Indian Journal of Positive Psychology

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Predictors of Positive Recovery Attitudes among Patients with Schizophrenia Attending a Psychiatric Outpatient Clinic in Maiduguri, Northeastern Nigeria


Affiliations
1 Departmental of Mental Health, Federal Neuropsychiatric Hospital Maiduguri, Nigeria, West Africa, Nigeria
2 Department of Mental Health, University of Maiduguri Teaching Hospital, Nigeria, West Africa, Nigeria
     

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An evolving concept in recovery from mental illness dwells on the patients' perspectives towards attainment of life goals despite incomplete remission. The study aims to explore the level of recovery attitude and the possible association with socio-demographic and clinical variables. Two hundred and eighty two male and female patients' with schizophrenia were interviewed using structured instruments: Recovery Attitude Questionnaire (RAQ), Brief Psychiatric Rating Scale (BPRS), Oslo 3 Social Support Scale, Morisky Medication adherence Scale (MMAS) and Simpson and Angus Scale (SAS). Chi square analysis was used to assess for the correlates of recovery attitude and variables with significant associations were subjected to binary logistic regression analysis. Two hundred and forty two (85.8%) of the participants had positive recovery attitude and the correlates of positive recovery attitude were: being employed (χ2 = 5.702; p = 0.017), duration of illness less than one year (χ2 = 7.947; p = 0.047), nil hospital admission (χ2 = 10.75; p = 0.013), nil history of relapse (χ2 = 6.307; p = 0.012), normal to minimally ill on BPRS (χ2 =18.20; p = 0.000), high social support (χ2 = 44.72; p = 0.000) and low stigma on discrimination (χ2 = 8.173; p = 0.004), social withdrawal (χ2 = 3.613; p = 0.05) and stigma resistance subscale (χ2 = 33.36; p = 0.000). The study revealed a high level of positive recovery attitude among patients with schizophrenia with high social support being the greatest independent predictor of recovery attitude. The outcome of this study therefore draws attention to the potential benefit of programmes that strengthen the social network as well as hope inspiring activities to enhance recovery.


Keywords

Recovery, Schizophrenia, Positive, Attitude.
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  • Andresen, R., Caputi, P., & Oades, L. (2006). Stages of recovery instrument: development of a measure of recovery from serious mental illness. Australian and New Zealand Journal of Psychiatry, 40(11-12), 972-980.

  • Bhullar, G., Norman, R. M., Klar, N., & Anderson, K. K. (2018). Untreated illness and recovery in clients of an early psychosis intervention program: A 10-year prospective cohort study. Social Psychiatry and Psychiatric Epidemiology, 53(2), 171-182.

  • Bleuler, E. (1950). Dementia praecox: or. The group of schizophrenias. International University Press, first published in 1911 (translated by J Zinkin).

  • Bøen, H., Dalgard, O. S., & Bjertness, E. (2012). The importance of social support in the associations between psychological distress and somatic health problems and socio- economic factors among older adults living at home: a cross sectional study. BMC Geriatrics, 12(1), 1-12.

  • Borkin, J. R., Steffen, J. J., Ensfield, L. B., Krzton, K., Wishnick, H., Wilder, K., & Yangarber, N. (2000). Recovery attitudes questionnaire: Development and evaluation. Psychiatric Rehabilitation Journal, 24(2), 95-102.

  • Corrigan, P. W. (2006). Recovery from schizophrenia and the role of evidence-based psychosocial interventions. Expert Review of Neurotherapeutics, 6(7), 993-1004.

  • Cavelti, M., Beck, E. M., Kvrgic, S., Kossowsky, J., & Vauth, R. (2012). The role of subjective illness beliefs and attitude toward recovery within the relationship of insight and depressive symptoms among people with schizophrenia spectrum disorders. Journal of Clinical Psychology, 68(4), 462-476.

  • Chan, R. C., Mak, W. W., Chio, F. H., & Tong, A. C. (2018). Flourishing with psychosis: a prospective examination on the interactions between clinical, functional, and personal recovery processes on well-being among individuals with schizophrenia spectrum disorders. Schizophrenia Bulletin, 44(4), 778-787.

  • Chronister, J., Chou, C. C., & Liao, H. Y. (2013). The role of stigma coping and social support in mediating the effect of societal stigma on internalized stigma, mental health recovery, and quality of life among people with serious mental illness. Journal of Community Psychology, 41(5), 582-600.

  • Connell, M., Schweitzer, R., & King, R. (2015). Recovery from first-episode psychosis: A dialogical perspective. Bulletin of the Menninger Clinic, 79(1), 70-90.

  • Cullen, B. A., Mojtabai, R., Bordbar, E., Everett, A., Nugent, K. L., & Eaton, W. W. (2017). Social network, recovery attitudes and internal stigma among those with serious mental illness. International Journal of Social Psychiatry, 63(5), 448-458.

  • Dalgard, O. S., Dowrick, C., Lehtinen, V., Vazquez-Barquero, J. L., Casey, P., Wilkinson, G., & Dunn, G. (2006). Negative life events, social support and gender difference in depression. Social Psychiatry and Psychiatric Epidemiology, 41(6), 444-451.

  • de Wet, A., Swartz, L., & Chiliza, B. (2015). Hearing their voices: The lived experience of recovery from first-episode psychosis in schizophrenia in South Africa. International Journal of Social Psychiatry, 61(1), 27-32.

  • Dazzi, F., Shafer, A., & Lauriola, M. (2016). Meta-analysis of the Brief Psychiatric Rating Scale Expanded (BPRS-E) structure and arguments for a new version. Journal of Psychiatric Research, 81, 140-151

  • Di Capite, S., Upthegrove, R., & Mallikarjun, P. (2018). The relapse rate and predictors of relapse in patients with first‐episode psychosis following discontinuation of antipsychotic medication. Early Intervention in Psychiatry, 12(5), 893-899.

  • El-Monshed, A., & Amr, M. (2020). Association between perceived social support and recovery among patients with schizophrenia. International Journal of Africa Nursing Sciences, 13, 100236.

  • Farkas, M., Gagne, C., Anthony, W., & Chamberlin, J. (2005). Implementing recovery oriented evidence based programs: Identifying the critical dimensions. Community Mental Health Journal, 41(2), 141-158.

  • Gopal, S., & Henderson, A. R. (2015). Trans-cultural study of recovery from severe enduring mental illness in Chennai, India and Perth, Western Australia. Journal of Psychosocial Rehabilitation and Mental Health, 2(1), 51-57.

  • Grover, S., Hazari, N., Singla, N., Chakrabarti, S., Aneja, J., Sharma, S., & Avasthi, A. (2016). Recovery among patients with severe mental illness: Factor analysis of recovery assessment scale in Indian setting. Indian Journal of Social Psychiatry, 32(2), 92.

  • Gureje, O. (1987). Tardive dyskinesia in schizophrenics: Prevalence, distribution and relationship to neurological “soft” signs in Nigerian patients. Acta Psychiatrica Scandinavica, 76(5), 523-528.

  • Ho, W. W., Chiu, M. Y., Lo, W. T., & Yiu, M. G. (2010). Recovery components as determinants of the health-related quality of life among patients with schizophrenia: structural equation modelling analysis. Australian & New Zealand Journal of Psychiatry, 44(1), 71-84.

  • Jahn, D. R., Leith, J., Muralidharan, A., Brown, C. H., Drapalski, A. L., Hack, S., & Lucksted, A. (2020). The influence of experiences of stigma on recovery: Mediating roles of internalized stigma, self-esteem, and self-efficacy. Psychiatric Rehabilitation Journal, 43(2), 97.

  • Jørgensen, R., Zoffmann, V., Munk-Jørgensen, P., Buck, K. D., Jensen, S. O., Hansson, L., & Lysaker, P. H. (2015). Relationships over time of subjective and objective elements of recovery in persons with schizophrenia. Psychiatry Research, 228(1), 14-19.

  • Knol, W., Keijsers, C. J., Jansen, P. A., & Van Marum, R. J. (2010). Systematic evaluation of rating scales for drug-induced parkinsonism and recommendations for future research. Journal of Clinical Psychopharmacology, 30(1), 57-63.

  • Kukla, M., Salyers, M. P., & Lysaker, P. H. (2013). Levels of patient activation among adults with schizophrenia: associations with hope, symptoms, medication adherence, and recovery attitudes. The Journal of Nervous and Mental Disease, 201(4), 339-344.

  • Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445-452.

  • Leucht, S., Kane, J. M., Kissling, W., Hamann, J., Etschel, E. V. A., & Engel, R. (2005). Clinical implications of brief psychiatric rating scale scores. The British Journal of Psychiatry, 187(4), 366-371.

  • Liberman, R. P., & Kopelowicz, A. (2005). Recovery from schizophrenia: A concept in search of research. Psychiatric Services, 56(6), 735-742.

  • Lukoff, D., Liberman, R. P., & Nuechterlein, K. H. (1986). Symptom monitoring in the rehabilitation of schizophrenic patients. Schizophrenia Bulletin, 12(4), 578-603.

  • Mathew, S. T., Nirmala, B. P., & Kommu, J. V. S. (2018). Meaning of recovery among persons with schizophrenia: A literature review. Journal of Psychosocial

  • Rehabilitation and Mental Health, 5(1), 73-81.

  • Mohamed,A.G.E.D.,El-Nady,M.T.,&Ramadan,A.A.H.(2019). Internalizedstigma and recovery attitude among mentally ill patients. International Journal of Novel

  • Research in Healthcare and Nursing, 6(2), 1206-1216.

  • Morisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care, 24(1), 67-74.

  • Morisky, D. E. (2008). Predictive validity of a medication adherence measure for hypertension control. Journal of Clinical Hypertension, 10, 348-354.

  • Overall, J. E., & Gorham, D. R. (1988). The Brief Psychiatric Rating Scale (BPRS): Recent developments in ascertainment and scaling. Psychopharmacology Bulletin, 21, 97-99.

  • Ritsher, J. B., Otilingam, P. G., & Grajales, M. (2003). Internalized stigma of mental illness: Psychometric properties of a new measure. Psychiatry Research, 121(1), 31-49.

  • Roe, D., Mashiach-Eizenberg, M., & Lysaker, P. H. (2011). The relation between objective and subjective domains of recovery among persons with schizophrenia- related disorders. Schizophrenia Research, 131(1-3), 133-138.

  • Ruggeri, M., Koeter, M., Schene, A., Bonetto, C., Vàzquez-Barquero, J. L., Becker, T., & EPSILON Study Group (2005). Factor solution of the BPRS-expanded version in schizophrenic outpatients living in five European countries. Schizophrenia Research, 75(1), 107-117.

  • Shettima, F. B., Wakil, M. A., Rabbebe, I. B., Kudale, H. A., & Pindar, S. K. (2022). The relationship between social support, internalized stigma of mental illness and recovery attitude among patients with schizophrenia in Maiduguri. American Journal of Psychology, 4(1), 10-21.

  • Simpson, G. M., & Angus, J. W. S. (1970). A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica, 45(S212), 11-19.

  • Singla, N., Avasthi, A., & Grover, S. (2020). Recovery and its correlates in patients with schizophrenia. Asian Journal of Psychiatry, 52, 102-162.

  • Soundy, A., Stubbs, B., Roskell, C., Williams, S. E., Fox, A., & Vancampfort, D. (2015). Identifying the facilitators and processes which influence recovery in individuals with schizophrenia: A systematic review and thematic synthesis. Journal of Mental Health, 24(2), 103-110.

  • Steffen, J. J., Borkin, J. R., Krzton, K., Wishnick, H., & Wilder, K. E. (1998). Consumer, family member, mental health professional, and student versions of the recovery attitudes questionnaire. Unpublished report.

  • Van Eck, R. M., Burger, T. J., Vellinga, A., Schirmbeck, F., & de Haan, L. (2018). The relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders: A systematic review and meta-analysis. Schizophrenia Bulletin, 44(3), 631-642.

  • Windell, D. L., Norman, R., Lal, S., & Malla, A. (2015). Subjective experiences of illness recovery in individuals treated for first-episode psychosis. Social Psychiatry and Psychiatric Epidemiology, 50(7), 1069-1077.

  • Winton-Brown, T. T., Elanjithara, T., Power, P., Coentre, R., Blanco-Polaina, P., & McGuire, P. (2017). Five-fold increased risk of relapse following breaks in antipsychotic treatment of first episode psychosis. Schizophrenia Research, 179, 50- 56.

  • Yanos, P. T., Roe, D., Markus, K., & Lysaker, P. H. (2008). Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders. Psychiatric Services, 59(12), 1437-1442.


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  • Predictors of Positive Recovery Attitudes among Patients with Schizophrenia Attending a Psychiatric Outpatient Clinic in Maiduguri, Northeastern Nigeria

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Authors

Falmata Baba Shettima
Departmental of Mental Health, Federal Neuropsychiatric Hospital Maiduguri, Nigeria, West Africa, Nigeria
Musa Abba Wakil
Department of Mental Health, University of Maiduguri Teaching Hospital, Nigeria, West Africa, Nigeria
Jidda Said
Department of Mental Health, University of Maiduguri Teaching Hospital, Nigeria, West Africa, Nigeria
Isa Bukar Rabbebe
Departmental of Mental Health, Federal Neuropsychiatric Hospital Maiduguri, Nigeria, West Africa, Nigeria
Umar Baba Musami
Department of Mental Health, University of Maiduguri Teaching Hospital, Nigeria, West Africa, Nigeria

Abstract


An evolving concept in recovery from mental illness dwells on the patients' perspectives towards attainment of life goals despite incomplete remission. The study aims to explore the level of recovery attitude and the possible association with socio-demographic and clinical variables. Two hundred and eighty two male and female patients' with schizophrenia were interviewed using structured instruments: Recovery Attitude Questionnaire (RAQ), Brief Psychiatric Rating Scale (BPRS), Oslo 3 Social Support Scale, Morisky Medication adherence Scale (MMAS) and Simpson and Angus Scale (SAS). Chi square analysis was used to assess for the correlates of recovery attitude and variables with significant associations were subjected to binary logistic regression analysis. Two hundred and forty two (85.8%) of the participants had positive recovery attitude and the correlates of positive recovery attitude were: being employed (χ2 = 5.702; p = 0.017), duration of illness less than one year (χ2 = 7.947; p = 0.047), nil hospital admission (χ2 = 10.75; p = 0.013), nil history of relapse (χ2 = 6.307; p = 0.012), normal to minimally ill on BPRS (χ2 =18.20; p = 0.000), high social support (χ2 = 44.72; p = 0.000) and low stigma on discrimination (χ2 = 8.173; p = 0.004), social withdrawal (χ2 = 3.613; p = 0.05) and stigma resistance subscale (χ2 = 33.36; p = 0.000). The study revealed a high level of positive recovery attitude among patients with schizophrenia with high social support being the greatest independent predictor of recovery attitude. The outcome of this study therefore draws attention to the potential benefit of programmes that strengthen the social network as well as hope inspiring activities to enhance recovery.


Keywords


Recovery, Schizophrenia, Positive, Attitude.

References





DOI: https://doi.org/10.15614/ijpp%2F2022%2Fv13i3%2F218238