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Background: In the past few decades, women with severe mentalillness have had more opportunities to be parents and raise theirchildren. This may be associated with deinstitutionalization,community-based rehabilitation and support programs, and devel-opment of antipsychotics. Mothers with severe mental illnessexperience many kinds of problems during childcare. Mentaldeterioration can lead to hospitalization, resulting in long separa-tion from children and further grief as well as a burden on healthcare facilities. In this study, we attempted to identify characteristicsof mothers whose condition did not deteriorate and who did notrequire hospitalization in order to obtain insights into preventingmental deterioration and the need for hospitalization.Methods: The subjects consisted of 34 women, aged 33-68, whohad experienced childcare and who were outpatients diagnosedwith schizophrenia (16 subjects), schizoaffective disorder (13),bipolar affective disorder (4) or depression with psychotic symp-toms (1). Sixteen of the participants required hospitalization withinthree years following the first childbirth and the remaining 18 didnot. Data were collected from medical records, interviews and froma self-administered questionnaire about attitudes and behaviorduring the first three years following the first childbirth. Thequestionnaire was composed of six sections on 1) living situation,2) psychiatric medication, 3) sleep, 4) subjective symptoms ofdeterioration, 5) resting time, and 6) the subjects' impressions andadvice about childcare.Results: The non-hospital group was more likely to take care ofthemselves (for instance, taking naps for their sleep deficit) thanthe hospital group. The non-hospital group was more likely torecognize the need for support, regular taking of psychiatricmedications and consultation with attending psychiatrists thanthe hospital group. There were no differences between the twogroups in diagnosis, age of onset, duration of illness, antipsychoticmedication, financial issues, living situation, resting time, orsubjective symptoms.Discussion: The results suggest that mothers' attitudes toward self-care and childcare can help to prevent mental illness deteriorationand the need for hospitalization, and that support from mentalhealth care facilities is essential for improving these attitudes.
doi:10.1016/j.schres.2010.02.468
Poster 241ASSESSING RECOVERY IN PEOPLE WITH SERIOUS MENTAL ILLNESS
Alan S. Bellack1,2, Amy Drapalski2, Deb Medoff11University of Maryland Baltimore, MD, USA; 2VAMHCS Baltimore,MD, USA
Background: Mental health care in the United States and WesternEurope is undergoing a shift in values and practice toward aconsumer driven recovery model, which assumes that all consumershave the capacity to improve and develop a life distinct from theirillness. The consumer model emphasizes hope, empowerment, andcontrol of one's life, in contrast to scientific and clinical models,which view recovery in the context of reduced symptoms. Despitethis political and programmatic change, there is little scientificliterature on the nature of recovery or the factors that contribute toit. Two factors that have limited empirical study of the construct andtreatment programs are: a) the absence of a scientifically groundedconceptual model of recovery, and b) the lack of a reliable and validassessment instrument to measure recovery status. This presentationwill report on the development of the Maryland Assessment ofRecovery in Serious Mental Illness (MARS, a psychometrically soundrecovery assessment scale based on Bandura's social cognitivetheory.
Methods: The MARS was developed using a multi-step empiricalprocess of scale development. A team of experts first developed anoperational definition of recovery based on the literature, and thendrafted a set of self-report items that reflected six primary recoverydimensions. The draft version of the MARS was then submitted to apanel of doctoral level experts on recovery and serious mental illness.These individuals then participated in a semi-structured telephoneinterview to solicit their opinions on the operational definitions, thestructure and format of the scale, adequacy of content coverage, andindividual items. Revisions were made based on their feedback, andthe revised instrumentwas then reviewed by a panel of consumers forfurther refinement. The revised version of the MARS was thenadministered to a sample of 65 consumers with serious mental illnessto examine its psychometric properties and ease of use.Results: The data demonstrate that the MARS is quite practical foruse with the targeted population. On average it took respondents14-min to complete the MARS. There was a very limited amount ofmissing data: less than 1% of the total number of items answered.There was no indication of consistent problems with the items or theformat of the scale. The range of responses for each item was broad.Subjects used all five response options on 64% of the items, and used 4of the 5 response options on another 36% of the items. Themean scoreacross all items was 3.59 (sd=0.66), and the range was 2.21 to 4.93.The MARS also has good internal consistency: Cronbach's alpha was.967, and correlations between the overall recovery score and eachrecovery domain ranged from .825 (Responsibility) to .939(Strengths). Twenty-five of the subjects were retested on the MARSafter 1-week to provide a preliminary estimate of test-retest reliability.The test-retest correlation was .868.Discussion: These data provide good support for further develop-ment of the MARS. It is practical for use in community mentalhealth settings as well as for research. Scores are both internallyconsistent and consistent over time, and the scale producesadequate dispersion among scores. Feedback from our consultantsand consumer advisors indicates that the MARS also has good faceand content validity. We have recently mounted a large scale studyto examine the factor structure of the MARS, the stability of scoresover a 1-year period, and the relationship of recovery status to otherdimensions of psychiatric and psychosocial functioning.
doi:10.1016/j.schres.2010.02.469
Poster 242PSYCHOMETRIC PROPERTIES OF THE FRENCH VERSION OF THEPERSONAL AND SOCIAL PERFORMANCE SCALE (PSP) AMONGINDIVIDUALS WITH SCHIZOPHRENIA
Olivier Blanc1, Antonio Delgado2, Christophe Lancon3,Raymund Schwan4, SchurhoffFranck Schürhoff5,Jean-Alexandre Lesturgeon6, Pierre Thomas7, Pierre-Michel Llorca11CHU Clermont ferrand Clermont-ferrand, France, France; 2JanssenCilag France Suresnes, France, France; 3CH Sainte MargueriteMarseille, France, France; 4CHU de nancy Nancy, France, France;5CH Albert Chenevier Créteil, France, France; 6CHS Sainte MArieClermont-Ferrand, France, France; 7CHU Lille Lille, France, France
Background: The Personal and Social Performance (PSP) scale is areliable and valid instrument that utilizes objective parameters forassessment of social functioning in patients with schizophrenia. Theaim of this study was to determine the validity and reliability of theFrench version of PSP in a population of French schizophrenic patients.Methods: Patients with DSM-IV diagnoses of schizophrenia andschizoaffective disorderwere recruited and assessed in a cross-sectionaldesignusing thePSP,GAF, SOFS, PANSS,CGI severity. Internal consistency
Abstracts 285