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Morandi S, Silva B, Pauli G, Martinez D, Bachelard M, Bonsack C, Golay P. How do decision making and fairness mediate the relationship between involuntary hospitalisation and perceived coercion among psychiatric inpatients? J Psychiatr Res 2024; 173:98-103. [PMID: 38518573 DOI: 10.1016/j.jpsychires.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/19/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Coercion perceived by psychiatric inpatients is not exclusively determined by formal measures such as involuntary admissions, seclusion or restraint, but is also associated with patients' characteristics and professionals' attitude. AIMS This study examined how inpatients' involvement in the decision making process, the respect of their decision making preference, and their feeling of having been treated fairly mediate the relationship between involuntary hospitalisation and perceived coercion both at admission and during hospital stay. METHODS Mediation analysis were performed in order to study the relationship between involuntary hospitalisation and perceived coercion among 230 patients, voluntarily and involuntarily admitted in six psychiatric hospitals. RESULTS 32.2% of the participants were involuntarily hospitalised. Taken individually, stronger participants' involvement in decision making process, better respect for their decision making preference and higher level of perceived fairness partially mediated the relationship between involuntary hospitalisation and perceived coercion by reducing the level of the latter both at admission and during the hospitalisation. In multiple mediator models, only involvement and respect played an important role at admission. During the hospitalisation, perceived fairness was the most relevant mediator, followed by involvement in decision making. CONCLUSIONS During psychiatric hospitalisation patients' involvement in decision making, respect of their decision making preference and perceived fairness determined the relationship between involuntary hospitalisation and perceived coercion, but not in the same way at admission and during the stay. Involving patients in decision making and treating them fairly may be more relevant than taking account of their decision making preference in order to reduce perceived coercion.
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Affiliation(s)
- Stéphane Morandi
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Cantonal Medical Office, Directorate General for Health of Canton of Vaud, Department of Health and Social Action (DSAS), Avenue des Casernes 2, 1014, Lausanne, Switzerland.
| | - Benedetta Silva
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Cantonal Medical Office, Directorate General for Health of Canton of Vaud, Department of Health and Social Action (DSAS), Avenue des Casernes 2, 1014, Lausanne, Switzerland
| | - Guillaume Pauli
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Debora Martinez
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mizué Bachelard
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Charles Bonsack
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Institute of Psychology, Faculty of Social and Political Science, University of Lausanne, Switzerland; General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Ramos-Ruiz JA, Pérez-Milena A, Noguera-Cuenca C, Rodríguez-Bayón A, Ruiz-Díaz B. Patients with severe mental illness and their carers' expectations for GPs' communication skills: a qualitative approach in Spain. BJGP Open 2024; 8:BJGPO.2023.0124. [PMID: 37931981 PMCID: PMC11169970 DOI: 10.3399/bjgpo.2023.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/18/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Effective communication with GPs (General Practitioners) enables higher rates of patient satisfaction and adherence to treatment plans. People with severe mental illness (SMI) and their caregivers present unique characteristics that present difficulties in the GP-carer-patient communication process. AIM To explore the expectations of patients with SMI and their caregivers regarding GPs' communication skills in primary care consultations. DESIGN & SETTING Face-to-face interviews, using focus group methodology, which were undertaken in southern Spain. METHOD Forty-two participants took part in 21 paired semi-structured interviews with an average duration of 19±7.2 minutes. Information was audio-recorded and transcribed verbatim. Qualitative content analysis was undertaken, obtaining a codification in categories by means of triangulation. RESULTS Four themes emerged from the analysis. Theme 1 was interviewer communication characteristics. The ability of GPs to use a language that was colloquial and adapted to each person was perceived as a determinant of the quality of care provided. An empathetic attitude, low reactivity, and efficient time management were the most valued communication skills. Theme 2 was telemedicine: telephone consultation and video consultation. The telephone consultation was perceived as a useful tool to care for people with SMI. Video consultation was valued as a requirement in isolated rural areas. Theme 3 was the role of the caregiver during the clinical interview. The caregiver was considered by the patients as an ally who improves the clinical interview. Theme 4 was the perceived barriers and facilitators during the clinical interview. The continuity of care, defined by a low turnover of GPs, determined the quality perceived by those who required care. CONCLUSION Themes emerging from this study have suggested that people with SMI require an inclusive, collaborative, and personalised approach in the care they receive from the public health system. Improved communication between GPs and patients with SMI is an essential requirement for quality medical care.
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Affiliation(s)
- Juan Andrés Ramos-Ruiz
- Multiprofessional Teaching Unit of Family and Community Care Jaén North - Northeast Andalusian Healthcare Service, Andalusia, Spain
| | | | | | - Antonina Rodríguez-Bayón
- Multiprofessional Teaching Unit of Family and Community Care Jaén North - Northeast Andalusian Healthcare Service, Andalusia, Spain
| | - Beatriz Ruiz-Díaz
- El Valle Primary Care Center, Andalusian Health Service, Jaén, Spain
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Luciano M, Fiorillo A, Brandi C, Di Vincenzo M, Egerhazi A, Hiltensperger R, Kawhol W, Kovacs AI, Rossler W, Slade M, Pushner B, Sampogna G. Impact of clinical decision-making participation and satisfaction on outcomes in mental health practice: results from the CEDAR European longitudinal study. Int Rev Psychiatry 2022; 34:848-860. [PMID: 36786107 DOI: 10.1080/09540261.2022.2085507] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present study aimed to assess: (1) whether a more active involvement of patients is associated with an improvement of clinical symptoms, global functioning, and quality-of-life; and (2) how patients' satisfaction with clinical decisions can lead to better outcome after 1 year. Data were collected as part of the study 'Clinical decision-making and outcome in routine care for people with severe mental illness (CEDAR)', a longitudinal observational study, funded by the European Commission and carried out in six European countries. Patients' inclusion criteria were: (a) aged between 18 and 60 years; (b) diagnosis of a severe mental illness of any kind according to the Threshold Assessment Grid (TAG) ≥ 5 and duration of illness ≥ 2 years; (c) expected contact with the local mental health service during the 12-month observation period; (d) adequate skills in the language of the host countries; and (e) the ability to provide written informed consent. The clinical decision-making styles of clinicians and the patient satisfaction with decisions were assessed using the Clinical Decision Making Style and the Clinical Decision Making Involvement and Satisfaction scales, respectively. Patients were assessed at baseline and 1 year after the recruitment. The sample consisted of 588 patients with severe mental illness, mainly female, with a mean age of 41.69 (±10.74) and a mean duration of illness of 12.5 (±9.27) years. The majority of patients were diagnosed with psychotic (45.75%) or affective disorders (34.01%). At baseline, a shared CDM style was preferred by 70.6% of clinicians and about 40% of patients indicated a high level of satisfaction with the decision and 31% a medium level of satisfaction. Higher participation in clinical decisions was associated with improved social functioning and quality-of-life, and reduced interpersonal conflicts, sense of loneliness, feelings of inadequacy, and withdrawal in friendships after 1 year (p < 0.05). Moreover, a higher satisfaction with decisions was associated with a better quality-of-life (p < 0.0001), reduced symptom severity (p < 0.0001), and a significantly lower illness burden associated with symptoms of distress (p < 0.0001), interpersonal difficulties (p < 0.0001), and problems in social roles (p < 0.05). Our findings clearly show that a higher involvement in and satisfaction of patients with clinical decision-making was associated with better outcomes. More efforts have to be made to increase the involvement of patients in clinical decision-making in routine care settings.
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Affiliation(s)
- Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Carlotta Brandi
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Aniko Egerhazi
- Department of Psychiatry and Psychotherapy Clinical Center, University of Debrecen, Debrecen, Hungary
| | | | - Wolfram Kawhol
- Clienia Schlössli AG, Oetwil am See, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics (KPPP), University Hospital of Psychiatry, Zurich, Switzerland
| | - Attila Istvan Kovacs
- Department of Psychiatry and Psychotherapy Clinical Center, University of Debrecen, Debrecen, Hungary
| | - Wulf Rossler
- Department of Psychiatry and Psychotherapy, Charité University of Medicine, Berlin, Germany
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK.,Nord University, Namsos, Norway
| | - Bernd Pushner
- Department of Psychiatry II, Ulm University, Ulm, Germany
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Piras M, Perra A, Gureje O, Preti A, Carta MG. The Current Quality of Web-Based Information on the Treatment of Bipolar Disorder: A Systematic Search. J Clin Med 2022; 11:jcm11185427. [PMID: 36143075 PMCID: PMC9501527 DOI: 10.3390/jcm11185427] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 11/21/2022] Open
Abstract
Background: An important aspect of managing chronic disorders like bipolar disorder is to have access to relevant health information. This study investigates and compares the quality of information on the treatments of bipolar disorder that is available on English websites, as an international language, and on Italian websites, as a popular local language. Methods: A systematic review search was obtained from four search engines. We excluded unrelated materials, scientific papers, and duplicates. We analyzed popularity with PageRank; technological quality with Nibbler; readability with the Flesh Reading Ease test and Gulpease index; quality of information with the DISCERN scale, the JAMA benchmark criteria, and on the extent of adherence to the HONCode. Results: 35 English and 31 Italian websites were included. The English websites were found to have a higher level of quality information and technological quality than the Italian ones. Overall, the websites were found to be difficult to read, requiring a high level of education. Conclusions: These results can be important to inform guidelines for the improvement of health information and help users to reach a higher level of evidence on the websites. Users should find the benefits of treatment, support for shared decision-making, the sources used, the medical editor’s supervision, and the risk of postponing treatment.
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Affiliation(s)
- Martina Piras
- Innovation Sciences and Technologies, University of Cagliari, 09124 Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Alessandra Perra
- Innovation Sciences and Technologies, University of Cagliari, 09124 Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
- Correspondence: ; Tel.: +39-348-144-4501
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan 200285, Nigeria
| | - Antonio Preti
- Department of Neuroscience, University of Turin, 10126 Turin, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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Morán-Sánchez I, Bernal-López MDLÁ, Salmerón D, Pérez-Cárceles MD. Correlates of preferring a passive role in decision-making among patients with schizophrenia or bipolar disorder. PATIENT EDUCATION AND COUNSELING 2021; 104:1125-1131. [PMID: 33268230 DOI: 10.1016/j.pec.2020.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/18/2020] [Accepted: 10/13/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the factors associated with the persistence of clinician-led style in the therapeutic relationship in cases of serious mental illness, and the conditioning factors that the patients identify as determinants of their health. METHOD Assessment of preferences in the decision-making process and health-related control locus of 107 outpatients with DSM-5 diagnosis of schizophrenia or bipolar disorder. Demographic and clinical information was also obtained through review of available records and using several scales. RESULTS 64.4 % patients preferred to adopt a passive role in the therapeutic relationship. In the multivariate analysis, the preference of playing a passive role in the decision-making process was significantly associated with the elderly, being disabled, or the view that one's health depends on doctors (AUC ROC value: 0.80). CONCLUSIONS Patients with severe mental illness more frequently preferred a passive role in the decision-making process. We found several factors associated with a preference for the "expert role" model. PRACTICE IMPLICATIONS The identified factors may permit care to be tailored to the most probable expectations as regard decision-making. Since the populations concerned may be vulnerable and suffer inequalities in the provision of health services, promoting participation in the care process could help improve clinical parameters ethically.
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Affiliation(s)
- Inés Morán-Sánchez
- Health Service of Murcia, Cartagena Mental Health Centre, Cartagena, Spain.
| | | | - Diego Salmerón
- Health Sciences Department, University of Murcia, Espinardo, Spain
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Rezaie L, Phillips D. Post-discharge needs of Iranian women diagnosed with severe mental illness: A qualitative study. J Psychiatr Ment Health Nurs 2020; 27:752-762. [PMID: 32277722 DOI: 10.1111/jpm.12634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 03/11/2020] [Accepted: 03/18/2020] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: A search of common databases indicates the absence of any research focused on the needs of Iranian women diagnosed with severe mental illness post-discharge from an inpatient setting. Moreover, there is a lacuna of information about the unique experiences and needs of persons diagnosed with severe mental illness living in non-Western communities (esp. Middle Eastern communities). WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE: This study examined interviews of women diagnosed with severe mental illness receiving treatment at an Iranian inpatient hospital. Three categories of post-discharge needs emerged: support, skill acquisition and information. Support consisted of family, social and health system subcategories. Skill acquisition was comprised of social skills, work skills and self-management skills. Lastly, information distinguished between illness-related information and women's health information. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Findings highlight the need for systemic changes to current care models. Broadly, families should be incorporated into care to improve outcomes and decrease stigma. Regarding mental health nursing, results highlighted the need for additional nursing and occupational therapy interventions to empower families and patients. Nursing practitioners can aid in preparing these patients for employment and public health initiatives to decrease stigma and improve access to care. ABSTRACT: Introduction Understanding the post-discharge needs of patients diagnosed with severe mental illness is critical for improving treatment outcomes. Aim The aim of the present study was to determine the unique post-discharge needs of Iranian women diagnosed with severe mental illness. Method Conventional content analysis was utilized to analyse data gathered via focus group interviews conducted within the psychiatric inpatient unit at Farabi hospital located in Kermanshah, Iran. Participants (N = 42; M age = 40; SD = 6.3 years) had been diagnosed with a severe mental illness, had a history of at least two psychiatric hospitalizations and were awaiting discharge following significant symptom improvement. Results Content analysis extracted three categories of post-discharge needs: support, skill acquisition and information. Support consisted of family, social and health system subcategories. Skill acquisition was comprised of social skills, work skills and self-management skills. Lastly, information distinguished between illness-related information and women's health information. Discussion/Implications for practice Analysis of interview data highlighted the general need for adopting a family-system approach to reduce stigma, increase knowledge and foster skill acquisition. Regarding mental health nursing, results highlighted the unique role of nurses and their capacity to pre-emptively address needs such as aiding in employment. Lastly, findings are contrasted against Western care models.
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Affiliation(s)
- Leeba Rezaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - David Phillips
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
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Lavhelani NR, Maluleke M, Mulaudzi MP, Masutha TC, Makhubele TE, Manyuma D, Nemathaga M, Makhavhu NA, Kharivhe ML, Mbedzi TE, Ramovha MR, Ramathuba DU, Netshikweta ML. How do family members perceive re-integration of male state patients into their families in South Africa? A qualitative analysis. S Afr J Psychiatr 2020; 26:1450. [PMID: 33240548 PMCID: PMC7670001 DOI: 10.4102/sajpsychiatry.v26i0.1450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/20/2020] [Indexed: 11/01/2022] Open
Abstract
Background State patients are admitted to a psychiatric hospital after being declared as such by the magistrate courts as a result of not found fit to stand trial for the offence they had committed. After successful rehabilitation of state patients at the psychiatric hospital, they need to be re-integrated into their families. Family members' perceptions regarding re-integration of male state patients are not largely explored in the scientific body of knowledge. Aim The aim of the study was to determine the perceptions of family members regarding reintegration of male state patients into their families. Setting This study was conducted in Vhembe District of Limpopo province, South Africa. Method A qualitative approach using explorative, descriptive and contextual designs was adopted. In-depth interviews were conducted with 10 family members who were purposefully sampled, and data were thematically analysed using Tech Open Coding method. Results Three themes emerged, namely, family members understand re-integration; family members' expectations from a mental healthcare user; and threat to re-integration as perceived by family members. Conclusion Data revealed that family members have varied perceptions regarding re-integration. These perceptions were based on the behaviour displayed or an offence committed by the mental healthcare user before admission and how participants experienced it. The study recommends that an investigation is to be conducted on the kind of support family members need regarding re-integration of state patients into their families.
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Affiliation(s)
- Ndivhaleni R Lavhelani
- Limpopo Department of Health, Hayani Psychiatric Hospital, Vhembe District, Thohoyandou, South Africa
| | - Mary Maluleke
- Department of Advanced Nursing Science, School of Health, University of Venda, Thohoyandou, South Africa
| | - Mulatedzi P Mulaudzi
- Limpopo Department of Health, Hayani Psychiatric Hospital, Vhembe District, Thohoyandou, South Africa
| | - Thingahangwi C Masutha
- Department of Health, Faculty of Nursing, Limpopo College of Nursing, Thohoyandou, South Africa
| | - Takalani E Makhubele
- Limpopo Department of Health, Tshilwavhusiku Clinic, Vhembe District, Thohoyandou, South Africa
| | - Duppy Manyuma
- United Nations High Commission for Refugees (UNHCR) Programme, Pretoria, South Africa
| | - Muofheni Nemathaga
- Limpopo Department of Health, Hayani Psychiatric Hospital, Vhembe District, Thohoyandou, South Africa
| | | | - Martha L Kharivhe
- Limpopo Department of Health, Louis Trichardt Memorial Hospital, Thohoyandou, South Africa
| | - Takalani E Mbedzi
- Department of Advanced Nursing Science, School of Health, University of Venda, Thohoyandou, South Africa
| | - Muvhango R Ramovha
- Limpopo Department of Health, Vhembe District, Thohoyandou, South Africa
| | - Dorah U Ramathuba
- Department of Advanced Nursing Science, School of Health, University of Venda, Thohoyandou, South Africa
| | - Mutshinyalo L Netshikweta
- Department of Advanced Nursing Science, School of Health, University of Venda, Thohoyandou, South Africa
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When does shared decision making is adopted in psychiatric clinical practice? Results from a European multicentric study. Eur Arch Psychiatry Clin Neurosci 2020; 270:645-653. [PMID: 31175448 DOI: 10.1007/s00406-019-01031-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 06/03/2019] [Indexed: 12/16/2022]
Abstract
To identify factors associated with the use of shared decision making in routine mental health care in a large multicenter European study. Data have been collected within the study "Clinical decision making and outcome in routine care for people with severe mental illness" (CEDAR), which is a naturalistic, longitudinal, observational study carried out in six European countries. Patients with a severe mental illness attending outpatient units and their treating clinicians have been recruited. Clinicians' Clinical Decision Making (CDM) styles have been explored through the Clinical Decision Making Style Scale. Patients' clinical and social outcomes have been assessed through validated assessment instruments. The sample consisted of 588 patients and 213 professionals. Professionals were mainly psychiatrists (35.7%), nurses (21.6%), support workers, social workers or occupational therapists (24.9%), psychologists (9.9%) or trainees in psychiatry (4.7%). In the majority of cases, clinicians adopted a shared CDM style. Shared CDM was more frequently adopted with patients with psychotic disorders, with a better quality of life and social functioning. At multivariate analyses, the likelihood of adopting shared decision making increased in patients with higher levels of interpersonal relationships' skills (p < 0.05) and global functioning (p < 0.01). On the contrary, being a trainee in psychiatry reduced the likelihood of adopting shared CDM (p < 0.008). Shared decision making has been adopted mainly when patients have a better functioning and less severe clinical symptomatology and by less trained clinicians, differently from national and international recommendations. More efforts should be made to implement interventions to promote shared CDM, with a specific focus for trainees in psychiatry.
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Steardo L, Luciano M, Sampogna G, Zinno F, Saviano P, Staltari F, Segura Garcia C, De Fazio P, Fiorillo A. Efficacy of the interpersonal and social rhythm therapy (IPSRT) in patients with bipolar disorder: results from a real-world, controlled trial. Ann Gen Psychiatry 2020; 19:15. [PMID: 32165907 PMCID: PMC7061484 DOI: 10.1186/s12991-020-00266-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/21/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) is one of the most burdensome mental disorders, with a lifetime prevalence of 2.4%, with a prevalence of 0.6% for bipolar type I and 0.4% for bipolar type II. Several interventions have been developed to implement the treatment strategy of bipolar disorder, including the Interpersonal and Social Rhythm Therapy (IPSRT). This intervention has been specifically developed to manage patients' stressful life events, improve the disruptions of social and circadian rhythms and increase adherence to medications. The aim of the present study is to assess the efficacy of IPSRT on affective and anxiety psychopathology, social functioning, response to pharmacological treatment and affective morbidity index (AMI) in BD patients. METHODS BD patients were consecutively recruited at the Mood Disorder Unit of the University of Campania "Luigi Vanvitelli" and randomly assigned to the experimental group receiving the IPSRT or to the Treatment as Usual (TAU) group. Patients were assessed at baseline, after 3 and 6 months with several validated assessment tools and with the affective morbidity index. RESULTS At the end of the intervention, compared to controls, patients from the experimental group reported a significant improvement in anxious depressive and manic symptomatology, global functioning; and response to mood stabilizers. Patients in the IPSRT group reported a reduction at the AMI score. CONCLUSIONS IPSRT has been confirmed to be effective in improving the clinical symptomology of BD patients and in improving the affective morbidity index. Further studies with longer follow-up are needed in order to assess the stability of the results.Trial registration The study was approved by the local ethical review board (N001567/28.01.2018).
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Affiliation(s)
- Luca Steardo
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy.,2Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Mario Luciano
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy
| | - Gaia Sampogna
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy
| | - Francesca Zinno
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy
| | | | - Filippo Staltari
- 2Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Cristina Segura Garcia
- 4Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Pasquale De Fazio
- 2Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Andrea Fiorillo
- 1Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 80138 Naples, Italy
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Morán-Sánchez I, Gómez-Vallés P, Bernal-López MÁ, Pérez-Cárceles MD. Shared decision-making in outpatients with mental disorders: Patients´ preferences and associated factors. J Eval Clin Pract 2019; 25:1200-1209. [PMID: 31373107 DOI: 10.1111/jep.13246] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/11/2019] [Accepted: 07/16/2019] [Indexed: 01/21/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Over the last years, traditional paternalistic model is being questioned. Shared Decision-Making (SDM) model has been proposed as a way to improve patient-physician interaction. Little is known to what extent people with severe mental illness want to be involved in decision-making process. This study evaluates their preferences about making clinical decisions and which variables influence these desires. METHOD One hundred seven patients with DSM diagnoses of bipolar disorder or schizophrenia and 100 Non Psychiatric Comparison (NPC) subjects recruited from mental health and primary care departments completed a self-reported questionnaire about preferences in decision-making process. Demographic and clinical information was obtained through review of available records and the Brief Psychiatric Rating Scale (BPRS). RESULTS Patients and NPCs differed as regards their preferences about their participation in medical decisions. NPCs were 18 times more likely to prefer options about their treatment and 2 times more likely to prefer to take medical decisions by their own than psychiatric patients. The best predictors of the preference of a SDM model were a lower BPRS global score and the absence of previous compulsory admissions. CONCLUSIONS Psychiatric patients more frequently preferred a passive role in the decision-making process. Interventions to promote SDM should be tailored to the values and needs of each patient because not everyone wants to participate to the same degree. We found several factors to take into account in patient engagement in SDM as these populations may be more vulnerable.
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Affiliation(s)
| | - Paula Gómez-Vallés
- Department of Legal Medicine, Regional Campus of International Excellence "Campus Mare Nostrum," Faculty of Medicine, University of Murcia, Cartagena, Spain
| | | | - María Dolores Pérez-Cárceles
- Department of Legal Medicine, Regional Campus of International Excellence "Campus Mare Nostrum," Faculty of Medicine, University of Murcia, Cartagena, Spain
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Affiliation(s)
- Nagesh Pai
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Shae-Leigh Vella
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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Sampogna G, Luciano M, Del Vecchio V, Pocai B, Palummo C, Fico G, Giallonardo V, De Rosa C, Fiorillo A. Perceived Coercion Among Patients Admitted in Psychiatric Wards: Italian Results of the EUNOMIA Study. Front Psychiatry 2019; 10:316. [PMID: 31164841 PMCID: PMC6536685 DOI: 10.3389/fpsyt.2019.00316] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/24/2019] [Indexed: 11/18/2022] Open
Abstract
The decision to use coercive measures (restraint, seclusion and forced medication) in psychiatric practice is controversial in mental health care. The EUNOMIA study was funded by the European Commission and carried out in 11 countries in order to develop European recommendations for good clinical practice on the use of coercive measures. The aim of the study is to identify sociodemographic and clinical predictors of the levels of perceived coercion in a sample of Italian patients with severe mental disorders at hospital admission. A total of 294 patients were recruited in five Italian psychiatric hospitals and screened with the MacArthur Perceived Coercion Scale to explore the levels of perceived coercion. Patients were assessed three times: within the first seven days after admission as well as after 1 and 3 months. At each time point, data on changes of perceived coercion, assessed by the Cantril Ladder of Perceived Coercion Scale, information on coercive measures received during hospitalization and the levels of satisfaction with the received treatments were collected. According to the multivariable regression model, being compulsorily admitted (OR: 2.5; 95% CI: 1.3-3.3, p < .000), being male (OR: 0.7; 95% CI: 0.9-1.4; p < .01), being older (OR: 0.03; 95% CI: 0.01-0.06) and less satisfied with received treatments (OR: -0.2; 95% CI: -0.3 to -0.1; p < .05) are all associated with higher levels of perceived coercion, even after controlling for the use of any coercive measure during hospitalization. Satisfaction with received treatment predicts the levels of perceived coercion and this should represent an important challenge for mental health professionals.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Napoli, Italy
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13
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Andrade MCR, Slade M, Bandeira M, Evans-Lacko S, Martin D, Andreoli SB. Need for information in a representative sample of outpatients with schizophrenia disorders. Int J Soc Psychiatry 2018; 64:476-481. [PMID: 29783875 DOI: 10.1177/0020764018776350] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Providing adequate information and involving patients in treatment have become an essential component of mental health care. Despite this, research regarding the extent to which this need has been met in clinical services is still scarce. AIMS To investigate the need for information about psychiatric condition and treatment among outpatients with schizophrenia disorders and how this need is associated with service use, adjusting for sociodemographic and clinical characteristics. METHODS Need for information about condition and treatment, using the corresponding domain in the Camberwell Assessment of Need (CAN), in a representative sample of 401 schizophrenia outpatients in Santos, Brazil was assessed. Hierarchical logistic regression was used to investigate the association of information as a reported need and as an unmet need with service use variables, adjusting for sociodemographic and clinical characteristics. RESULTS Need for information was reported by 214 (53.4%) patients, being met in 101 (25.2%) and unmet in 113 (28.2%). Hierarchical regression indicated a significant association of a reported need with higher age of onset, family monitoring medication use last year and lower education level, which was only associated with an unmet need. CONCLUSION Information was a commonly reported need and which was often unmet, showing no significant association with service use. Greater attention should be given by mental health services to information provision.
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Affiliation(s)
- Mário César Rezende Andrade
- 1 Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,2 Department of Psychology, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, Brazil
| | - Mike Slade
- 3 Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Marina Bandeira
- 2 Department of Psychology, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, Brazil
| | - Sara Evans-Lacko
- 4 Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Denise Martin
- 5 Department of Preventive Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,6 Universidade Católica de Santos (UNISANTOS), Santos, Brazil
| | - Sérgio Baxter Andreoli
- 1 Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,6 Universidade Católica de Santos (UNISANTOS), Santos, Brazil
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14
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Ditton-Phare P, Loughland C, Duvivier R, Kelly B. Communication skills in the training of psychiatrists: A systematic review of current approaches. Aust N Z J Psychiatry 2017; 51:675-692. [PMID: 28462636 DOI: 10.1177/0004867417707820] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES A range of communication skills training programmes have been developed targeting trainees in various medical specialties, predominantly in oncology but to a lesser extent in psychiatry. Effective communication is fundamental to the assessment and treatment of psychiatric conditions, but there has been less attention to this in clinical practice for psychiatrists in training. This review examines the outcomes of communication skills training interventions in psychiatric specialty training. METHODS The published English-language literature was examined using multiple online databases, grey literature and hand searches. The review was conducted and reported using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies examining the efficacy of communication skills training were included. Randomised controlled trials, pseudo-randomised studies and quasi-experimental studies, as well as observational analytical studies and qualitative studies that met criteria, were selected and critically appraised. No limits were applied for date of publication up until 16 July 2016. RESULTS Total search results yielded 2574 records. Of these, 12 studies were identified and reviewed. Two were randomised controlled trials and the remaining 10 were one-group pretest/posttest designs or posttest-only designs, including self-report evaluations of communication skills training and objective evaluations of trainee skills. There were no studies with outcomes related to behaviour change or patient outcomes. Two randomised controlled trials reported an improvement in clinician empathy and psychotherapeutic interviewing skills due to specific training protocols focused on those areas. Non-randomised studies showed varying levels of skills gains and self-reported trainee satisfaction ratings with programmes, with the intervention being some form of communication skills training. CONCLUSION The heterogeneity of communication skills training is a barrier to evaluating the efficacy of different communication skills training programmes. Further validation studies examining specific models and frameworks would support a stronger evidence base for communication skills training in psychiatry. It remains a challenge to develop research to investigate behaviour change over time in clinical practice or to measure patient outcomes due to the effects of communication skills training.
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Affiliation(s)
- Philippa Ditton-Phare
- 1 Hunter New England Mental Health, Newcastle, NSW, Australia.,2 School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,3 Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, NSW, Australia
| | - Carmel Loughland
- 1 Hunter New England Mental Health, Newcastle, NSW, Australia.,2 School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,3 Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, NSW, Australia
| | - Robbert Duvivier
- 2 School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Brian Kelly
- 1 Hunter New England Mental Health, Newcastle, NSW, Australia.,2 School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,3 Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, NSW, Australia
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15
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MacDonald-Wilson KL, Hutchison SL, Karpov I, Wittman P, Deegan PE. A Successful Implementation Strategy to Support Adoption of Decision Making in Mental Health Services. Community Ment Health J 2017; 53:251-256. [PMID: 27262699 DOI: 10.1007/s10597-016-0027-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 05/28/2016] [Indexed: 10/21/2022]
Abstract
Individual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model. Participation in learning collaborative activities was high, indicating feasibility of the implementation model. Progress by staff in meeting process aims around utilization of components of the toolkit improved significantly over time (p < .0001). Survey responses by individuals in service corroborate successful implementation. Community-based providers were able to successfully implement decision support in mental health services as evidenced by improved process outcomes and sustained practices over 1 year through the structure of the learning collaborative model.
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Affiliation(s)
- Kim L MacDonald-Wilson
- UPMC Insurance Services Division, Community Care Behavioral Health, Pittsburgh, PA, USA.
| | - Shari L Hutchison
- UPMC Insurance Services Division, Community Care Behavioral Health, Pittsburgh, PA, USA
| | - Irina Karpov
- UPMC Insurance Services Division, Community Care Behavioral Health, Pittsburgh, PA, USA
| | - Paul Wittman
- UPMC Insurance Services Division, Community Care Behavioral Health, Pittsburgh, PA, USA
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16
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Bauer R, Conell J, Glenn T, Alda M, Ardau R, Baune BT, Berk M, Bersudsky Y, Bilderbeck A, Bocchetta A, Bossini L, Castro AMP, Cheung EY, Chillotti C, Choppin S, Del Zompo M, Dias R, Dodd S, Duffy A, Etain B, Fagiolini A, Hernandez MF, Garnham J, Geddes J, Gildebro J, Gonzalez-Pinto A, Goodwin GM, Grof P, Harima H, Hassel S, Henry C, Hidalgo-Mazzei D, Kapur V, Kunigiri G, Lafer B, Larsen ER, Lewitzka U, Licht RW, Lund AH, Misiak B, Monteith S, Munoz R, Nakanotani T, Nielsen RE, O'Donovan C, Okamura Y, Osher Y, Piotrowski P, Reif A, Ritter P, Rybakowski JK, Sagduyu K, Sawchuk B, Schwartz E, Scippa ÂM, Slaney C, Sulaiman AH, Suominen K, Suwalska A, Tam P, Tatebayashi Y, Tondo L, Vieta E, Vinberg M, Viswanath B, Volkert J, Zetin M, Whybrow PC, Bauer M. Internet use by patients with bipolar disorder: Results from an international multisite survey. Psychiatry Res 2016; 242:388-394. [PMID: 27391371 DOI: 10.1016/j.psychres.2016.05.055] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/30/2016] [Accepted: 05/30/2016] [Indexed: 02/03/2023]
Abstract
There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important.
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Affiliation(s)
- Rita Bauer
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Jörn Conell
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, University Hospital of Cagliari, Cagliari, Italy
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; University Hospital Geelong, Barwon Health, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia; Orygen Youth Health Research Centre, Parkville, VIC, Australia
| | - Yuly Bersudsky
- Beer Sheva Mental Health Center, Beer Sheva, Israel; Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Amy Bilderbeck
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Alberto Bocchetta
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Letizia Bossini
- Department of Molecular Medicine and Department of Mental Health (DAI) and University of Siena and University of Siena Medical Center (AOUS), Siena, Italy
| | - Angela M Paredes Castro
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Eric Yw Cheung
- Department of General Adult Psychiatry, Castle Peak Hospital, Hong Kong
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, University Hospital of Cagliari, Cagliari, Italy
| | - Sabine Choppin
- AP-HP, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | - Maria Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Rodrigo Dias
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Seetal Dodd
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; University Hospital Geelong, Barwon Health, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Anne Duffy
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Bruno Etain
- AP-HP, Hôpitaux Universitaires Henri-Mondor, INSERM U955 (IMRB), Université Paris Est, Créteil, France
| | - Andrea Fagiolini
- Department of Molecular Medicine and Department of Mental Health (DAI) and University of Siena and University of Siena Medical Center (AOUS), Siena, Italy
| | - Miryam Fernández Hernandez
- Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Julie Garnham
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - John Geddes
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Jonas Gildebro
- Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Denmark
| | - Ana Gonzalez-Pinto
- Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Guy M Goodwin
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ottawa, Canada; Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Hirohiko Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Stefanie Hassel
- Department of Psychology & Aston Brain Centre, Aston University, Birmingham, UK
| | - Chantal Henry
- AP-HP, Hôpitaux Universitaires Henri-Mondor, INSERM U955 (IMRB), Université Paris Est, Créteil, France; Institut Pasteur, Unité Perception et Mémoire, F-75015 Paris, France
| | - Diego Hidalgo-Mazzei
- Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Vaisnvy Kapur
- Department of Clinical Psychology, NIMHANS, Bangalore 560029, India
| | | | - Beny Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Erik R Larsen
- Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Denmark
| | - Ute Lewitzka
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Rasmus W Licht
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Anne Hvenegaard Lund
- Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Denmark
| | - Blazej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Rodrigo Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA USA
| | - Takako Nakanotani
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - René E Nielsen
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yasushi Okamura
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Yamima Osher
- Beer Sheva Mental Health Center, Beer Sheva, Israel; Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Patryk Piotrowski
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Germany; University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Kemal Sagduyu
- Department of Psychiatry, University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | - Brett Sawchuk
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | | | - Ângela M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - Claire Slaney
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ahmad H Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kirsi Suominen
- City of Helsinki, Department of Social Services and Health Care, Psychiatry, Helsinki, Finland
| | - Aleksandra Suwalska
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Peter Tam
- Department of Psychiatry, Department of Medicine, University of Hong Kong, Hong Kong
| | - Yoshitaka Tatebayashi
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - Leonardo Tondo
- Harvard Medical School-McLean Hospital, Boston, MA, USA; Lucio Bini Center, Cagliari e Roma, Italy
| | - Eduard Vieta
- Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Maj Vinberg
- Psychiatric Center Copenhagen, Copenhagen, Denmark
| | - Biju Viswanath
- Department of Psychiatry, NIMHANS, Bangalore 560029, India
| | - Julia Volkert
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Mark Zetin
- Department of Psychology, Chapman University, Orange, CA, USA
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Germany.
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17
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Online information seeking by patients with bipolar disorder: results from an international multisite survey. Int J Bipolar Disord 2016; 4:17. [PMID: 27552813 PMCID: PMC4995194 DOI: 10.1186/s40345-016-0058-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 08/09/2016] [Indexed: 12/30/2022] Open
Abstract
Background Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. Methods A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. Results 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. Conclusion Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites. Electronic supplementary material The online version of this article (doi:10.1186/s40345-016-0058-0) contains supplementary material, which is available to authorized users.
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18
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Bär Deucher A, Hengartner MP, Kawohl W, Konrad J, Puschner B, Clarke E, Slade M, Del Vecchio V, Sampogna G, Égerházi A, Süveges Á, Krogsgaard Bording M, Munk-Jørgensen P, Rössler W. Participation in medical decision-making across Europe: An international longitudinal multicenter study. Eur Psychiatry 2016; 35:39-46. [PMID: 27061376 DOI: 10.1016/j.eurpsy.2016.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/13/2016] [Accepted: 02/15/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The purpose of this paper was to examine national differences in the desire to participate in decision-making of people with severe mental illness in six European countries. METHODS The data was taken from a European longitudinal observational study (CEDAR; ISRCTN75841675). A sample of 514 patients with severe mental illness from the study centers in Ulm, Germany, London, England, Naples, Italy, Debrecen, Hungary, Aalborg, Denmark and Zurich, Switzerland were assessed as to desire to participate in medical decision-making. Associations between desire for participation in decision-making and center location were analyzed with generalized estimating equations. RESULTS We found large cross-national differences in patients' desire to participate in decision-making, with the center explaining 47.2% of total variance in the desire for participation (P<0.001). Averaged over time and independent of patient characteristics, London (mean=2.27), Ulm (mean=2.13) and Zurich (mean=2.14) showed significantly higher scores in desire for participation, followed by Aalborg (mean=1.97), where scores were in turn significantly higher than in Debrecen (mean=1.56). The lowest scores were reported in Naples (mean=1.14). Over time, the desire for participation in decision-making increased significantly in Zurich (b=0.23) and decreased in Naples (b=-0.14). In all other centers, values remained stable. CONCLUSIONS This study demonstrates that patients' desire for participation in decision-making varies by location. We suggest that more research attention be focused on identifying specific cultural and social factors in each country to further explain observed differences across Europe.
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Affiliation(s)
- A Bär Deucher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland.
| | - M P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Pfingstweidstrasse 96, PO Box 707, 8037 Zurich, Switzerland
| | - W Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland
| | - J Konrad
- Section Process-Outcome Research, Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg, Germany
| | - B Puschner
- Section Process-Outcome Research, Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg, Germany
| | - E Clarke
- Kings College London, Section for Recovery, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
| | - M Slade
- Kings College London, Section for Recovery, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
| | - V Del Vecchio
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie 1, 80138 Naples, Italy
| | - G Sampogna
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie 1, 80138 Naples, Italy
| | - A Égerházi
- Department of Psychiatry, Medical and Health Science Centre, University of Debrecen, 98, Nagyerdei krt, 4012, Debrecen, Hungary
| | - Á Süveges
- Department of Psychiatry, Medical and Health Science Centre, University of Debrecen, 98, Nagyerdei krt, 4012, Debrecen, Hungary
| | - M Krogsgaard Bording
- Aalborg University Hospital, Psychiatry, Mølleparkvej 10, Aalborg, 9000, Denmark
| | - P Munk-Jørgensen
- Department M, Aarhus University Hospital, Skovagervej 2, 8240 Risskov, Denmark
| | - W Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland
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