end of one year naturalistic follow-up. CGI-S score decreases from baseline for positive symptoms were significantly higher with atypical antipsychotics when compared to typicals. Conclusion: The categorical modeling of social functioning may be a simple and valid tool for the further exploration ofthe classes in schizophrenia patients. Testing for long-term efficacy of different treatments in the putative groups may provide valuable insight for functional outcomes of patients with schizophrenia.
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    Effects of an antistigma program on medical students' attitudes towards people with schizophrenia
    (Wiley, 2006) Altindag, Abdurrahman; Yanik, Medaim; Ucok, Alp; Alptekin, Koksal; Ozkan, Mustafa
    People with schizophrenia are amongst the most stigmatized of those with mental illnesses. The purpose of this study was to examine whether an antistigma program which consists of education, contact, and viewing a film that depicts an individual with schizophrenia, can change attitudes towards people with schizophrenia. The antistigma program was carried out with first-year medical students (n = 25). Students' attitudes towards people with schizophrenia were assessed before and after the program. In parallel, a control group of first-year medical students were questioned (n = 35). Assessment was repeated after 1 month. Favorable attitudinal changes were observed in terms of 'belief about the etiology of schizophrenia', 'social distance to people with schizophrenia', and 'care and management of people with schizophrenia'. In contrast, no significant change was observed in the control group. Attitude changes tended to decrease at the 1-month follow up. These results suggest that attitudes towards schizophrenia could be changed favorably with this program. To sustain changed attitudes towards people with schizophrenia, antistigma programs should be offered on a regular basis.