Psychosis patients typically have a chronic course of illness that requires frequent hospitalizations and medical visits, medications, and intensive treatment--resulting in high health care costs for society and reduced quality of life for the patient. Our studies to date have shown some very interesting psychosocial characteristics of older patients with schizophrenia and related psychoses. In the proposed CRC renewal, we will examine the social and health-related outcomes associated with psychosis in late life. In a longitudinal design, the Psychosocial Core will assess patient functioning, health services utilization, and health-related quality of life among older psychosis patients, with a specific emphasis on symptom status, and characteristics of the individual/environment as factors which influence these outcomes. As depicted in our conceptual model, symptom status (e.g., increased positive and negative symptoms), functional status (e.g., performance of activities of daily living, social functioning), and use of health care services interact with characteristics of the individual (e.g., coping) and characteristics of the environment (e.g., life adversity) to influence health-related quality of life among older psychosis patients. The Psychosocial Core will conduct interviews with the entire sample of psychosis patients and normal comparison subjects on a semi-annual basis. Specifically, this Core will gather data on health-related quality of life (e.g., Quality of Well-Being or QWB scale), health services utilization, functional status (e.g., functioning in the domains of work, family, social/leisure, marital relations; aggressive behavior). In addition, we will gather data on characteristics of the individual (i.e., coping, interpersonal competence) and characteristics of the environment (i.e., social support, life adversity). Data regarding the symptom status of the patient and medical treatments (e.g., neuropsychological deficits, antipsychotic medications) will be provided by other Cores within the Center.
The aims of the Psychosocial Core are twofold. First, this Core will employ state-of-the-art methodology to provide a valid and reliable description of the social and health-related outcomes associated with late-life psychosis. Second, psychosocial outcomes data will be made available for use by other Cores and projects within the Center. The significance of the Psychosocial Core, therefore, results from both its focus on psychosocial outcomes as an important area of inquiry and from its close interactions with other components of the Center, which will ensure optimal use of the data collected.
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