Treatment-resistant schizophrenia and staff rejection

This study examined the relationship between characteristics of patients su ffering from treatment-refractory schizophrenia and staff rejection and cri ticism. Subjects were 30 inpatients with treatment-resistant schizophrenia and the 29 staff members treating them. Measures included assessment of the patients' symptoms and aggression risk profile using the Positive and Nega tive Syndrome Scale (PANSS) and assessment of staff attitudes toward these patients using the Patient Rejection Scale (PRS), Nursing staff completed t he Nurses' Observation Scale for Inpatient Evaluation (NOSIE), PRS ratings did not correlate with patients' demographic and treatment characteristics. Significant correlations existed, however, between increased staff rejecti on and higher scores for PANSS cognitive factor and NOSIE manifest psychosi s factor. Negative symptoms, although preponderant in the patient sample, w ere not significant predictors of staff rejection on the PRS. Older nursing staff tended to view patients as more irritable and manifestly psychotic. These findings suggest that disorganized behavior and impaired cognition dy sfunction areas are more likely to be associated with high levels of reject ion among staff working with treatment-resistant schizophrenia patients. In corporation of the relatively new concepts of cognitive dysfunction and tre atment resistance in staff training programs and multidisciplinary team rev iews may greatly benefit schizophrenia patients and the staff treating them .