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El-Mallakh P, Findlay J. Strategies to improve medication adherence in patients with schizophrenia: the role of support services. Neuropsychiatr Dis Treat 2015; 11:1077-90. [PMID: 25931823 PMCID: PMC4404876 DOI: 10.2147/ndt.s56107] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The purpose of this review is to describe research over the past 10 years on the role of support services in promoting medication adherence in mental health consumers diagnosed with schizophrenia. A literature search was conducted using the terms "medication adherence," "schizophrenia," and "support services," using Medline, PubMed, and CINAHL. Reference lists from published studies were also reviewed to identify additional research studies. Twenty-two articles focused on support-service intervention studies, and these were selected for review. Available support-service interventions include adherence therapy, electronic reminders via text messages and telephones, cognitive-behavioral and motivational strategies, and financial incentives. Support-service intervention strategies need to be tailored to the specific needs of mental health consumers with schizophrenia. More research is needed to investigate effective support services to enhance long-term adherence and adherence to medications for medical illnesses in this population.
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Affiliation(s)
| | - Jan Findlay
- College of Nursing, University of Kentucky, Lexington, KY, USA
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Chaix J, Ma E, Nguyen A, Ortiz Collado MA, Rexhaj S, Favrod J. Safety-seeking behaviours and verbal auditory hallucinations in schizophrenia. Psychiatry Res 2014; 220:158-62. [PMID: 25219615 DOI: 10.1016/j.psychres.2014.08.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 08/21/2014] [Accepted: 08/24/2014] [Indexed: 11/19/2022]
Abstract
Verbal auditory hallucinations can have a strong impact on the social and professional functioning of individuals diagnosed with schizophrenia. The safety-seeking behaviours used to reduce the threat associated with voices play a significant role in explaining the functional consequences of auditory hallucinations. Nevertheless, these safety-seeking behaviours have been little studied. Twenty-eight patients with schizophrenia and verbal auditory hallucinations were recruited for this study. Hallucinations were evaluated using the Psychotic Symptom Rating Scale and the Belief About Voice Questionnaire and safety behaviours using a modified version of the Safety Behaviour Questionnaire. Our results show that the vast majority of patients relies on safety behaviours to reduce the threat associated with voices. This reliance on safety behaviours is mostly explained by beliefs about origin of voices the omnipotence attributed to hallucinations and the behavioural and emotional reactions to the voices. Safety-seeking behaviours play an important role in maintaining dysfunctional beliefs with respect to voices. They should be better targeted within the cognitive and behavioural therapies for auditory hallucinations.
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Affiliation(s)
- Joséphine Chaix
- School of Nursing Sciences, University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Edgar Ma
- School of Nursing Sciences, University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Alexandra Nguyen
- School of Nursing Sciences, University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Maria Assumpta Ortiz Collado
- School of Nursing Sciences, University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Shyhrete Rexhaj
- School of Nursing Sciences, University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland; Community Psychiatry Service, Department of Psychiatry, University Hospital Centre of Lausanne, Switzerland
| | - Jérôme Favrod
- School of Nursing Sciences, University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland; Community Psychiatry Service, Department of Psychiatry, University Hospital Centre of Lausanne, Switzerland.
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53
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Moritz S, Ramdani N, Klass H, Andreou C, Jungclaussen D, Eifler S, Englisch S, Schirmbeck F, Zink M. Overconfidence in incorrect perceptual judgments in patients with schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2014; 1:165-170. [PMID: 29379749 PMCID: PMC5779164 DOI: 10.1016/j.scog.2014.09.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 09/05/2014] [Indexed: 12/25/2022]
Abstract
Background Patients with schizophrenia show overconfidence in memory and social cognition errors. The present investigation examined whether this cognitive distortion also manifests in perceptual tasks. Methods A total of 55 individuals with schizophrenia, 58 with obsessive–compulsive disorder (OCD) as well as 45 non-clinical controls were presented 24 blurry black and white pictures, half of which contained a hidden object; the other half contained (“snowy”) visual noise. Participants had to judge whether the pictures depicted an object or not and how confident they were in this judgment. Results Participants with schizophrenia showed overconfidence in errors and an enhanced knowledge corruption index (i.e. rate of high-confident errors on all high-confident responses) relative to both control groups. In contrast, accuracy scores did not differ between clinical groups. Metacognitive parameters were correlated with self-rated levels of current paranoia. Discussion To the best of our knowledge, this is the first study to demonstrate overconfidence in errors among individuals with psychosis using a visual perception task. Speaking to the specificity of this abnormality for schizophrenia and its pathogenetic relevance, overconfidence in errors and knowledge corruption were elevated in patients with schizophrenia relative to both control groups and were correlated with paranoia.
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Affiliation(s)
- Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, D-20246 Hamburg, Germany
| | - Nora Ramdani
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, D-20246 Hamburg, Germany
| | - Helena Klass
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, D-20246 Hamburg, Germany
| | - Christina Andreou
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, D-20246 Hamburg, Germany
| | - David Jungclaussen
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, D-20246 Hamburg, Germany
| | - Sarah Eifler
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, PO Box 12 21 20, D-68072 Mannheim, Germany
| | - Susanne Englisch
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, PO Box 12 21 20, D-68072 Mannheim, Germany
| | - Frederike Schirmbeck
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, PO Box 12 21 20, D-68072 Mannheim, Germany
| | - Mathias Zink
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, PO Box 12 21 20, D-68072 Mannheim, Germany
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54
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Sundag J, Lincoln TM, Hartmann MM, Moritz S. Is the content of persecutory delusions relevant to self-esteem? PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2014. [DOI: 10.1080/17522439.2014.947616] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Nonadherence to antipsychotics: the role of positive attitudes towards positive symptoms. Eur Neuropsychopharmacol 2014; 24:1745-52. [PMID: 25444234 DOI: 10.1016/j.euroneuro.2014.09.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 09/07/2014] [Indexed: 11/23/2022]
Abstract
Approximately 50-75% of all patients do not take their antipsychotic medication as prescribed. The current study examined reasons why patients continue versus discontinue antipsychotic medication. We were particularly interested to which extent positive attitudes towards psychotic symptoms foster medication nonadherence. An anonymous online questionnaire was set up to decrease response biases. After a strict selection process, 91 participants with schizophrenia spectrum disorders were retained for the final analyses. On average, 6.2 different reasons for nonadherence were reported. Side-effects (71.4%), sudden subjective symptom improvement (52.4%) and forgetfulness (33.3%) emerged as the most frequent reasons for drug discontinuation. Approximately one fourth of all participants (27.3%) reported at least one positive aspect of psychosis as a reason for nonadherence. In contrast, patients reported on average 3.5 different reasons for adherence (e.g., want to live a normal life (74.6%) and fear of psychotic symptoms (49.3%)). The belief that paranoia represents a survival strategy (subscale derived from the Beliefs about Paranoia Scale) was significantly associated with nonadherence. Patients' attitudes toward medication and the individual illness model need to be carefully considered when prescribing medication. In particular for patients who are likely to discontinue psychopharmacological treatment complementary or alternative psychological treatment should be sought because of a largely increased risk of relapse in the case of sudden drug discontinuation.
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56
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Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders. Epidemiol Psychiatr Sci 2014; 23:271-9. [PMID: 23883668 PMCID: PMC6998353 DOI: 10.1017/s2045796013000322] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Aims. Insight, positive and negative symptoms, hope, depression and self-stigma are relevant variables in schizophrenia spectrum disorders. So far, research on their mutual influences has been patchy. This study simultaneously tests the associations between these variables. Methods. A total of 284 people with schizophrenia spectrum disorders were assessed using the Schedule for the Assessment of Insight, Positive and Negative Syndrome Scale, Integrative Hope Scale, Centre for Epidemiological Studies Depression Scale and Internalized Stigma of Mental Illness scale. Path analysis was applied to test the hypothesized relationships between the variables. Results. Model support was excellent. Strong and mutual causal influences were confirmed between hope, depression and self-stigma. The model supported the assumption that insight diminishes hope and increases depression and self-stigma. While negative symptoms directly affected these three variables, reducing hope and increasing depression and self-stigma, positive symptoms did not. However, positive symptoms diminished self-stigma on a pathway via insight. Conclusions. This study provides a comprehensive synopsis of the relationships between six variables relevant for schizophrenia spectrum disorders. Research implications include the need to investigate determinants of consequences of insight, and the sequence of influences exerted by positive and negative symptoms. Clinical implications include the importance of interventions against self-stigma and of taking a contextualized approach to insight.
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57
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Henriksen MG, Parnas J. Self-disorders and schizophrenia: a phenomenological reappraisal of poor insight and noncompliance. Schizophr Bull 2014; 40:542-7. [PMID: 23798710 PMCID: PMC3984518 DOI: 10.1093/schbul/sbt087] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Poor insight into illness is considered the primary cause of treatment noncompliance in schizophrenia. In this article, we critically discuss the predominant conceptual accounts of poor insight, which consider it as an ineffective self-reflection, caused either by psychological defenses or impaired metacognition. We argue that these accounts are at odds with the phenomenology of schizophrenia, and we propose a novel account of poor insight. We suggest that the reason why schizophrenia patients have no or only partial insight and consequently do not comply with treatment is rooted in the nature of their anomalous self-experiences (ie, self- disorders) and the related articulation of their psychotic symptoms. We argue that self-disorders destabilize the patients' experiential framework, thereby weakening their basic sense of reality (natural attitude) and enabling another sense of reality (solipsistic attitude) to emerge and coexist. This coexistence of attitudes, which Bleuler termed "double bookkeeping," is, in our view, central to understanding what poor insight in schizophrenia really is. We suggest that our phenomenologically informed account of poor insight may have important implications for early intervention, psychoeducation, and psychotherapy for schizophrenia.
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Affiliation(s)
- Mads G. Henriksen
- Psychiatric Center Hvidovre, University of Copenhagen, Copenhagen, Denmark;,Danish National Research Foundation: Center for Subjectivity Research, University of Copenhagen, Copenhagen, Denmark,*To whom correspondence should be addressed; Danish National Research Foundation: Center for Subjectivity Research, University of Copenhagen, Njalsgade 140-142, 25.5.23, DK-2300 Copenhagen S, Denmark; tel: +45-3532-8688, fax: +45-3532-8681, e-mail:
| | - Josef Parnas
- Psychiatric Center Hvidovre, University of Copenhagen, Copenhagen, Denmark;,Danish National Research Foundation: Center for Subjectivity Research, University of Copenhagen, Copenhagen, Denmark
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58
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Potik D. Self psychology conceptualization of postpsychotic depression and recovery among paranoid schizophrenic patients. Bull Menninger Clin 2014; 78:70-86. [DOI: 10.1521/bumc.2014.78.1.70] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Explaining attitudes and adherence to antipsychotic medication: the development of a process model. SCHIZOPHRENIA RESEARCH AND TREATMENT 2014; 2014:341545. [PMID: 24693426 PMCID: PMC3945895 DOI: 10.1155/2014/341545] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 12/23/2013] [Accepted: 12/23/2013] [Indexed: 01/18/2023]
Abstract
Although nonadherence to antipsychotic medication poses a threat to outcome of medical treatment, the processes preceding the intake behavior have not been investigated sufficiently. This study tests a process model of medication adherence derived from the Health Belief Model which is based on cost-benefit considerations. The model includes an extensive set of potential predictors for medication attitudes and uses these attitudes as a predictor for medication adherence. We conducted an online study of 84 participants with a self-reported psychotic disorder and performed a path analysis. More insight into the need for treatment, a higher attribution of the symptoms to a mental disorder, experience of less negative side effects, presence of biological causal beliefs, and less endorsement of psychological causal beliefs were significant predictors of more positive attitudes towards medication. The results largely supported the postulated process model. Mental health professionals should consider attitudes towards medication and the identified predictors when they address adherence problems with the patient in a shared and informed decision process.
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Moritz S, Andreou C, Klingberg S, Thoering T, Peters MJV. Assessment of subjective cognitive and emotional effects of antipsychotic drugs. Effect by defect? Neuropharmacology 2013; 72:179-86. [PMID: 23643756 DOI: 10.1016/j.neuropharm.2013.04.039] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 03/11/2013] [Accepted: 04/23/2013] [Indexed: 11/29/2022]
Abstract
Antipsychotic medication represents the first-line treatment for schizophrenia. While it is undisputed that antipsychotics ameliorate positive symptoms, the exact cognitive and emotional pathways through which the effect is exerted has remained unclear. The present study investigated the subjective effects of antipsychotics across various domains of cognition and emotion in both patients with psychotic symptoms and patients with other psychiatric diagnoses. A total of 69 patients with a probable history of psychosis or psychotic symptoms and 26 patients with psychiatric diagnoses other than psychosis participated in a survey conducted over the Internet. Multiple control measures aimed to secure response validity. All patients were currently or had previously been treated with antipsychotic agents. A questionnaire comprising 49 items and measuring possible effects of antipsychotics on cognition and emotion was administered. For 30 out of 49 items a clear response pattern emerged, which was similar for patients with psychotic disorders and patients with other diagnoses. Factor analysis of these items revealed three main effects of antipsychotic medication related to doubt and self-doubt, cognitive and emotional numbing, and social withdrawal. Antipsychotic treatment appears to be connected to a number of negative subjective effects on cognition and emotion. Further studies are warranted to assess how these effects impact on the patients' subjective well-being and quality of life, as well as their association with antipsychotic efficacy on one hand, and adherence rates on the other. Induction of doubt and dampening of emotion may be one reason why antipsychotics work and at the same time offer an explanation why they are experienced as rather unpleasant and are eventually discontinued by many patients.
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Affiliation(s)
- Steffen Moritz
- University Medical Center Hamburg Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany.
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61
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Ten Velden Hegelstad W, Haahr U, Larsen TK, Auestad B, Barder H, Evensen J, Joa I, Johannessen JO, Langeveld J, Melle I, Opjordsmoen S, Rossberg JI, Rund BR, Simonsen E, Vaglum P, McGlashan T, Friis S. Early detection, early symptom progression and symptomatic remission after ten years in a first episode of psychosis study. Schizophr Res 2013; 143:337-43. [PMID: 23219862 DOI: 10.1016/j.schres.2012.10.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 08/31/2012] [Accepted: 10/07/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND Poor symptom outcome remains a challenge in psychosis: At least 50% of first-episode patients continue to have positive and/or negative symptoms after ten years. OBJECTIVE To investigate rates, early predictors and early symptom progression of long-term non-remitted psychosis in an early detection study. METHODS Symptomatic remission according to new international criteria was assessed in 174 patients at ten-year follow-up. Remitted and non-remitted patients were compared on early symptom progression, and logistic regression was applied to predict non-remission. RESULTS At ten years, 50% of patients were in symptomatic remission. Non-remission was predicted by positive symptoms at inclusion and during the first year of treatment. Of individual symptoms only hallucinations were significantly predictive of ten-year non-remission. Early symptom differences were not reflected by differences in treatment. CONCLUSIONS Long-term symptomatic non-remission is associated with early positive symptoms. More assertive intervention may be needed in patients who do not respond robustly in the first year of treatment, whether or not they have been detected "early".
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Affiliation(s)
- Wenche Ten Velden Hegelstad
- Regional Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Norway, PO Box 8100, 4068 Stavanger, Norway.
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Parnas J, Henriksen MG. Subjectivity and schizophrenia: another look at incomprehensibility and treatment nonadherence. Psychopathology 2013; 46:320-9. [PMID: 23860468 DOI: 10.1159/000351837] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Psychiatry is in a time of crisis. The absence of significant breakthroughs to actionable etiological knowledge has left the discipline in a state of uncertainty and worries are being voiced about its status and future. In our view, the stagnation can be, at least in part, ascribed to an excessive, behaviorist-oriented, epistemological, and ontological simplification of psychopathology. The aim of this phenomenological study is to articulate the notion of the 'disordered self' in schizophrenia, a notion that we believe constitutes an important step forward in grasping its essential pathogenetic structures. Through the framework of self-disorders, we analyze two domains of the psychopathology of schizophrenia, seeking to recast their puzzling nature into more useful clinical and scientific terms. First, we examine the so-called schizophrenic incomprehensibility (bizarre gestalt, bizarre delusions, and 'crazy actions') and argue that grasping the altered framework for experiencing, associated with the disordered self, makes these phenomena appear comprehensible to a considerable extent. Second, we explore the issue of treatment noncompliance and provide a novel account of 'poor insight' into illness. We propose that poor insight into schizophrenia is not simply a problem of insufficient self- reflection due to psychological defenses or impaired metacognition, but rather that it is intrinsically expressive of the severity and nature of self-disorders. The instabilities of the first-person perspective throw the patient into a different, often quasisolipsistic, ontological-existential framework. We argue that interventions seeking to optimize the patients' compliance might prove more efficient if they take the alterations of the patients' ontological-existential framework into account.
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Affiliation(s)
- Josef Parnas
- Psychiatric Center Hvidovre, University of Copenhagen, Copenhagen, Denmark
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63
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Can we trust the internet to measure psychotic symptoms? SCHIZOPHRENIA RESEARCH AND TREATMENT 2013; 2013:457010. [PMID: 23936652 PMCID: PMC3725883 DOI: 10.1155/2013/457010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 05/24/2013] [Accepted: 06/06/2013] [Indexed: 12/02/2022]
Abstract
Online studies are increasingly utilized in applied research. However, lack of external diagnostic verification in many of these investigations is seen as a threat to the reliability of the data. The present study examined the robustness of internet studies on psychosis against simulation. We compared the psychometric properties of the Community Assessment of Psychic Experiences scale (CAPE), a self-report instrument measuring psychotic symptoms, across three independent samples: (1) participants with a confirmed diagnosis of schizophrenia, (2) participants with self-reported schizophrenia who were recruited over the internet, and (3) clinical experts on schizophrenia as well as students who were asked to simulate a person with schizophrenia when completing the CAPE. The CAPE was complemented by a newly developed 4-item psychosis lie scale. Results demonstrate that experts asked to simulate schizophrenia symptoms could be distinguished from real patients: simulators overreported positive symptoms and showed elevated scores on the psychosis lie scale. The present study suggests that simulated answers in online studies on psychosis can be distinguished from authentic responses. Researchers conducting clinical online studies are advised to adopt a number of methodological precautions and to compare the psychometric properties of online studies to established clinical indices to assert the validity of their results.
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Favrod J, Rexhaj S, Ferrari P, Bardy S, Hayoz C, Morandi S, Bonsack C, Giuliani F. French version validation of the psychotic symptom rating scales (PSYRATS) for outpatients with persistent psychotic symptoms. BMC Psychiatry 2012; 12:161. [PMID: 23020603 PMCID: PMC3514145 DOI: 10.1186/1471-244x-12-161] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 09/25/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Most scales that assess the presence and severity of psychotic symptoms often measure a broad range of experiences and behaviours, something that restricts the detailed measurement of specific symptoms such as delusions or hallucinations. The Psychotic Symptom Rating Scales (PSYRATS) is a clinical assessment tool that focuses on the detailed measurement of these core symptoms. The goal of this study was to examine the psychometric properties of the French version of the PSYRATS. METHODS A sample of 103 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms over the previous three months was assessed using the PSYRATS. Seventy-five sample participants were also assessed with the Positive And Negative Syndrome Scale (PANSS). RESULTS ICCs were superior to .90 for all items of the PSYRATS. Factor analysis replicated the factorial structure of the original version of the delusions scale. Similar to previous replications, the factor structure of the hallucinations scale was partially replicated. Convergent validity indicated that some specific PSYRATS items do not correlate with the PANSS delusions or hallucinations. The distress items of the PSYRATS are negatively correlated with the grandiosity scale of the PANSS. CONCLUSIONS The results of this study are limited by the relatively small sample size as well as the selection of participants with persistent symptoms. The French version of the PSYRATS partially replicates previously published results. Differences in factor structure of the hallucinations scale might be explained by greater variability of its elements. The future development of the scale should take into account the presence of grandiosity in order to better capture details of the psychotic experience.
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Affiliation(s)
- Jerome Favrod
- La Source, Health Campus of the University of Applied Sciences of Western Switzerland, Lausanne, Switzerland
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Shyhrete Rexhaj
- La Source, Health Campus of the University of Applied Sciences of Western Switzerland, Lausanne, Switzerland
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Pascale Ferrari
- La Source, Health Campus of the University of Applied Sciences of Western Switzerland, Lausanne, Switzerland
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Sabrina Bardy
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | | | - Stéphane Morandi
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Charles Bonsack
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Fabienne Giuliani
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
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