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immediate family and the community at large. Moreover, it has been proved to be highly cost effective. It is concluded that treatment of the schizophrenic patient in the community is a feasible and effective means of management of the schizophrenic patient. The management of the schizophrenic patient in the community is discussed.

P A T T E R N S O F D R U G A B U S E I N P A T I E N T S

W I T H S C H I Z O P H R E N I A A N D O T H E R

F U N C T I O N A L P S Y C H O S E S

R a m m o h a n Rao Malesu

Psych&tric Hospital Black Rock, St Michael Barbados (W.L )

Patients with functional psychosis and drug abuse are prob- lematic from a clinical, economic and health care systems perspective. With a lifetime prevalence of over 40%, these patients place a significant burden on the mental health delivery system through chronic disability, social dysfunction, frequent rehospitalizations and poor treatment compliance. This pros- pective study reviews all admissions to the Psychiatric Hospital, Barbados over a three-month period. There was a total of 307 patients in the study group, which included 154 with schizophre- nia, 36 with mood disorders, 3 with schizoaffective disorder, 8 with delusional disorders and 7 with schizophreniform disor- ders. The drugs abused included cocaine, marijuana and alco- hol. Seventy percent of the patients abused at least one drug and 20% abused all three drugs. Although overall, marijuana was the most common drug abused, its abuse was significantly higher in schizophrenics (p < 0.001 ). Demographic characteris- tics (gender, age, socioeconomic status, educational level) were strong predictors of drug abuse in schizophrenics. There was also a significant correlation between drug abuse and number of readmissions (p<0.01). This study stresses the need for adequate management of drug abuse in patients with schizo- phrenia and other functional psychosis.

T H E C O N S T R U C T V A L I D I T Y O F T H E

M O D I F I E D E N G U L F M E N T S C A L E

E.A. McCay

The Clarke Institute of Psychiatry, 250 College Street, Toronto, Ontario M5T 1R8, Canada

This is a methodological study designed to contribute to the psychometric evaluation of the Modified Engulfment Scale (MES). The MES was adapted for the purpose of this study from the Engulfment scale developed by Lally (1988). Engulfment was defined as the degree to which an individual's self-concept becomes solely defined by schizophrenia. A homogeneous convenience sample of 100 was recruited from the Schizophrenia Research Registry of Toronto and the Continuing Care Division of the Clarke Institute of Psychiatry. A co-efficient alpha of 0.91 was obtained for the MES, once

six skewed items were deleted. Hypotheses were generated to examine the factorial, convergent, divergent, and discriminant validity of the MES. The MES was found to correlate positively with hopelessness and low self-esteem, indicating convergence. On the other hand, the MES was found to correlate negatively with self-efficacy, indicating divergence. Sufficient information exists concerning the reliability and validity of the MES within the schizophrenia population, to recommend its use in clinical research. The MES in conjunction with engulfment theory, provide directions for clinical interventions and future research designed to improve the quality of life for individuals with schizophrenia.

I N D E P E N D E N C E O F E X P R E S S E D

E M O T I O N I N F A M I L Y M E M B E R S

L. McCleary, H. Munroe-Blum*

Research and lnternational Relations, University of Toronto, Simcoe Hall, 27 King's College Circle, Toronto, ON, Canada M5S 1A1

Expressed emotion, a measure of family attitudes towards an ill relative, is an important predictor of schizophrenia relapse. Questions remain, however, regarding the nature of EE, whether it is a trait of the relative, a response to the patient or a characteristic of the relationship between the relative and the patient. We examined the independence of EE in family members using data from five minute speech samples of 133 relatives of 80 patients with schizophrenia or schizoaffective disorder enroled in a trial or outpatient psychosocial treatments. We found that: (1) high EE does not aggregate or "run in families", and (2) prevalence of family high EE increases with increasing family size according to the laws of probability. The findings indicate that EE is an independent characteristic of the relative. Implications for treatment planning, interpretation of research findings and sampling strategies in studies of expressed emotion in families are discussed.

P R E D I C T I N G C O M P L I A N C E W I T H S O C I A L

T R E A T M E N T S F O R S C H I Z O P H R E N I A

H. Munroe-Blum*, L. McCleary

Research and lnternational Relations, University of Toronto, Simcoe Hall, 27 King's College Circle, Toronto, ON, Canada M5S 1A1

In a randomized controlled trial of three social treatments for people with schizophrenia and their relatives (time-limited group social skills training for the patients vs group psychoedu- cation for the relatives vs both treatments in tandem) we found important outcome differences depending on compliance with treatment. In order to target treatments to those most likely to benefit from them and modify programs to maximize compli- ance and treatment effects it is important to identify patient,