L'EPSILON Study of Schizophrenia. Uno studio multicentrico europeo sulle variabili psicosociali di esito dell'assistenza ai pazienti schizofrenici. I risultati del centro di Verona-Sud

Background. Most research on the outcome of care for patients with schizophrenia generally focus on clinical variables, whereas only few studies have addressed psychosocial subjective outcomes and have explored their complex relationships with input and process variables. To fill this gap, an international multisite research, the EPSILON Study of Schizophrenia was undertaken with the aim to compare in five European countries some important psycho-social variables assessing subjective dimensions of outcome in patients with schizophrenia and to explore possible relationships with input, organizational and service utilization factors. The EPSILON Study was conducted in five European sites (Amsterdam, Copenhagen, London, Santander e Verona) with a cross-sectional design and among the variables assessed were needs for care, quality of life, family burden and satisfaction with mental health services. Objective – To provide an overall picture of the results drown from a sample of schizophrenic patients assessed in the Italian site of the EPSILON Study of Schizophrenia. Method – The study was conducted on a sample of 107 ICD-10 schizophrenic patients (diagnosed ascertained by the SCAN) receiving care from the South-Verona Community-based mental health service (CMHS). A comprehensive set of standardised instruments were used: the BPRS for measuring psychopathology, the GAF for measuring global functioning and the European versions of CAN, IEQ, LQL and VSSS for measuring respectively needs for care, family burden, quality of life and satisfaction with services. Socio-demographic and service utilisation data were extracted from the South-Verona Psychiatric Case Register. Results – Patients assessed in the frame of the EPSILON Study were representative of the one year prevalence of the schizophrenic patients on the caseloads of South-Verona CMHS; the majority of the patients had an ICD-10 diagnosis of undifferentiated (47%) or paranoid schizophrenia (45%); they tend to show a high mean number of outpatient contacts (on average 7 contacts in the last month) and a long duration of contact with the South-Verona CMHS (on average 10 years). Overall, the sample showed low mean levels of global psychopathology and in the various psychopathological dimensions; however, moderate to severe levels of psychopathology were found in BPRS items such as unusual thought content, hallucinations, anxiety and depressives symptoms for the 19%, 28%, 21% and 18% of the total sample respectively. Global functioning was severely impaired in about one third of the sample, whereas the majority of patients showed only mild to low impairment. Patients reported a low mean number of needs for care (4.75, d.s. 3.16); clinical needs were generally met, while social need and needs for services were mostly unmet. Conclusions – The present data might be seen as a reference minimum data set for similar evaluative research projects to be conducted in other mental health services across our nation, and in a meantime represent the baseline assessment for a longitudinal outcome study in the ‘real world’ of mental health services, fulfilling adequate methodological requirements. KEY WORDS: schizophrenia, multi-site collaborative studies, psychopathology, global functioning, needs for care