An Italian psychiatrist is obtaining startling results with patients suffering from schizophrenia and depression by enlisting them in a competitive football team. Mauro Raffaeli trains his players, many of whom cannot work and are on psychiatric medication, twice a week on a pitch on the outskirts of Rome.
Of the 80 who have passed through the ranks since the team formed in 1993, over half have cut down their drug intake, but more importantly, more than half have returned to work. "Drugs you can often never get rid of, but reintegrating into society is as important," he said.
Former accountant Luca Enei saw his life "go off the rails" when depression set in, but after signing up with Dr Raffaeli's team he returned to work as a security guard, married and had four children.
Psychology graduate and schizophrenic Benedetto Quirino was pestered by voices in his head until he became a rightwinger for Dr Raffaeli. "When you run out on the pitch, the voices stop," he said. "Your opponent is no longer inside you, he has come out and you can dribble round him and beat him."
Since the team was formed, 50 other squads of mental patients have sprung up around Italy, but Dr Raffaeli's charges remain the benchmark, winning the 2006 all-Italy tournament and are now in search of international fixtures.
The team's exploits are also the subject of a documentary film, Mad about football, which focuses on players such as Sandro Faraoni, a former presidential bodyguard who bounced back from schizophrenia to become a stalwart defender and now a painter and poet.
"Mental health sufferers are often locked inside themselves, and football allows them to open up," said film-maker Volfango di Biasi, who wants to de-stigmatise illnesses such as schizophrenia in the film.
Source: The Guardian
Curious to see what else Italian psychiatrists might be doing with Italian schizophrenics, I went googling. This article was revealing...
A Multicenter Italian Study of Patients' Relatives' Beliefs About Schizophrenia
Abstract: This study explored patients' relatives' beliefs about schizophrenia in Italy, a country with a long history of community-based psychiatry. The study was conducted among 709 key relatives of patients with schizophrenia who were recruited in 30 mental health departments.
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Results: Only 24 percent of the relatives (156 of 652) believed that both biological and psychosocial factors had been involved in the development of their loved ones' schizophrenia. Seventy percent of the relatives (457 of 652) maintained that the disorder was due exclusively to psychosocial factors, such as stress, psychological traumas, or the breakdown of a romantic relationship; 6 percent (39 of 652) thought that the disorder had been caused exclusively by biological factors. Patients' intentional behaviors, such as using drugs or keeping bad company, were mentioned as factors by 28 percent of the relatives (182 of 652).
Seventy-five percent of the relatives (455 of 607) indicated a belief that mental hospitals are more similar to prisons than to general hospitals and that patients who have schizophrenia should not be admitted to such institutions. On the other hand, 77 percent (538 of 699) complained that the burden of their loved one's situation rested solely on them.
Sixty-eight percent of the relatives (405 of 596) agreed that patients with schizophrenia should be allowed to vote, 29 percent (171 of 596) believed that they should have children, and 45 percent (268 of 589) thought that a woman who has recovered from schizophrenia should be able to work as a baby-sitter. Forty percent (228 of 571) expressed the belief that their loved one would not recover any further, and 56 percent (384 of 686) complained of their loved one's being kept at a distance by other people.
Analysis of variance showed that the patients' political rights were more frequently recognized by relatives who lived in northern Italy than by those living in central and southern Italy. The same was true for relatives' opinions about patients' capacity to work after recovery from schizophrenia. Relatives who believed that schizophrenia is due exclusively to biological causes were more pessimistic about the possibility that their loved ones would ever recover from their disorder than those who believed that schizophrenia is due to psychosocial factors or to a combination of factors. Relatives who expressed a belief that the patient is at least partly responsible for his or her condition perceived higher levels of objective and subjective burden. Regression analysis showed that spouses of younger patients and of patients with lower levels of disability were more likely to have expressed the belief that persons with schizophrenia should have children than spouses of older patients and of patients with higher levels of disability
Discussion: To our knowledge, this is the first study of patients' relatives' beliefs about schizophrenia in a country in which psychiatric practice has been community oriented for several years. The most significant finding is that relatives of patients with schizophrenia who are living in Italy have been remarkably influenced by media campaigns emphasizing the drawbacks of large mental hospitals and supporting the civil and political rights of persons who have mental disorders. In fact, the relatives surveyed seemed to believe that mental hospitals are not appropriate places in which to treat their loved ones. Moreover, most of the relatives agreed that people with schizophrenia should be allowed to vote.
However, the relatives in our study appeared to have a stricter attitude toward affective rights, such as the right to get married and have children, and tended to perceive their loved ones as being subject to social discrimination. These attitudes may be related to the difficulties in implementing rehabilitative interventions, especially in southern Italy, and the associated increases in family burden. This added burden, plus the poor availability of family psychosocial interventions, may have exacerbated relatives' pessimism about the affective, social, and employment opportunities of persons with schizophrenia. Patients' political rights and ability to work after recovery from schizophrenia were more frequently recognized by relatives in northern Italy, where the average educational level is higher and social and work opportunities are more commonly available.
Relatives who expressed the belief that patients with schizophrenia are responsible for their condition indicated higher levels of personal burden. It is likely that when relatives think that schizophrenia is caused by factors that are under the patient's control, they are less understanding and perceive illness-related problems to be more demanding.
Relatives' beliefs about the causes of schizophrenia were very different from those reported in European countries that have different sociocultural backgrounds and where mental health care is organized differently. Although no other European study has investigated relatives' beliefs about the psychosocial consequences of schizophrenia, significant differences between countries are likely to exist.
The results suggest that psychoeducational programs and sensitization campaigns should focus on the affective and social rights of patients with schizophrenia in addition to addressing the clinical aspects of psychiatric disorders. Moreover, programs and campaigns should be tailored for the social and cultural background of the targeted population.
Source: American Psychiatric Association
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