study on schizophrenia

We as a research team would like to know; Who is affected by a disorder of schizophrenia. We ask ourselves the following questions:

- What are their causes, or which symptoms are accompanied by the disease?

- Whom does it concern? From what age to what age?

- What gender is particularly affected?

- What is the education level and what kind of employment do affected people have?

- What is the state of health of relatives?

- Which belief systems play a vital role in the lives of the patients?

- Which people or tasks help those affected to a meaningful handling of the disease?

Participation

Are you an affected person, a physician / psychiatrist, a caretaker / nurse or

a therapist / psychotherapist / psycholgist?

Then we would be very pleased about your valuable cooperation.

Guidance instructions

Thank you for your willingness to participate in this study. Please note that the

fields marked with an asterisk (*) must be completed. All other data are voluntary

and allow a higher evaluation quality.

All information provided is handled strictly confidential.

Survey

Surname:

Given name(s):

Sex *:

Born in the year *:

Type of disease *:

ICD-10 Code:

Start of the disease in the year:

Treatment

How is or how has the disease been treated?

Therapy *:

Medication

What medicines do you use to treat schizophrenia?

Name of drug # 1:

Name of drug # 2:

Name of drug # 3:

Others:

Substances

Do you consume or did you consume one or more substances before or during the illness?

Substance use *:

Type of substance # 1:

Type of substance # 2:

Type of substance # 3:

Other substances:

Systemic Information

Are also other family-members affected by schizophrenia?

Family *:

If your answer was "yes":

Who is or has been affected? (Spouse, father, mother, grandmother, father, cousin, daughter, son, etc.)

Family members:

Demographic Information

Civil Status *:

Home country *:

Living in

Country *:

State *:

Religious affiliation

Please include your affiliation with a particular faith. If this does not apply to you, please specify "None".

Religion *:

Education

What is your highest degree?

Education *:

Occupational title:

Field of activity

In which of the following areas are you active:

Field of work *:

Further Information

Would you like to provide us with further details?

Additional:

E-Mail:

Address:

Keep me informed about the course of the study: