Effects of Peer support on recovery of Patients.pptx
1. Effects of Peer support on recovery
of Patients with Schizophrenia
Dr Neil Shah,3rd year Resident,
Dr Ritambhara Mehta, Professor and Head,
Department of Psychiatry,
New Civil Hospital ,Surat
2. Aims and Objectives
1
• To assess the effects of Peer support on Subjective
Recovery of Patients with Schizophrenia
2
• To assess the effects of Peer support on Objective Recovery
of Patients with Schizophrenia
3
• To find correlation between Subjective Recovery and
Illness profile and Sociodemographic Variables of Patients
3. Methodology
The study was carried out in a General Hospital Psychiatry Unit of South
Gujarat
PANSS scale was used for inclusion of patients(60) in the study (PANSS score
<75
Informed consent was taken and Patients were cross matched for age, sex and
socio-economic status
Cases(30) Controls(30)
Patients who were taking help of Peer
support services since atleast 3 months
Patients who were not taking help of
Peer Support services
Recovery Assessment Scale and Global
Assessment of Functioning scale were applied
Statistical analysis was done using Chi square test and Fischer’s
Exact test
4. PANSS
1.Positive symptom scale- 7
items
2. Negative symptoms scale- 7
items
3. General Psychopathology
scale- 16 items
Maximum score- 210
Recovery Assessment
Scale
1. 41 item scale
2. 5 point likert scale
3. 5 domains of subjective
recovery
a. Personal confidence and hope
b. Goal and success orientation
c. Willingness to ask for help
d. Reliance on others
e. No domination by symptoms
Maximum score=210
Global Assessment of
Functioning scale
1.100 point scale divided into
intervals each with 10 points
2. 10 point intervals have anchor
points describing symptoms
and functioning
3. 1-10 describe the most
severely ill and 91-100 describe
the healthiest
Tools used
Screening
Subjective
Recovery
Objective
Recovery
7. Illness profile
Variables Cases(%) Controls(%)
Duration of untreated
psychosis
< 1 year 25(83.3) 26(86.7)
> 1 year 5(16.7) 4(13.3)
Previous history of
hospitalization
Yes 21(70) 16(53.3)
No 9(30) 14(46.7)
History of ECT Yes 16(53.3) 8(26.7)
No 14(46.7) 22(73.3)
History of non compliance Yes 10(33.3) 7(23.3)
No 20(66.7) 23(76.7)
Number of times non
compliance
Once 1(8.3) 3(42.9)
2-3 times 9(75) 3(42.9)
2(16.7) 1(14.3)
> 3 times
8. Subjective Recovery
Variables Mean (SD) P value
Cases Controls
Total recovery score 154.4 (5.75) 141(4.62) 0.000
Personal confidence and hope 33.7(2.30) 31(2.11) 0.000
Willingness to ask for help 11.3(0.99) 10.5(0.77) 0.000
Goal and success orientation 18.5(1.45) 17.2(0.88) 0.000
Reliance on others 15.3(0.85) 13.7(1.13) 0.001
No domination by symptoms 11.5(1.13) 10.2(0.77) 0.000
11. Correlations of Subjective Recovery with
Socio demographic variables
Variables Cases(30) Mean Total
Recovery score
Frequency of
visits per month
Once 18 154.00
Twice 7 154.71
Thrice 4 154.00
> 3 times 1 162.00
Current
employment
status
Employed 16 155.29
Unemployed 14 153.69
Marital Status Married 8 155.85
Unmarried 13 154.50
Separated 2 155.00
Divorced 7 151.57
Type of family Nuclear 28 154.04
Joint 2 160.00
12. Correlations of Subjective Recovery with
Socio demographic variables
Subjective
Recovery
Cuurent
employemt
status
Marital
Status
Type of
family
Frequency
of Visits per
month
P=0.622
P=0.457
P=0.457
P=0.160
13. Correlation between Subjective recovery
and Illness Profile
Variables Cases Mean Total recovery score
Duration of
untreated
psychosis
< 1 year 25 155.16
> 1 year 5 150.80
Number of non-
compliances
Once 1 156.00
Twice 9 156.22
> 2 times 2 153.50
History of ECT Yes 16 153.50
No 14 155.50
14. Correlation between Subjective recovery
and Illness Profile
Subjective
Recovery
History of
ECT
Duration of
untreated
psychosis
Number of
non-
compliances
P=0.351
P=0.124 P=0.124
15. Conclusions
• Patients who were taking help of Peer support services had a better subjective
recovery in terms of their personal confidence and hope, their willingness to ask
others for help in times of crisis, their goals and views of success about the future
as compared to patients who were not taking help of peer support services.
• Patients who were taking help of Peer support services by attending Maitry group
meeting had a better objective clinical recovery in terms of symptom remission
and psychosocial rehabilitation as compared to those who were not taking help of
peer support services.
• Patients who attended Maitry meetings more frequently ( >3 times in a month)
had better subjective recovery than those who were attending less frequently.
• Amongst patients using Peer support services who were married, were currently
employed, had duration of untreated psychosis less than one year, who had lesser
number of non- compliances and no history of ECT had a non significantly better
subjective recovery
16. Strengths and Limitations
• Strengths
1. In India Quality Rights Project has been implemented only in Gujarat, which
makes this study of assessing the effects of peer support on recovery of
patients with Schizophrenia unique to the Indian scenario.
2. Subjective recovery area is much less researched and this study has attempted
it.
3. It was a case control study where recovery was compared in patients who
were attending Maitry group meeting with those who were not attending.
• Limitations
1. This study was a cross sectional study. Longitudinal follow up study over 2 to
5 years can give better picture.
2. Sample size was small in this study, a study with more sample size can be
planned
17. Future Implications
1. Longitudinal follow up studies can be done to know the long term impact of
peer support on recovery of patients with Schizophrenia
2. Quality Rights Project and Peer support services can be introduced in other
states of India for better subjective recovery of patients with Schizophrenia.
3. This study was done in only one hospital of South Gujarat, large multicentric
study in other hospitals of Gujarat can be done to generalise the results.
4. More time and resources should be allocated by concerned authorities to
strengthen peer support services
18. References
1. Cook JA, Steigman P, Pickett S, Diehl S, Fox A, Shipley P, et al.
Randomized controlled trial of peer-led recovery education using
building recovery of individual dreams and goals through education
and support (BRIDGES). Schizophrenia Research 2012;136(1-
3):36–42. CSzG: 24471
2. Davidson L, Bellamy C, Guy K, Miller R. Peer support among
persons with severe mental illnesses: a review of evidence and
experience. World Psychiatry 2012;11(2): 123–8.
3. Ahmed El-Monshed, Mostafa Amr,Association between perceived
social support and recovery among patients with schizophrenia,
International Journal of Africa Nursing Sciences, Volume 13
