Patients may have functional goals that are personal and meaningful to them

Key message: Better social and occupational functioning are consistently identified as important self-defined treatment goals, and improved functioning may be the most meaningful and valued outcome of treatment from a patient and family perspective.^{[Bellack et al., 2007]}

Background

• In an Australian study that combined the findings of two studies of patients with psychosis (the first in 1997–98^[n=687], the second in 2010^[n=1211]), 63.2% were found to have obvious/severe dysfunction in socializing, and 32.3% had obvious or severe dysfunction in quality of self care.^{[Morgan et al., 2012]}
• Both the 1997−98 and 2010 surveys had similar aims, employed the same two-phase design and methodology, and used the same core instruments: the ‘Psychosis Screener’ for census month screening and the ‘Diagnostic Interview for Psychosis’ for the interview.^{[Morgan et al., 2012]}
• Social dysfunction is one of the most important factors in the disability associated with the illness, and is a source of great distress for patients and family members.^{[Bellack et al., 2007]}
• Most patients have significant impairments in social relationships, and are often socially isolated. When they do interact with others, they often have difficulty maintaining appropriate conversations, expressing their needs and feelings, achieving social goals, or developing close relationships.^{[Bellack et al., 2007]}
• There is increasing recognition that deficits in functioning in the form of social isolation, unemployment and impaired self-care represent a significant component of illness burden. While symptom control is an important treatment outcome, both patients and families consistently identify better social and occupational functioning as important self-defined treatment goals.^{[Bellack et al., 2007]}
• From the patient and family perspective, enhanced functioning may be the most meaningful and valued outcome of treatment. Given the societal costs of poor functioning, it is also a priority for society at large.^{[Bellack et al., 2007]}

References:
Med IQ. Goal-Setting Worksheet for People with Schizophrenia.
Available at: https://www.mediq.com/files/noncme/material/pdfs/. Last accessed June 2016.

Morgan VA, et al. Aust N Z J Psychiatry. 2012; 46(8): 73552.

Bellack AS, et al. Schizophr Bull. 2007; 33(3): 805–22.