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Abstract
Rapid urbanization worldwide is associated to an increase of population in the urban settings and this is leading to new emerging mental health issues. This narrative mini-review is based on a literature search conducted through PubMed and EMBASE. A total of 113 articles published on the issue of urban mental health have been selected, cited, reviewed, and summarized. There are emerging evidences about the association between urbanization and mental health issues. Urbanization affects mental health through social, economic, and environmental factors. It has been shown that common mental syndromes report higher prevalence in the cities. Social disparities, social insecurity, pollution, and the lack of contact with nature are some of recognized factors affecting urban mental health. Further reserach studies and specific guidelines should be encouraged to help policy makers and urban designers to improve mental health and mental health care facilities in the cities; additional strategies to prevent and reduce mental illness in the urban settings should be also adopted globally.
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Caqueo-Urízar A, Alessandrini M, Boyer L. Calidad de vida en pacientes con esquizofrenia de origen Aymara en la zona Centro-Sur de los Andes. UNIVERSITAS PSYCHOLOGICA 2018. [DOI: 10.11144/javeriana.upsy16-5.qlap] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
El objetivo de este estudio consistió en comparar la calidad de vida (CV) de pacientes con esquizofrenia pertenecientes al grupo étnico aymara de los Andes Centro-Sur, con pacientes no Aymara. En este estudio transversal participaron 253 pacientes de tres clínicas de salud mental en Chile, Perú y Bolivia. Se recogieron datos sociodemográficos y características clínicas. La calidad de vida se evaluó utilizando el Cuestionario S-QoL18. Los análisis comparativos exploraron las diferencias de QoL entre los pacientes Aymara y no Aymara. Los participantes de origen Aymara tuvieron puntuaciones de CV más bajos en comparación con los pacientes no Aymara para el Índice total, las relaciones familiares y la dimensión de vida sentimental. Los ingresos familiares mensuales y la duración del trastorno fueron significativamente más bajos en los pacientes Aymara. Nuestro estudio soporta la hipótesis de una peor CV en pacientes aymaras con esquizofrenia.
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Caqueo-Urízar A, Alessandrini M, Urzúa A, Zendjidjian X, Boyer L, Williams DR. Caregiver's quality of life and its positive impact on symptomatology and quality of life of patients with schizophrenia. Health Qual Life Outcomes 2017; 15:76. [PMID: 28424076 PMCID: PMC5395968 DOI: 10.1186/s12955-017-0652-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 04/06/2017] [Indexed: 11/10/2022] Open
Abstract
Background Although the quality of life (QoL) experienced by patients with schizophrenia has been recognized, few studies have assessed the relationship between the caregivers’ QoL and patients’ QoL. Methods The study included 253 stabilized outpatients with schizophrenia and their caregivers from 3 Mental Health Services in Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). Caregivers’ and patients’ QoL were respectively assessed using two specific QoL questionnaires (S-CGQoL and S-QoL 18). We collected socio-demographic information and clinical data. Multiple linear regressions were performed to determine which variables were associated with patient’s QoL. We tested the following hypothesis using structural equation modeling (SEM): caregivers’ QoL may have an indirect effect on patients’ QoL mediated by their influence of the severity of psychotic symptoms. Results In the multivariate analysis, the caregivers’ QoL was not significantly associated with the patients’ QoL, except for one QoL dimension about relationship with family (Beta = 0.23). Among patients’ characteristics, being a woman and Aymara, having lower educational level, unemployment and severity of symptoms was significantly associated to a lower QoL. The SEM revealed a moderate significant association between caregivers’ QoL and psychotic symptoms severity (path coefficient = −0.32) and a significant association between psychotic symptoms severity and patients QoL (path coefficient = −0.40). The indirect effect of caregivers’ QoL on patients’ QoL was significant (mediated effect coefficient = 0.13). Conclusion Improvement of caregiver’s QoL may have a direct impact on the psychotic symptoms of patients and indirectly on patient’s QoL, confirming the need for ongoing family interventions in these regions.
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Affiliation(s)
- Alejandra Caqueo-Urízar
- Escuela de Psicología y Filosofía, Universidad de Tarapacá, Avenida 18 de Septiembre 2222, Arica, Chile. .,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115-6018, USA.
| | - Marine Alessandrini
- Assistance publique des hôpitaux de Marseille, Hôpital de la Conception, pôle psychiatrie centre, 13005, Marseille, France.,Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, EA 3279 - Public Health, 13005, Marseille, France
| | - Alfonso Urzúa
- Universidad Católica del Norte, Avda. Angamos 0610, Antofagasta, Chile
| | - Xavier Zendjidjian
- Assistance publique des hôpitaux de Marseille, Hôpital de la Conception, pôle psychiatrie centre, 13005, Marseille, France.,Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, EA 3279 - Public Health, 13005, Marseille, France
| | - Laurent Boyer
- Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille University, EA 3279 - Public Health, 13005, Marseille, France
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115-6018, USA.,Department of African and African American Studies, Harvard University, Cambridge, MA, USA
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Millier A, Horváth M, Ma F, Kóczián K, Götze A, Toumi M. Healthcare resource use in schizophrenia, EuroSC findings. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2017; 5:1372027. [PMID: 29081923 PMCID: PMC5645906 DOI: 10.1080/20016689.2017.1372027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 08/22/2017] [Indexed: 05/16/2023]
Abstract
Background: It is unclear if the burden associated with schizophrenia is affected by the type and severity of patient's symptoms. Objective: This study aims to quantify healthcare resource use associated with different profiles of schizophrenia symptoms. Study design: Post-hoc analysis of data from a naturalistic follow-up study. Setting: Secondary psychiatric services in France, Germany and the UK. Patients: EuroSC cohort:, representative sample of 1,208 schizophrenia patients Main outcome measure: We classified patients into eight health states, according to the Lenert classification (HS1-HS8), and estimated 6-month healthcare resource use (outpatient and day clinic visits, and hospitalisations) across the health states. Results: Approximately half of the patients were classed as having mild symptoms (HS1), with around 20% experiencing moderate, predominantly negative symptoms (HS2). The remaining health states were represented by <10% of patients each. Very few patients experienced extremely severe symptoms (HS8). No health state was associated with excess utilisation across all resource types. In terms of outpatient visits, patients were estimated to see a psychiatrist most often (3.01-4.15 visits over 6 months). Hospital admission was needed in 11%(HS1) - 35%(HS8) of patients and inpatient stays were generally prolonged for all health states (39-57 days). The average number of inpatient days was highest for patients in HS8 (18.17 days), followed by patients with severe negative symptoms (HS4; 13.37 days). In other health states characterised by severe symptoms (HS5-HS7), the average number of inpatient days was approximately half of those seen for HS4 (6.09-7.66). Conclusion: While none of the symptom profiles was associated with excess resource usage, hospitalization days were highest for HS with severe, predominantly negative or extremely severe symptoms. Patients with predominantly negative, moderate or severe symptoms appeared to have a high number of psychologist visits - an interesting finding that may reflect a specific therapeutic approach to the treatment of these patients.
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Affiliation(s)
- A. Millier
- Health Economics and Outcomes Research, Creativ-Ceutical, Paris, France
- CONTACT A. Millier Creativ-Ceutical, 215 rue du Faubourg Saint Honoré, Paris75008, France
| | - M. Horváth
- Market Access, Medical & Marketing, Gedeon Richter Plc, Budapest, Hungary
| | - F. Ma
- Health Economics and Outcomes Research, Creativ-Ceutical, Beijing, China
| | - K. Kóczián
- Market Access, Medical & Marketing, Gedeon Richter Plc, Budapest, Hungary
| | - A. Götze
- Market Access, Medical & Marketing, Gedeon Richter Plc, Budapest, Hungary
| | - M. Toumi
- Public Health Department, Aix-Marseille University, France
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Depp CA, Harmell AL, Vahia IV, Mausbach BT. Neurocognitive and functional correlates of mobile phone use in middle-aged and older patients with schizophrenia. Aging Ment Health 2016; 20:29-35. [PMID: 25768842 PMCID: PMC4568167 DOI: 10.1080/13607863.2015.1008987] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Our objective was to examine the association of mobile phone use and ownership with psychopathology, cognitive functioning, and functional outcome in 196 outpatients aged 40 years and older who were diagnosed with schizophrenia. METHOD Participants reported their past and current mobile phone use on a standardized self-report scale and they were administered tests of global cognition, functional capacity, and informant-rated functional outcome. RESULTS The great majority of subjects had used a mobile phone (78%) but few currently owned one (27%). After adjusting for age (mean age 51), any past mobile phone use was associated with less severe negative symptoms, and higher global cognitive performance, functional capacity, and functional outcome. A total of 60% of participants reported being comfortable with mobile phones, but comfort was not associated with any cognitive or functional outcomes. CONCLUSION Most of the older patients with schizophrenia have used mobile phones and lifetime mobile phone use is a positive indicator of cognitive and functional status.
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Affiliation(s)
- Colin A Depp
- Department of Psychiatry, UC San Diego, La Jolla, California, VA San Diego Healthcare System, San Diego, California
| | | | - Ipsit V Vahia
- Department of Psychiatry, UC San Diego, La Jolla, California
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de Sousa P, Spray A, Sellwood W, Bentall RP. 'No man is an island'. Testing the specific role of social isolation in formal thought disorder. Psychiatry Res 2015; 230:304-13. [PMID: 26384574 DOI: 10.1016/j.psychres.2015.09.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 07/27/2015] [Accepted: 09/06/2015] [Indexed: 11/24/2022]
Abstract
Recent work has focused on the role of the environment in psychosis with emerging evidence that specific psychotic experiences are associated with specific types of adversity. One risk factor that has been often associated with psychosis is social isolation, with studies identifying isolation as an important feature of prodromal psychosis and others reporting that social networks of psychotic patients are smaller and less dense than those of healthy individuals. In the present study, we tested a prediction that social isolation would be specifically associated with formal thought disorder. 80 patients diagnosed with psychosis-spectrum disorder and 30 healthy participants were assessed for formal thought disorder with speech samples acquired during an interview that promoted personal disclosure and an interview targeting everyday topics. Social isolation was significantly associated with formal thought disorder in the neutral interview and in the salient interview, even when controlling for comorbid hallucinations, delusions and suspiciousness. Hallucinations, delusions and suspiciousness were not associated with social isolation when formal thought disorder was controlled for. Formal thought disorder is robustly and specifically associated with social isolation. Social cognitive mechanisms and processes are discussed which may explain this relationship as well as implications for clinical practice and future research.
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Affiliation(s)
- Paulo de Sousa
- Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building Block B, Liverpool L69 3GL, UK.
| | - Amy Spray
- School of Psychology, Eleanor Rathbone Building, University of Liverpool, Bedford Street South, Liverpool L69 7ZA, UK
| | - William Sellwood
- Division of Health Research, Faculty of Health and Medicine, Furness Building, Lancaster University, Lancaster LA1 4YG, UK
| | - Richard P Bentall
- Institute of Psychology, Health and Society, University of Liverpool, Waterhouse Building Block B, Liverpool L69 3GL, UK
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Association between ANKK1 (rs1800497) and LTA (rs909253) Genetic Variants and Risk of Schizophrenia. BIOMED RESEARCH INTERNATIONAL 2015. [PMID: 26114114 DOI: 10.1155/2015/821827]] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Limited research has assessed associations between schizophrenia and genetic variants of the ankyrin repeat and kinase domain containing 1 (ANKK1) and lymphotoxin-alpha (LTA) genes among individuals of Middle Eastern ancestry. Here we present the first association study investigating the ANKK1 rs1800497 (T>C) and LTA rs909253 (A>G) single-nucleotide polymorphisms in an Egyptian population. Among 120 patients with DSM-IV and PANSS (Positive and Negative Syndrome Scale) assessments of schizophrenia and 100 healthy controls, we determined the genotypes for the polymorphisms using endonuclease digestion of amplified genomic DNA. Results confirmed previous findings from different ethnic populations, in that the rs1800497 and rs909253 polymorphisms were both associated with risk of schizophrenia. Differences between the genotypes of cases and controls were strongly significant (P = 0.0005 for rs1800497 and P = 0.001 for rs909253). The relative risk to schizophrenia was 1.2 (P = 0.01) for the C allele and 0.8 (P = 0.04) for the G allele. The CC, GG, and combined CC/AA genotypes were all more frequent in cases than in controls. These results support an association between ANKK1 and LTA genetic markers and vulnerability to schizophrenia and show the potential influence of just one copy of the mutant C or G allele in the Egyptian population.
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Caqueo-Urízar A, Boyer L, Baumstarck K, Gilman SE. Subjective perceptions of cognitive deficits and their influences on quality of life among patients with schizophrenia. Qual Life Res 2015; 24:2753-60. [DOI: 10.1007/s11136-015-1019-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2015] [Indexed: 01/10/2023]
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Arab AH, Elhawary NA. Association between ANKK1 (rs1800497) and LTA (rs909253) Genetic Variants and Risk of Schizophrenia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:821827. [PMID: 26114114 PMCID: PMC4465678 DOI: 10.1155/2015/821827] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/18/2015] [Indexed: 02/05/2023]
Abstract
Limited research has assessed associations between schizophrenia and genetic variants of the ankyrin repeat and kinase domain containing 1 (ANKK1) and lymphotoxin-alpha (LTA) genes among individuals of Middle Eastern ancestry. Here we present the first association study investigating the ANKK1 rs1800497 (T>C) and LTA rs909253 (A>G) single-nucleotide polymorphisms in an Egyptian population. Among 120 patients with DSM-IV and PANSS (Positive and Negative Syndrome Scale) assessments of schizophrenia and 100 healthy controls, we determined the genotypes for the polymorphisms using endonuclease digestion of amplified genomic DNA. Results confirmed previous findings from different ethnic populations, in that the rs1800497 and rs909253 polymorphisms were both associated with risk of schizophrenia. Differences between the genotypes of cases and controls were strongly significant (P = 0.0005 for rs1800497 and P = 0.001 for rs909253). The relative risk to schizophrenia was 1.2 (P = 0.01) for the C allele and 0.8 (P = 0.04) for the G allele. The CC, GG, and combined CC/AA genotypes were all more frequent in cases than in controls. These results support an association between ANKK1 and LTA genetic markers and vulnerability to schizophrenia and show the potential influence of just one copy of the mutant C or G allele in the Egyptian population.
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Affiliation(s)
- Arwa H. Arab
- 1Department of Psychology, Faculty of Arts and Humanities, King Abdulaziz University, P.O. Box 80200, Jeddah 21589, Saudi Arabia
| | - Nasser A. Elhawary
- 2Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University, P.O. Box 57543, Mecca 21955, Saudi Arabia
- 3Department of Molecular Genetics, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
- *Nasser A. Elhawary:
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Kirkbride JB. Hitting the floor: understanding migration patterns following the first episode of psychosis. Health Place 2014; 28:150-2. [PMID: 24845239 PMCID: PMC4076512 DOI: 10.1016/j.healthplace.2014.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 04/22/2014] [Accepted: 04/28/2014] [Indexed: 01/08/2023]
Abstract
Recent research published in Health and Place (Ngamini Ngui et al., 2013b) found that one third of people with first episode psychosis [FEP] will have made a large-scale migration six years after initial diagnosis. Here, I extend this discussion around three important observations. Namely, at first presentation the most disadvantaged communities already shoulder the burden of psychotic morbidity; people with FEP in more rural communities migrate less often, and; people with FEP exhibit both upwards and downwards social mobility after onset. Understanding the reasons for (non-)migration before and after psychosis onset is now required for effective public mental health and service provision.
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Affiliation(s)
- James B Kirkbride
- Sir Henry Dale Fellow, Division of Psychiatry, University College London, UCL, 2nd Floor Charles Bell House, 67-73 Riding House Street, London W1W 7E, UK.
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Service user attachments to psychiatric key workers and teams. Soc Psychiatry Psychiatr Epidemiol 2012; 47:817-25. [PMID: 21626057 DOI: 10.1007/s00127-011-0388-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Accepted: 04/18/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE The first aim of the study was to evaluate whether self-reported attachment styles of individuals with psychosis are consistent with their self-reported attachment in therapeutic relationships with both key workers and mental health teams. The second aim was to evaluate the level of concordance in attachment ratings given by different raters (self-report, key worker informant-report and team informant-report). METHODS Three self-report versions of the Psychosis Attachment Measure (PAM; attachment in general relationships, attachment towards key worker and attachment in relation to the mental health team) were administered to 24 individuals with a diagnosis of psychosis in psychiatric rehabilitation settings. Key worker and 'team' informant versions of the PAM were also completed. RESULTS There were strong, significant correlations among the three self-reported attachment measures. There was less consistent evidence of correlations between key worker ratings of attachment and self-report attachment ratings. The majority of the correlations between team ratings of attachment and self-report attachment were small and non-significant. CONCLUSIONS Strong correlations among the self-reported PAM scales suggest that self-reported attachment in specific therapeutic relationships is consistent with self-reported attachment in general relationships. The self-ratings were not consistently correlated with informant-ratings and team informant ratings were particularly poorly correlated with self-ratings. This suggests that it is vital that teams consult service users themselves when making decisions about their care.
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Millier A, Sarlon E, Azorin JM, Boyer L, Aballea S, Auquier P, Toumi M. Relapse according to antipsychotic treatment in schizophrenic patients: a propensity-adjusted analysis. BMC Psychiatry 2011; 11:24. [PMID: 21314943 PMCID: PMC3045883 DOI: 10.1186/1471-244x-11-24] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 02/11/2011] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To compare the rate of relapse as a function of antipsychotic treatment (monotherapy vs. polypharmacy) in schizophrenic patients over a 2-year period. METHODS Using data from a multicenter cohort study conducted in France, we performed a propensity-adjusted analysis to examine the association between the rate of relapse over a 2-year period and antipsychotic treatment (monotherapy vs. polypharmacy). RESULTS Our sample consisted in 183 patients; 50 patients (27.3%) had at least one period of relapse and 133 had no relapse (72.7%). Thirty-eight (37.7) percent of the patients received polypharmacy. The most severely ill patients were given polypharmacy: the age at onset of illness was lower in the polypharmacy group (p = 0.03). Patients that received polypharmacy also presented a higher general psychopathology PANSS subscore (p = 0.04) but no statistically significant difference was found in the PANSS total score or the PANSS positive or negative subscales. These patients were more likely to be given prescriptions for sedative drugs (p < 0.01) and antidepressant medications (p = 0.03). Relapse was found in 23.7% of patients given monotherapy and 33.3% given polypharmacy (p = 0.16). After stratification according to quintiles of the propensity score, which eliminated all significant differences for baseline characteristics, antipsychotic polypharmacy was not statistically associated with an increase of relapse: HR = 1.686 (0.812; 2.505). CONCLUSION After propensity score adjustment, antipsychotic polypharmacy is not statistically associated to an increase of relapse. Future randomised studies are needed to assess the impact of antipsychotic polypharmacy in schizophrenia.
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Affiliation(s)
- Aurelie Millier
- Creativ-Ceutical France, rue du Faubourg Saint-Honoré, 75008 Paris, France
| | - Emmanuelle Sarlon
- National Institute of Health and Medical Research, INSERM, U669, Maison de Solenn, Boulevard de Port Royal, 75679 Paris, France,University of Paris-Sud and University of Paris Descartes, UMR-S0669, 75014 Paris, France,Department of Public Health, Hospital Center, Creil/Senlis, 60309 Senlis, France
| | - Jean-Michel Azorin
- Department of Psychiatry, University Hospital Ste-Marguerite, Boulevard Sainte-Marguerite, 13009 Marseille, France
| | - Laurent Boyer
- Department of Public Health, EA 3279 Research Unit, University Hospital, Boulevard Jean Moulin 13385 Marseille, France
| | - Samuel Aballea
- Creativ-Ceutical France, rue du Faubourg Saint-Honoré, 75008 Paris, France
| | - Pascal Auquier
- Department of Public Health, EA 3279 Research Unit, University Hospital, Boulevard Jean Moulin 13385 Marseille, France
| | - Mondher Toumi
- UCBL 1 - Chair of Market Access University Claude Bernard Lyon I, Decision Sciences & Health Policy, Boulevard du 11 Novembre 1918, 69622 Villeurbanne, France
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Carrà G, Johnson S. Variations in rates of comorbid substance use in psychosis between mental health settings and geographical areas in the UK. A systematic review. Soc Psychiatry Psychiatr Epidemiol 2009; 44:429-47. [PMID: 19011722 DOI: 10.1007/s00127-008-0458-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Revised: 10/16/2008] [Indexed: 01/14/2023]
Abstract
BACKGROUND Comorbid substance misuse in psychosis is associated with significant clinical, social and legal problems. An epidemiologically informed approach to planning service delivery requires an understanding of which clinical populations are at particularly high risk for such 'dual diagnosis'. Evidence has now been accumulating in the UK since the early 1990s, and allows a relatively comprehensive comparison of rates between service settings, geographical areas and social contexts in terms of ethnic background. METHODS A literature search was carried out with the aim of investigating: (a) comorbid alcohol and drug misuse rates in people with established psychosis in different mental health and addiction settings in the UK, (b) variations in such rates between different population groups. RESULTS There are wide variations in reported drug and alcohol misuse rates in psychosis. Most recent UK studies report rates between 20 and 37% in mental health settings, while figures in addiction settings are less clear (6-15%). Rates are generally not as high as in US studies, but appear to be especially high in inpatient and crisis team settings (38-50%) and forensic settings. In terms of geography, rates appear highest in inner city areas. Some ethnic groups are over-represented among clinical populations of people with dual diagnosis. CONCLUSIONS Rates of substance misuse in psychosis are likely to be influenced by service setting, population composition and geography. Acute and forensic settings are especially appropriate for the development of targeted interventions.
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Affiliation(s)
- Giuseppe Carrà
- Dept. of Mental Health Sciences, Royal Free and University College Medical School, Charles Bell House, 67-73 Riding House Street, London, W1W 7EY, UK.
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Measurement of problems in activities and participation in patients with anxiety, depression and schizophrenia using the ICF checklist. Soc Psychiatry Psychiatr Epidemiol 2009; 44:377-84. [PMID: 19183817 DOI: 10.1007/s00127-008-0449-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Revised: 10/02/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although disability in persons with anxiety and depression disorders has been measured, the problem with some studies is that they use tools that measure the state of health, when the subjective nature of the measuring system does not permit the exact measurement of disability. The ICF Checklist provides a new paradigm for measuring disability that focuses more on the consequences than on the illness itself. The objective of this study is to compare the problems in Activities and Participation observed in patients with anxiety, depressive, and schizophrenic disorders, using the ICF Checklist. METHODS The ICF Checklist was administered to 72 patients with anxiety or depressive disorders and 28 patients with schizophrenia. They were diagnosed in accordance with the criteria of the ICD-10. Chi-square analysis was carried out to determine the differences between the groups studied with respect to the Activities and Participation scales of the ICF Checklist and the nominal data of the socio-demographic variables. RESULTS The group with anxiety-depression had a higher percentage of patients with problems preparing meals (30.6%) and achieving intimate relationships (59.7%) than did the patients with schizophrenia. The group with schizophrenia had a higher percentage of patients who had problems watching (39.3%), listening (42.9%), undertaking a single task (60.7%), communicating, fine hand use (57.1%), using transportation (64.3%), and caring for body parts (67.9%), among others. CONCLUSIONS The ICF Checklist permits comparison of the impact mental disorders have on patients. It provides a more appropriate way of evaluating these illnesses in relation to others, considering not only the question of mortality but also the years lived with disability due to illness.
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Mobility limitations in persons with psychotic disorder: findings from a population-based survey. Soc Psychiatry Psychiatr Epidemiol 2009; 44:325-32. [PMID: 18802653 DOI: 10.1007/s00127-008-0433-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Accepted: 08/18/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are few reports on mobility limitations in persons with psychotic disorder although restrictions in mobility may aggravate the general functional limitations of these patients. Our aim was to investigate mobility limitations among subjects with psychotic disorder in a general population-based sample. METHODS A nationally representative sample of 6,927 persons aged 30 and older self-reported mobility limitations in an interview and was examined in performance tests. Diagnostic assessment of DSM-IV psychotic disorders combined SCID interview and case note data. Lifetime-ever diagnoses of psychotic disorder were classified into schizophrenia, other nonaffective psychotic disorders and affective psychoses. RESULTS Self-reported mobility limitations were highly prevalent in persons with schizophrenia and other nonaffective psychosis, but not in the affective psychosis group. After adjusting for age and sex, persons with schizophrenia and other nonaffective psychoses but not affective psychoses had significantly increased odds of having both self-reported and test-based mobility limitations as well as weak muscle strength. Schizophrenia remained an independent predictor of mobility limitations even after controlling for lifestyle-related factors and chronic medical conditions. Among persons with nonaffective psychoses, higher levels of negative symptoms predicted mobility limitations. CONCLUSION Self-reported mobility limitations are prevalent already at a young age in persons with schizophrenia and other nonaffective psychotic disorders, and among older persons with these disorders both self-reported limitations and measured performance tests show lower capacity in mobility. Difficulties in mobility are associated with negative symptoms. Mental health care professionals should pay attention to mobility limitations in persons with psychotic disorder.
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Berry K, Wearden A, Barrowclough C. Adult attachment styles and psychosis: an investigation of associations between general attachment styles and attachment relationships with specific others. Soc Psychiatry Psychiatr Epidemiol 2007; 42:972-6. [PMID: 17932610 DOI: 10.1007/s00127-007-0261-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Accepted: 09/07/2007] [Indexed: 11/30/2022]
Abstract
BACKGROUND If attachment theory is to help inform our understanding of relationship difficulties in people with psychosis, it is first important to understand the composition of attachment networks in this group and how attachment style measured with reference to relationships in general actually relates to attachment in relationships with specific others. METHOD We examined attachment networks and associations between general attachment style and attachment in relationships with parents and psychiatric staff in a sample of 58 patients with psychosis. We assessed attachment dimensions of anxiety and avoidance using the Psychosis Attachment Measure (PAM) and an adapted version of the instrument asking about relationships with specific others. RESULTS Patients reported a median of two attachment relationships. Both attachment anxiety and avoidance measured with reference to close relationships in general were positively correlated with attachment in key worker and parental relationships, although levels of attachment anxiety and avoidance did vary across relationships. CONCLUSION Future research should determine factors influencing variations in attachment working models in samples of people with psychosis, as it may be possible to help individuals with insecure attachment styles develop more positive relationships with others.
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Affiliation(s)
- Katherine Berry
- School of Psychological Sciences, University of Manchester, Rutherford House, Manchester Science Park, Lloyd Street North, Manchester, M15 6SZ, UK.
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