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Alemu WG, Mwanri L, Due C, Azale T, Ziersch A. Quality of life among people with mental illness attending a psychiatric outpatient clinic in Ethiopia: a structural equation model. Front Psychiatry 2024; 15:1407588. [PMID: 39188522 PMCID: PMC11345643 DOI: 10.3389/fpsyt.2024.1407588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/22/2024] [Indexed: 08/28/2024] Open
Abstract
Background Mental illness is one of the most severe, chronic, and disabling public health problems that affects patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total study participants who had a follow-up appointment during the data collection period (2400), by the total sample size 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the quality of life (QoL) of people with mental illness. The domains of QoL were identified, and indirect and direct effects of variables were calculated using structural equation modelling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results A total of 636 (99.7%) participants agreed to participate and completed the data collection. The mean score of overall QoL of people with mental illness in the outpatient clinic was 49.6 ± 10 Sd. The highest QoL was found in the physical health domain (50.67 ± 9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41 ± 10 Sd). Rural residence, drug nonadherence, suicidal ideation, not getting counselling, moderate or severe subjective severity, family does not participate in patient care and a family history of mental illness had an indirect negative effect on QoL. Alcohol use and psychological health domain had direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having history of mental illness in the family had both direct and indirect effect on QoL. Furthermore, sociodemographic factors (rural residence, illiterate educational status, not married marital status), social support-related factors (poor self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use) and clinical factors (high objective and subjective severity of illness, not getting counselling, suicidal ideation, higher number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions In this study, the QoL of people with mental illness was poor, with the psychological health domain the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors, directly and indirectly affected QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the QoL of those with mental illness, including the development of policy and practice responses that address the above identified factors.
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Affiliation(s)
- Wondale Getinet Alemu
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lillian Mwanri
- Research Centre for Public Health, Equity, and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia
| | - Clemence Due
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Telake Azale
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anna Ziersch
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
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Gebreselassie AF, Shimelash N, Kallon A, Mkondo G, Huston T, Schurer JM. 'We no longer experience the same pain': a cross-sectional study assessing the impact of Heart and Sole Africa's podoconiosis prevention education program. Trans R Soc Trop Med Hyg 2024; 118:520-526. [PMID: 38465481 DOI: 10.1093/trstmh/trae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/18/2024] [Accepted: 02/22/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Podoconiosis is a non-infectious neglected tropical disease caused by long-term exposure to irritant volcanic soils. It results in severe physical, psychological and financial consequences. Heart and Sole Africa (HASA) is a non-governmental, community-based organization providing management to podoconiosis patients in Rwanda. We sought to analyze the impact of their program on the lives of patients. METHODS Quantitative surveys recorded the participants' demographics, adherence to HASA's management recommendations and changes in quality of life (QOL). Qualitative questions were used to gather respondent perspectives on HASA programming. RESULTS We interviewed 127 patients from HASA's Musanze (n=47) and Burera (n=80) clinics. Almost all participants (98.4%) reported statistically significant (p<0.01) improvements in their QOL, and more than one-half (51.2%) had a favorable adherence score of >80%. Qualitative feedback identified specific challenges to adherence and recognition of program success in symptom management. CONCLUSIONS Our study demonstrated the value of community-based podoconiosis programming in improving the lives of patients. Practices such as regular feet washing, emollient application, shoe wearing and limb raising can result in a marked reduction of morbidity. Our findings support the argument for scaling up these management practices across Rwanda.
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Affiliation(s)
| | - Natnael Shimelash
- Simulation Center, University of Global Health Equity, Butaro, Rwanda
| | - Ahamed Kallon
- Center for One Health, University of Global Health Equity, Butaro, Rwanda
| | - George Mkondo
- Center for One Health, University of Global Health Equity, Butaro, Rwanda
| | - Tonya Huston
- Hill Country Memorial Physician Practice, Texas, USA
| | - Janna M Schurer
- Center for One Health, University of Global Health Equity, Butaro, Rwanda
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, North Grafton, USA
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Sulaiman IH, Abdul Taib NI, Lim JTY, Mohd Daud TI, Midin M. The role of peer support in recovery among clients with mental illness attending the psychiatric service in a tertiary hospital in Malaysia: a qualitative study. BMC Psychiatry 2024; 24:470. [PMID: 38926661 PMCID: PMC11210002 DOI: 10.1186/s12888-024-05901-1] [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: 01/19/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The understanding that mental health recovery is a personal and subjective experience informs mental health policies in many countries. However, most of the populations in these studies are from the West, limiting their applicability in Asia. Peer support in mental health refers to helping and mentoring people who have overcome similar obstacles. Despite being proven to be effective in promoting recovery, little is known about its use in Malaysian psychiatric patients. This study aims to explore the participants' perspectives on their concept of recovery and how the peer support group (PSG) aid them to achieve recovery. METHODOLOGY This study was conducted on clients with mental illness who attended the PSG provided by the Community Psychiatry and Psychosocial Intervention Unit in National University Malaysia Medical Centre. A qualitative generic inductive approach was employed in this thematic exploratory study. Purposive sampling was the method used to collect the data for this thematic exploratory study. In-depth interviews of 11 study participants were audio recorded and transcribed verbatim. Data were analyzed using Braun and Clarke (2006) descriptive thematic analysis method. RESULTS The findings of this study highlighted six key themes; three pertaining to the participants' perspectives on the meaning of recovery (1. Gaining self-reliance and social inclusion, 2. Personal growth and improved life circumstances in recovery, and 3. Symptoms improvement) and another three pertaining to how the peer support group aids recovery (1. Empowerment and growth through peer support, 2. Promoting well-being, 3. Social connection and support). CONCLUSION The findings of this study provide valuable insights into the perspectives of psychiatry clinic patients enrolled in PSG on the concept of recovery and the role of such groups in their recovery journey. The findings demonstrated that the PSG complemented the participants' perspectives on recovery, reinforcing the notion that a comprehensive and person-centered approach to mental health services is essential for successful and sustained recovery outcomes.
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Affiliation(s)
- Izzul Hazwan Sulaiman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Iwana Abdul Taib
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Jane Tze Yn Lim
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Shokrgozar S, Abdollahi E, Abedrad M, Asadi P, Rouzbehan V, Nazari Z, Zare R. Investigating gender differences in quality of life and social support in patients with severe mental illnesses. Int J Soc Psychiatry 2024; 70:750-762. [PMID: 38439517 DOI: 10.1177/00207640241227366] [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] [Indexed: 03/06/2024]
Abstract
BACKGROUND Severe mental illnesses (SMIs), including schizophrenia and bipolar disorder affect patients significantly. Gender has been identified as a key factor influencing the experience of SMIs with notable disparities in prevalence, symptoms, and treatment outcomes. Additionally, the quality of life (QoL) and social support for patients with SMIs can vary based on gender. AIMS This study examined gender differences in QoL and social support of patients with SMIs. METHOD Participants include 170 outpatients with schizophrenia and bipolar disorder at Shafa Hospital (2021). QoL and social support were assessed using World Health Organization QoL (WHOQOL-BREF) questionnaire and Medical Outcomes Study Social Support Survey (MOS-SSS), respectively. Group differences were analyzed using t-test or Mann-Whitney U test, and two-way multivariate analyses of variance explored the effect of gender and disease type. RESULTS It was indicated that females with schizophrenia reported higher QoL than males, but the opposite was observed for bipolar disorder. Gender differences in social support were not significant among schizophrenia patients, nor between the two patient groups. However, women with bipolar disorder and multiple hospitalizations experienced lower social support and QoL compared to men. Additionally, more hospitalizations were associated with decreased QoL in both genders with schizophrenia. CONCLUSIONS Findings suggest the need for gender- specific interventions and support policies to enhance QoL and social support in patients with SMI.
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Affiliation(s)
- Somayeh Shokrgozar
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Abdollahi
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Morvarid Abedrad
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Parham Asadi
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Vida Rouzbehan
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Nazari
- Department of Psychology, Lahijan Branch, Islamic Azad University, Iran
| | - Roghayeh Zare
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Wang M, Jin G, Li T, Pan Z, Lu X, Wang X. Development of family resource indicators for people with schizophrenic disorder in community by modified Delphi method in Beijing, China. BMJ Open 2024; 14:e076838. [PMID: 38719334 PMCID: PMC11086501 DOI: 10.1136/bmjopen-2023-076838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 04/17/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Most people with schizophrenia in China are supported by their family members in community. The patient's family is confronted with severe care burden and pressure, which directly affects the caregiver's own health and social life, and indirectly affects the patient's rehabilitation. Adequate family resources can reduce the burden and pressure on families. But there is an absence of systematic family resource indicators for people with schizophrenic disorder in China. OBJECTIVES This study aimed to develop a set of family resource indicators for people with schizophrenic disorder in China. DESIGN Preliminary family resource indicators were generated and refined by literature review and an expert consultation meeting. Two rounds of email-based Delphi survey were carried out to identify family resource indicators. SETTING Two rounds of email-based Delphi survey were performed from July to September 2021 in Beijing, China. PARTICIPANTS There were 15 mental health doctors from community health service centres and four psychiatrists from tertiary hospitals, and two primary care researchers from universities in the first and second rounds Delphi survey. RESULTS All the 21 experts participated in both rounds of Delphi survey. A total of 46 indicators achieved consensus for inclusion in the final set of indicators after two rounds of Delphi survey. The final set of indicators was grouped into 10 domains: financial support (three indicators), psychological and spiritual support (eight indicators), medical treatment (three indicators), information and education (three indicators), structural support (two indicators), external family resources included social resources (five indicators), cultural resources (two indicators), economic resources (seven indicators), environmental resources (four indicators) and medical resources (nine indicators). CONCLUSIONS A set of 46 family resource indicators for people with schizophrenic disorder in community was identified by an iterative Delphi process in Beijing, China. However, the indicators still need to be validated by testing in further studies.
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Affiliation(s)
- Meirong Wang
- General Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guanghui Jin
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Ting Li
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Zhaolu Pan
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Xiaoqin Lu
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Xiaojuan Wang
- General Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Howie JH, Faith LA, Jarvis SP, Rempfer MV. Social Cognition and Other Determinants of Perceived Social Support in Individuals With Serious Mental Illness. J Nerv Ment Dis 2023; 211:848-855. [PMID: 37647619 DOI: 10.1097/nmd.0000000000001708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
ABSTRACT Social support provides protective effects for those with serious mental illness (SMI), but these effects may be attenuated by factors that hinder positive perceptions of support. Improved understanding of social support and its determinants may hold relevance for clinical interventions and provide avenues to promote recovery and improve functioning. The present study is a cross-sectional, correlational analysis investigating the relationships among social cognition (Mayer-Salovey-Caruso Emotional Intelligence Test-Managing Emotions subscale), social anxiety (Liebowitz Social Anxiety Scale), negative symptoms (Scale for the Assessment of Negative Symptoms), and perceived social support (Interpersonal Support Evaluation List) among individuals with SMI. Data were analyzed for 59 participants from a psychosocial rehabilitation treatment study at a public, urban academic-affiliated medical center in the Midwest. Bivariate Pearson correlations revealed statistically significant associations among perceived social support and social cognition (total perceived social support, p < 0.05; appraisal support, p < 0.01), negative symptoms (appraisal support, p < 0.05), and social anxiety (self-esteem support, p < 0.05). Further, multiple linear regression revealed social cognition remained a significant predictor of perceived social support ( p < 0.05) when controlling for social anxiety and negative symptoms. Overall findings suggest a correlative relationship between social cognition and perceived social support. Conclusions, limitations, and future directions are discussed.
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Affiliation(s)
- J Hunter Howie
- Department of Psychology, The University of Missouri, Kansas City, Missouri
| | | | | | - Melisa V Rempfer
- Department of Psychology, The University of Missouri, Kansas City, Missouri
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Abstract
BACKGROUND Schizophrenia is a severe, chronic mental disorder that causes many psychosocial problems. In order to reveal these problems, it is necessary to measure the quality of life of people with schizophrenia. AIM The aim of this meta-analysis is to compare the quality of life of people with schizophrenia and healthy subjects. METHODS Literature search was conducted in the Web of Science Core Collection database including the dates of January 2000 and March 2021. The systematic search provided 464 potentially relevant studies. The final sample consisted of 18 studies. RESULTS The results of using a random effects model for analysis indicated that schizophrenia subjects showed considerably lower quality of life scores compared to healthy controls. CONCLUSION Determining the quality of people with schizophrenia will help us to create effective psychosocial intervention programs.
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Affiliation(s)
| | - Melike Tekindal
- Department of Social Work, İzmir Katip Çelebi University, İzmir, Turkey
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Chen YL, Jian CR, Chang YP, Chao SR, Yen CF. Association of loneliness with suicide risk and depression in individuals with schizophrenia: moderating effects of self-esteem and perceived support from families and friends. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:41. [PMID: 37402821 PMCID: PMC10319791 DOI: 10.1038/s41537-023-00368-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023]
Abstract
Loneliness is prevalent among individuals with mental illnesses. This cross-sectional survey study examined the moderating effects of self-esteem and perceived support from families and friends on the association of loneliness with suicide risk and depression in individuals with schizophrenia. In total, 300 participants (267 with schizophrenia and 33 with schizoaffective disorder) completed the University of California, Los Angeles, Loneliness Scale (Version 3); suicide module of the Mini International Neuropsychiatric Interview; Center for Epidemiologic Studies Depression Scale; Family and Friend Adaptability, Partnership, Growth, Affection, and Resolve Index; and Rosenberg Self-Esteem Scale. Moderation analysis was performed to examine the moderating effects of self-esteem and perceived support from families and friends on the association of loneliness with suicide risk and depression. The results found that self-esteem was significantly associated with a reduced magnitude of depression in participants with loneliness. In addition, perceived support from friends was significantly associated with a reduced magnitude of suicide risk in participants with loneliness. Our findings indicate the importance of intervention programs that strengthen support from friends and self-esteem in reducing suicide risk and depression among lonely individuals with schizophrenia.
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Affiliation(s)
- Yi-Lung Chen
- Department of Psychology, Asia University, Taichung, Taiwan
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Cian-Ruei Jian
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY, USA
| | - Shu-Ru Chao
- Department of Social Work, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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Ma R, Romano E, Ashworth M, Yadegarfar ME, Dregan A, Ronaldson A, de Oliveira C, Jacobs R, Stewart R, Stubbs B. Multimorbidity clusters among people with serious mental illness: a representative primary and secondary data linkage cohort study. Psychol Med 2023; 53:4333-4344. [PMID: 35485805 PMCID: PMC10388332 DOI: 10.1017/s003329172200109x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND People with serious mental illness (SMI) experience higher mortality partially attributable to higher long-term condition (LTC) prevalence. However, little is known about multiple LTCs (MLTCs) clustering in this population. METHODS People from South London with SMI and two or more existing LTCs aged 18+ at diagnosis were included using linked primary and mental healthcare records, 2012-2020. Latent class analysis (LCA) determined MLTC classes and multinominal logistic regression examined associations between demographic/clinical characteristics and latent class membership. RESULTS The sample included 1924 patients (mean (s.d.) age 48.2 (17.3) years). Five latent classes were identified: 'substance related' (24.9%), 'atopic' (24.2%), 'pure affective' (30.4%), 'cardiovascular' (14.1%), and 'complex multimorbidity' (6.4%). Patients had on average 7-9 LTCs in each cluster. Males were at increased odds of MLTCs in all four clusters, compared to the 'pure affective'. Compared to the largest cluster ('pure affective'), the 'substance related' and the 'atopic' clusters were younger [odds ratios (OR) per year increase 0.99 (95% CI 0.98-1.00) and 0.96 (0.95-0.97) respectively], and the 'cardiovascular' and 'complex multimorbidity' clusters were older (ORs 1.09 (1.07-1.10) and 1.16 (1.14-1.18) respectively). The 'substance related' cluster was more likely to be White, the 'cardiovascular' cluster more likely to be Black (compared to White; OR 1.75, 95% CI 1.10-2.79), and both more likely to have schizophrenia, compared to other clusters. CONCLUSION The current study identified five latent class MLTC clusters among patients with SMI. An integrated care model for treating MLTCs in this population is recommended to improve multimorbidity care.
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Affiliation(s)
- Ruimin Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Eugenia Romano
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Mark Ashworth
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK
- School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Mohammad E. Yadegarfar
- School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Alexandru Dregan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK
| | - Amy Ronaldson
- Health Services and Population Research Department, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | | | - Rowena Jacobs
- Centre for Health Economics, University of York, York, UK
| | - Robert Stewart
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- Physiotherapy Department, South London and Maudsley National Health Services Foundation Trust, London, SE5 8AB, UK
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Jagan S, Mohd Daud TI, Chia LC, Saini SM, Midin M, Eng-Teng N, Ratnasingam S. Evidence for the Effectiveness of Psychological Interventions for Internalized Stigma among Adults with Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5570. [PMID: 37107852 PMCID: PMC10138403 DOI: 10.3390/ijerph20085570] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 05/11/2023]
Abstract
In recent years, psychological interventions have been used to alleviate internalized stigma in people with schizophrenia spectrum disorders, but outcomes have been inconsistent. The aim of this review was to examine the existing evidence regarding this matter. Four electronic databases (EMBASE, MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials) were searched from inception until 8 September 2022, using appropriate strategies. The eligibility, quality, and strength of evidence of each study were all evaluated against the predetermined standards. Further quantitative analyses were performed using the RevMan software. A total of 27 studies were included in the systematic review. Eighteen studies with extractable data for meta-analysis yielded a statistically significant overall effect (Z = 3.00; p = 0.003; 95% CI: -0.69 [-1.15, -0.24]; n = 1633), although there was considerable heterogeneity (Tau2 = 0.89; Chi2 = 303.62, df = 17; p < 0.00001; I2 = 94%). Subgroup analyses for Narrative Enhancement and Cognitive Therapy (NECT) produced a statistically significant and highly homogenous effect (Z = 3.40; p = 0.0007; 95% CI: -0.44 [-0.70, -0.19]; n = 241; Tau2 = 0.00; Chi2 = 0.14, df = 2 (p = 0.93); I2 = 0%). In conclusion, the majority of the psychological interventions are successful in lowering levels of internalized stigma, especially NECT, and interventions that integrate multiple therapies may be more beneficial.
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Affiliation(s)
- Shankar Jagan
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
- Department of Psychiatry & Mental Health, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak 93586, Malaysia
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Lip Choy Chia
- Department of Psychiatry and Mental Health, Hospital Keningau, Peti Surat 11 Jalan Apin-Apin, Keningau 89007, Malaysia
| | - Suriati Mohamed Saini
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Ng Eng-Teng
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Selvasingam Ratnasingam
- Department of Psychiatry & Mental Health, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak 93586, Malaysia
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Social Factors and Recovery: A Longitudinal Study of Patients with Psychosis in Mental Health Services. Community Ment Health J 2023; 59:294-305. [PMID: 35976477 PMCID: PMC9859912 DOI: 10.1007/s10597-022-01007-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 07/01/2022] [Indexed: 01/25/2023]
Abstract
To study the prospective associations between social factors and recovery in patients with psychotic disorders in mental health specialist services. In this prospective observational cohort study, analyzes were based on baseline- and follow-up data after 18 months from 108 patients with psychosis. Personal recovery was assessed by the Questionnaire about the Process of Recovery (QPR). Linear regression models were used to test the prospective associations between social predictor variables and QPR. An association was found between experienced quality of interpersonal relationships at baseline and change in QPR score over the next 18 months. Stratified analyzes showed that the effect of experienced quality of interpersonal relationships on recovery was due to an association among persons living with others. Patients' experience of quality of interpersonal relationships are prospectively associated with recovery. In conclusion, findings indicate that interpersonal relationships and social interaction are central drivers of recovery in patients with psychotic disorders.
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Murwasuminar B, Munro I, Recoche K. Mental health recovery for people with schizophrenia in Southeast Asia: A systematic review. J Psychiatr Ment Health Nurs 2023. [PMID: 36681884 DOI: 10.1111/jpm.12902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 10/26/2022] [Accepted: 01/05/2023] [Indexed: 01/23/2023]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Mental health recovery has become a more prevalent approach to empowering people with schizophrenia (PWS), especially in western countries. However, despite the benefits, there is a lack of evidence regarding its practice in developing countries such as Southeast Asian Countries. The optimal treatment for PWS has not yet been identified, since most mental health care is provided in hospital-based settings in Southeast Asia. Mental health treatment in Southeast Asia is highly influenced by cultural norms, values, and practices. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The findings highlight the importance of integrating cultural aspects into the treatment of people with schizophrenia. The sample of unique elements in Southeast Asian mental health recovery include using a close neighbour/cadre as social support and using religious activity to increase hope. Lack of government support, high level of employment, and stigma are the biggest barriers in the PWS recovery process. WHAT IS THE IMPLICATION FOR PRACTICE?: There is a research gap regarding the awareness and implementation of mental health recovery in psychiatric programs across the Southeast Asian region which likely impacts the effectiveness of the treatment. The review shows that little research has explored the concept of personal recovery in Southeast Asian Countries. ABSTRACT INTRODUCTION: Recovery has become an important approach used by mental health services around the world. Many mental health systems have taken steps to move towards more recovery-oriented practices and service delivery. Therefore, establishing recovery-oriented services in developing countries like those in the Southeast Asian region requires a detailed understanding of the cultural norms, values, and current mental health practices. AIMS To investigate the mental health practices that promote recovery, its barrier in Southeast Asia, and to determine if they align with the CHIME recovery model. METHOD Electronic databases MEDLINE, EMBASE, CINAHL, PsycINFO and SCOPUS, were searched [PROSPERO] (CRD42021227962). Peer-reviewed English language articles from 2004 to January 2021 were included. Methodological quality was assessed using the CASP checklist, and thematic synthesis of included studies was conducted. RESULTS Thirty-one studies met inclusion criteria. Several themes illustrated mental health recovery services and the current obstacles identified in South-east Asian studies. Connection includes peer support and support groups, relationship status, and limited opportunities to become involved in the community. Hope is found in cultural concepts of hope, stimulating recovery through mental health programs, whilst lack of knowledge and education are the main barriers. Ethnicity is linked to a high level of stigma, but ethnicity also builds identity. Meaning and spirituality manifest in religious activities as the catalyst for recovery. Finally, the opposite of Empowerment is seen in the tendency of people with schizophrenia to remain in a passive position. Further barriers to empowerment are unemployment and a lack of social support. DISCUSSION In Southeast Asia, the elements of culture, religiosity, and communality are essential to mental health recovery. The obstacles to recovery are relate to human rights, social support, family involvement, and continuity of care. IMPLICATIONS FOR PRACTICE This review explores the concept of mental health recovery for people who are experiencing psychosis and living in Southeast Asian countries. The evidence may contribute to the further development of mental health programs in this region.
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Affiliation(s)
- Bandu Murwasuminar
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia.,West Java Mental Hospital, West Java, Indonesia
| | - Ian Munro
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
| | - Katrina Recoche
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
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Chen C, Chen Y, Huang Q, Yan S, Zhu J. Self-Care Ability of Patients With Severe Mental Disorders: Based on Community Patients Investigation in Beijing, China. Front Public Health 2022; 10:847098. [PMID: 35719645 PMCID: PMC9198226 DOI: 10.3389/fpubh.2022.847098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Severe Mental Disorders have become a topic of increasing interest in research due to their serious consequences for the quality of life and functioning. In the pages that follow, it will be argued that the self-care ability and its influencing factors among patients with severe mental disorders in Beijing, according to the questionnaire survey in 2019. Methods Proportionate stratified sampling was used to select representative patients as samples. The demographic characteristics of were obtained from the Management Information System for Severe Mental Disorders and the questionnaires. The self-care ability was measured by self-made scales. Descriptive statistics, t-test, and multiple linear regression were used to analyze the data. Results We surveyed 662 people and found that the deficiency of self-care ability is common in patients with severe mental disorders. Self-care ability was positively correlated with educated levels and guardian takes care of alone, and negatively correlated with age, course of disease and physical disease (P < 0.05). From a dimensional perspective, the daily basic activity was positively correlated with educated levels and negatively correlated with physical disease (P < 0.05); the housework ability was positively correlated with gender, educated levels and medication adherence, and negatively correlated with source of income and physical disease (P < 0.05); the social function was positively correlated with educated levels, guardian takes care of alone and medication adherence, and negatively correlated with age, source of income, course of disease and physical disease (P < 0.05). Conclusion The self-care ability of patients with severe mental disorders is affected by many factors, including patient characteristics and social factors. Therefore, targeted interventions are needed to help patients restore their self-care ability, which requires the joint efforts of the government and the whole society.
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Affiliation(s)
- Chen Chen
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| | - Yun Chen
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Qingzhi Huang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Shengming Yan
- Department of Sociology, Peking University, Beijing, China
| | - Junli Zhu
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
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Nwafor CE, Ofonedu M, Nwankwo NI, Obuna A, Ugwu PC. Perceived stress moderates the relationship between family support and family quality of life among parents of children living with intellectual and developmental disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Mirian Ofonedu
- Maryland Center for Developmental Disabilities Kennedy Krieger Institute Baltimore Maryland USA
| | - Nelson I. Nwankwo
- Department of Psychology Nnamdi Azikiwe University Awka Awka Nigeria
| | - Adaoga Obuna
- Department of Psychology Enugu State University of Science and Technology Enugu Nigeria
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Şahin Altun Ö, Asi Karakas S, Öztürk Z, Polat H. An analysis of the relationship between social support levels and treatment compliance of individuals diagnosed with schizophrenia. Perspect Psychiatr Care 2022; 58:578-583. [PMID: 33904170 DOI: 10.1111/ppc.12813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 03/05/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study was to determine the relationship between social support levels and treatment compliance of individuals with schizophrenia. DESIGN AND METHODS A descriptive and correlational research design was used in the study. The sample was not selected from the universe and the study was completed with 110 patients. FINDINGS There was a significant positive correlation between the total score of family subscale and total score of the Morisky compliance scale (p < 0.05). Morisky adherence scale (p < 0.05), suggesting that family support can favor the treatment adherence of patients. PRACTICE IMPLICATIONS Psychiatric professionals should carefully evaluate the family support perceived from the patients with schizophrenia to improve their adherence to treatment.
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Affiliation(s)
- Özlem Şahin Altun
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Sibel Asi Karakas
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Zeynep Öztürk
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Hatice Polat
- Malatya Education and Research Hospital Psychiatry Clinic, Malatya, Turkey
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Prediction of quality of life in schizophrenia using machine learning models on data from Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial. NPJ SCHIZOPHRENIA 2022; 8:29. [PMID: 35314708 PMCID: PMC8938459 DOI: 10.1038/s41537-022-00236-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 02/11/2022] [Indexed: 12/22/2022]
Abstract
While research focus remains mainly on psychotic symptoms, it is questionable whether we are placing enough emphasis on improving the quality of life (QoL) of schizophrenia patients. To date, the predictive power of QoL remained limited. Therefore, this study aimed to accurately predict the QoL within schizophrenia using supervised learning methods. The authors report findings from participants of a large randomized, double-blind clinical trial for schizophrenia treatment. Potential predictors of QoL included all available and non-redundant variables from the dataset. By optimizing parameters, three linear LASSO regressions were calculated (N = 697, 692, and 786), including 44, 47, and 41 variables, with adjusted R-squares ranging from 0.31 to 0.36. Best predictors included social and emotion-related symptoms, neurocognition (processing speed), education, female gender, treatment attitudes, and mental, emotional, and physical health. These results demonstrate that machine learning is an excellent predictive tool to process clinical data. It appears that the patient’s perception of their treatment has an important impact on patients’ QoL and that interventions should consider this aspect. Trial registration: ClinicalTrials.gov Identifier: NCT00014001.
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Yang F, Hong X, Tao J, Chen Y, Zhang Y, Xiao H. Hair cortisol, social support, personality traits, and clinical course: differences in schizophrenia and bipolar disorder. Brain Behav 2021; 11:e2412. [PMID: 34775692 PMCID: PMC8671778 DOI: 10.1002/brb3.2412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/01/2021] [Accepted: 10/19/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the differences in the relationship between hair cortisol concentration (HCC) and psychosocial stress, social support, clinical features, clinical course, and outcome in schizophrenia and bipolar disorder. METHODS A total of 109 schizophrenia patients, 93 bipolar disorder patients and 86 healthy controls between 18 and 60 years old were enrolled in the study. Linear regression and factor analysis were employed to examine and compare the relationship between HCC and childhood trauma, the number of stressful life events, the amount of social support in the three months before the hair cortisol assessment, clinical fearures, clinical course, and outcome in schizophrenia and bipolar disorder. RESULTS HCC is significantly associated with clinical syndromes, including depression-anxiety factor of Positive and Negative Syndrome Scale in schizophrenia patients, and thought disorder in bipolar disorder patients. However, HCC is positively related to social support and personality traits only in schizophrenia patients but not in bipolar disorder patients. Factor analysis indicates schizophrenia and bipolar disorder share a very similar but somewhat different structure in terms of HCC, psychosocial stress, social support, clinical features, clinical course, and outcome. CONCLUSION Findings support that schizophrenia and bipolar disoder have a significant overlap in both clinical characteristics and enviromental risk factors. Aberrant HCC contributes to the complexity of clinical characteristics mainly in schizophrenia.
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Affiliation(s)
- Fuzhong Yang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiangfei Hong
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jing Tao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yupeng Chen
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yanbo Zhang
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Hua Xiao
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
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Shumye S, Amare T, Derajew H, Endris M, Molla W, Mengistu N. Perceived quality of life and associated factors among patients with severe mental illness in Ethiopia: a cross-sectional study. BMC Psychol 2021; 9:152. [PMID: 34602067 PMCID: PMC8489038 DOI: 10.1186/s40359-021-00664-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 09/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Severe mental illness is strongly associated with an impaired quality of life. This intern can affect the treatment adherence and outcomes of the illness. However, there are insufficient studies in the literature pertaining to the quality of life of patients with severe mental illness in Ethiopia. Therefore, assessing the quality of life of patients with severe mental illness and its correlates is a yardstick measure of the effectiveness of the mental health service. Methods An institutional based cross-sectional study was conducted from May 1 to 16, 2019 at Amanuel Mental Specialized Hospital. A systematic random sampling technique was used to get a total number of 387 samples. Data were collected using interview-administered questionnaires; World Health Organization Quality of Life Brief Version, Morisky Medication Adherence Screening Tool, Oslo Social Support Scale, and Jacoby Stigma Scale. Simple and multiple linear regression analysis were used to assess the contributing factors of quality of life in the participants and B coefficient with 95% CI confidence interval was used. The statistical significance was accepted at p value < 0.05. Results The result showed that the Mean quality of life score of patients with severe mental illness for each domain (mean ± SD) was 41.3 ± 7.5, 42.8 ± 8.2, 38.9 ± 8.9, and 41.8 ± 6.5 for physical, psychological, social and environmental, respectively. Multiple regression analysis showed that age of participants was strongly positively correlated with all domains of quality of life. It predicts above 45% of the variability in each domain. Social support is also another strong predictor which was negatively correlated with all domains of quality of life, except physical. Conclusion This study revealed that the mean score quality of life of patients with severe mental illness in each domain was low. This demonstrates a need for improving the quality of life of people with severe mental illness by integration of a positive mental health approach and bio-psychosocial view with biological treatment of severe mental illness. Moreover, in Collaboration with medical professionals, people with severe mental illness should screen and managed for any comorbid medical conditions.
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Affiliation(s)
- Seid Shumye
- Department of Psychiatry, Dilla University, P.O. Box (DU): 419, Dilla, Ethiopia
| | - Tadele Amare
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Habtamu Derajew
- Department of Psychiatry, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| | - Merdia Endris
- Department of Psychiatry, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| | - Wondwosen Molla
- Department of Midwifery, Dilla University, P.O. Box (DU): 419, Dilla, Ethiopia
| | - Nebiyu Mengistu
- Department of Psychiatry, Dilla University, P.O. Box (DU): 419, Dilla, Ethiopia.
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Ismail MA, Midin M. Shared Decision-Making and Role Preference Among Patients With Schizophrenia in Malaysia: A Cross-Sectional Study. Front Psychiatry 2021; 12:680800. [PMID: 34381387 PMCID: PMC8350437 DOI: 10.3389/fpsyt.2021.680800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/25/2021] [Indexed: 01/19/2023] Open
Abstract
Introduction: Shared decision-making (SDM) is recognized as a promising strategy for improving collaboration between clinicians and their patients in achieving recovery. In Malaysia, SDM among people with schizophrenia is still lacking both in practice and in research. This study aimed to determine the level of SDM and role preference and their associated factors among patients with schizophrenia in Malaysia. Methods: A cross-sectional study was conducted on 86 outpatient attendees with schizophrenia at a teaching hospital in Kuala Lumpur, Malaysia. The nine-item Shared Decision Making Questionnaire and Control Preference Scale were used to assess perceived SDM experience and role preference, respectively. Linear and logistic regression models were used to analyze the factors associated with SDM and role preference, respectively. Factors with a p <0.25 from the simple regression analyses were controlled as the covariates in the multiple regression analyses. Results: The study respondents were predominantly female, single, and unemployed, with a mean age of 44 years. Only 35% of the participants reported having high SDM experiences, even though the majority (56%) preferred autonomous role preference. Among the participants who preferred autonomous roles, only 40% experienced high SDM. High SDM was found to be significantly associated with being younger (B = -0.33, 95% CI = -0.67 to -0.003) and being non-clozapine users (B = 19.90, 95% CI = 9.39-30.41), while autonomous role preference was significantly associated with a lower level of insight [adjusted odds ratio (AOR) = 0.84, 95% CI = 0.72-0.99] and being on oral antipsychotic drugs only (AOR = 2.94, 95% CI = 1.10-7.82). Conclusion: The practice of SDM is still lacking in the treatment of patients with schizophrenia in Malaysia, even though many of them preferred to be involved in the decision-making pertaining to their treatment. This study indicates the need for clinicians to improve their patients' involvement in the treatment process. More research is needed on how SDM can be implemented in patients with schizophrenia, especially in Asian population settings.
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Affiliation(s)
| | - Marhani Midin
- Psychiatry Department, Universiti Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia
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Telemedical care and quality of life in patients with schizophrenia and bipolar disorder: results of a randomized controlled trial. BMC Psychiatry 2021; 21:318. [PMID: 34187420 PMCID: PMC8243575 DOI: 10.1186/s12888-021-03318-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Schizophrenia and bipolar disorder are serious psychiatric disorders with a high disease burden, a high number of years of life lived with disability and a high risk for relapses and re-hospitalizations. Besides, both diseases are often accompanied with a reduced quality of life (QoL). A low level of quality of life is one predictor for relapses. This study examines whether a telemedical care program can improve QoL. METHODS Post stationary telemedical care of patients with severe psychiatric disorders" (Tecla) is a prospective controlled randomized intervention trial to implement and evaluate a telemedical care concept for patients with schizophrenia and bipolar disorder. Participants were randomized to an intervention or a control group. The intervention group received telemedical care including regular, individualized telephone calls and SMS-messages. QoL was measured with the German version of the WHOQOL-BREF. Effects of telemedicine on QoL after 6 months and treatment*time interactions were calculated using linear regressions (GLM and linear mixed models). RESULTS One hundred eighteen participants were recruited, thereof 57.6% men (n = 68). Participants were on average 43 years old (SD 13). The treatment*time interaction was not significant. Hence, treatment had no significant effect either. Instead, gender is an influencing factor. Further analysis showed that social support, the GAF-level and QoL-values at baselines were significant determinants for the improvement of QoL. CONCLUSION The telemedicine care concept Tecla was not significant for QoL in patients with severe psychiatric disorders. More important for the QoL is the general social support and the level of global functioning of the patients. TRIAL REGISTRATION German Clinical Trials Register, DRKS00008548, registered 21 May 2015 - retrospectively registered, https://www.drks.de/drks_web/setLocale_EN.do.
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The Association of Social Support and Symptomatic Remission among Community-Dwelling Schizophrenia Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083977. [PMID: 33918873 PMCID: PMC8070210 DOI: 10.3390/ijerph18083977] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/17/2022]
Abstract
Schizophrenia is a mental disease that often leads to chronicity. Social support could reduce the severity of psychotic symptoms; therefore, its influence on remission should be examined. This study investigated the remission rates in community-dwelling schizophrenia patients and examined the association between social support and remission status. A cross-sectional study was conducted in 129 schizophrenia patients in Taiwan. Remission rates were evaluated, and the level of social support, clinical characteristics, sociodemographic variables, and healthy lifestyle status were compared between the remission and nonremission groups. The association between social support and remission was analyzed after adjusting for confounding factors. The mean illness duration is 12.9 years. More than 95% of the participants lived with their families, 63% were unemployed, and 43% achieved remission. Higher social support was observed in the remission group, and a significant correlation was observed between family domain of social support and remission status. Family support was a protective factor of symptomatic remission in community-dwelling schizophrenia patients in Taiwan. The results reflect the effects of a family-centered culture on patients during illness. Consequently, reinforcing family relationships and the capacity of families to manage the symptoms of patients and providing support to families are recommended.
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Assessment of the Impact of a Daily Rehabilitation Program on Anxiety and Depression Symptoms and the Quality of Life of People with Mental Disorders during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041434. [PMID: 33546511 PMCID: PMC7913642 DOI: 10.3390/ijerph18041434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 11/23/2022]
Abstract
Community psychiatry is a modern and effective form of care for patients with mental disorders. The aim of the study was to assess the impact of a rehabilitation program at the Mental Health Support Centre in Tarnowskie Góry (Poland) on reducing severity of anxiety and depression symptoms, as well as improving overall quality of life during the COVID-19 pandemic. The study involved 35 patients, examined with an authors’ questionnaire on sociodemographic data, the Hospital Scale of Anxiety and Depression (HADS) and the Short Form Health Survey (SF-36). Data was obtained during the first national lockdown and compared to data gathered before the pandemic on the same study group. Imposed restrictions, negative emotional state during lockdown, subjectively assessed higher health risk and a low level of knowledge about the COVID-19 pandemic did not significantly correlate with a severity of depression and anxiety, as well as general quality of life. However, the comparison of the results obtained in HADS and SF-36 scales show a significant improvement in both categories. Rehabilitation activities, including physical training, cognitive exercise and social therapy, reduce the severity of the symptoms and have a positive effect on the overall quality of life in patients suffering from schizophrenia and affective disorders. Therefore, holistic mental health support services may positively affect building an individual resilience. The severity of anxiety symptoms during the COVID-19 pandemic shows a negative correlation with the patient’s age.
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Ali O, Deribe K, Semrau M, Mengiste A, Kinfe M, Tesfaye A, Bremner S, Davey G, Fekadu A. A cross-sectional study to evaluate depression and quality of life among patients with lymphoedema due to podoconiosis, lymphatic filariasis and leprosy. Trans R Soc Trop Med Hyg 2020; 114:983-994. [PMID: 33190154 PMCID: PMC7738660 DOI: 10.1093/trstmh/traa130] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/23/2020] [Accepted: 11/09/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Podoconiosis, lymphatic filariasis (LF) and leprosy are neglected tropical diseases (NTDs) that cause lymphoedema. When left untreated, they lead to substantial disability. This study determined the quality of life (QOL) and depression associated with lymphoedema in patients with podoconiosis, LF and leprosy. The study was conducted in northwestern Ethiopia. METHODS This baseline cross-sectional study, nested within an interventional, non-comparative, longitudinal study, included patients with lymphoedema. Depression and QOL were assessed using versions of the 9-item Patient Health Questionnaire and Dermatologic Life Quality Index (DLQI), respectively, that had been translated into Amharic and validated. Factors associated with depression and QOL were assessed using multivariate linear regression analysis. RESULTS Of the 251 patients with lymphoedema included in the study, 119 (47.4%) had moderate to severe depression and overall QOL was poor (mean±standard deviation [SD] DLQI score: 11.4±4.2). Disability was significantly associated with depression (β=0.26 [95% confidence interval {CI} 0.19 to 0.33]). Currently receiving treatment (β=-3.05 [95% CI -5.25 to -0.85), disability (β=-0.08 [95% CI -0.15 to -0.01]) and social support (moderate support: β=-2.27 [95% CI -3.66 to -0.89] and strong support: β=-2.87 [95% CI -5.35 to -0.38]) were significantly associated with better QOL. CONCLUSION High levels of depression and low QOL were found among patients with lymphoedema due the three NTDs in Ethiopia.
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Affiliation(s)
- Oumer Ali
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT)-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, 9086, Ethiopia
- Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK
| | - Kebede Deribe
- Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, 1176, Ethiopia
| | - Maya Semrau
- Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK
| | - Asrat Mengiste
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT)-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, 9086, Ethiopia
| | - Mersha Kinfe
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT)-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, 9086, Ethiopia
| | - Abraham Tesfaye
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT)-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, 9086, Ethiopia
| | - Stephen Bremner
- Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK
| | - Gail Davey
- Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, 1176, Ethiopia
| | - Abebaw Fekadu
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT)-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, 9086, Ethiopia
- Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK
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Shioda A, Yamauchi K. Community integration and related factors among people with mental illness in Japan: Multiple regression analysis stratified by social isolation level. Int J Soc Psychiatry 2020; 66:614-622. [PMID: 32475198 DOI: 10.1177/0020764020924690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUD AND AIM Community integration is an essential for people with mental illness that affects their health and quality of life. The objective of this study is to find the factors useful in improving community integration of people with mental illness. METHODS The study method was self-reporting questionnaires for people with mental illness living in the community. The decision tree analysis revealed that people with mental illness into high or low social isolation level strata. Multiple regression analyses stratified by using two social isolation levels were conducted. RESULTS Common factors among the strata were living environment of formal care accessibility and daily life activity. Specific factors for social isolation low-level stratum were self-efficacy for coping with symptoms, self-efficacy for social relationships, healthy lifestyle habits, treatment, exchange daily life information with friends and family members. Specific factors for social isolation high-level stratum were self-efficacy for daily living, self-efficacy for treatment-related behavior and satisfaction with formal care. All specific factors were positively associated with community integration. CONCLUSIONS The findings suggest the devising interventions to enhance community integration by social isolation level among people with mental illness.
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Affiliation(s)
- Ai Shioda
- Keio Research Institute at SFC, Fujisawa, Japan
| | - Keita Yamauchi
- Graduate School of Health Management, Keio University, Fujisawa, Japan
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Dopamine D2 Receptor Occupancy Estimated From Plasma Concentrations of Four Different Antipsychotics and the Subjective Experience of Physical and Mental Well-Being in Schizophrenia: Results From the Randomized NeSSy Trial. J Clin Psychopharmacol 2020; 39:550-560. [PMID: 31688449 DOI: 10.1097/jcp.0000000000001131] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Impaired subjective well-being in schizophrenia patients treated with antipsychotics has often been linked inter alia to the antidopaminergic effects of medication. Thus, it is important to capture the association between striatal dopamine D2 receptor occupancy (D2-RO) and global subjective well-being. We examined this association using data from our multicenter, randomized, double-blind Neuroleptic Strategy Study (NeSSy). METHODS An innovative double randomization process was used for allocation of patients to the specific treatment groups. Plasma drug concentrations were measured after 6 and 24 weeks of treatment to obtain the estimated D2-RO (eD2-RO) relative to literature values. We made an exploratory analysis of associations between eD2-RO and subjective well-being scores. One hundred two blood samples from 69 patients were available for the analysis. Because of the lack of a satisfactory occupancy model for quetiapine, only haloperidol, flupentixol, and olanzapine treatment groups were pooled, whereas aripiprazole data were analyzed separately, because of its partial agonistic properties. RESULTS In the pooled antagonist group, eD2-RO correlated negatively with the summarized well-being score. In a more detailed analysis, this association could be confirmed for all first-generation antipsychotic-treated patients, but not for the separate second-generation antipsychotic groups. In the aripiprazole group, higher eD2-RO was associated with impaired physical well-being, but had no association with mental well-being. CONCLUSIONS Our results suggest that high plasma levels and consequently high occupancy at D2 receptors are disadvantageous for subjective well-being, as distinct from the objective extrapyramidal side effects. To minimize patients' malaise, which disfavors adherence, implementation of therapeutic drug monitoring in the clinical routine may be useful.
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Marutani T, Chhim S, Nishio A, Nosaki A, Fuse-Nagase Y. Quality of life and its social determinants for patients with schizophrenia and family caregivers in Cambodia. PLoS One 2020; 15:e0229643. [PMID: 32130240 PMCID: PMC7055908 DOI: 10.1371/journal.pone.0229643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 02/11/2020] [Indexed: 11/30/2022] Open
Abstract
Due to inadequate human and financial resource support, the development of mental health services in Cambodia has been undertaken by various non-governmental organizations (NGOs). Schizophrenia is the most common functional psychotic disorder, causing severe and chronic symptoms, and the programs provided by the NGOs should have enhanced the quality of life (QoL) of patients and their caregivers; however, epidemiological research, which is a driving force behind the recognition of mental health as a global public health concern, is lacking for schizophrenia in Cambodia. This study therefore aimed to create QoL evaluation questionnaires available in Khmer (the Cambodian language) for patients with schizophrenia and family caregivers, and to identify the social determinants and predictors of their QoL. This cross-sectional study recruited 59 patients and 59 caregivers attending three clinics operated by two NGOs: the Transcultural Psychosocial Organization (TPO) Cambodia and the Supporters for Mental Health (SUMH) Cambodia. We conducted linguistic validation of the Schizophrenia Quality of Life Questionnaire 18-item version (S-QoL 18) and the Schizophrenia Caregiver Questionnaire (SCQ), then analyzed correlations between the QoL dimensions and socio-demographic factors. The main findings of this study were as follows: 1) the newly created Khmer versions of S-QoL 18 and SCQ are relatively good psychometric tools that are suitable for research to identify patients’ and caregivers’ needs to improve their QoL; and 2) engaging in paid work or being of the post-Khmer Rouge generation results in higher QoL for patients, but having low household economic status or being affected by chronic disease leads to lower QoL for family caregivers. These findings are useful for enabling community mental health professionals and aid organizations to create programs to lessen the patient and caregiver burden in Cambodia. Further research is necessary to develop practical projects that will improve patients’ and caregivers’ QoL in various clinical settings in Cambodia.
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Affiliation(s)
- Toshiyuki Marutani
- Health Support Center, Tokyo Institute of Technology, Yokohama, Japan
- Supporters for Mental Health, Tokyo, Japan
- * E-mail:
| | - Sotheara Chhim
- Transcultural Psychosocial organization Cambodia, Phnom Penh, Cambodia
| | - Akihiro Nishio
- Supporters for Mental Health, Tokyo, Japan
- Health Administration Center, Gifu University, Gifu, Japan
| | - Akiko Nosaki
- Supporters for Mental Health, Tokyo, Japan
- Psychiatric and Mental Health Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan
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Examining the Influence of Social Support on Psychological Distress in a Canadian Population with Symptoms of Mania. Psychiatr Q 2020; 91:251-261. [PMID: 31832975 DOI: 10.1007/s11126-019-09674-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Individuals who experience symptoms of mania in the form of a manic episode (ME) are at a greater risk of experiencing psychological distress. Given that a ME is a period during which one can become extremely socially dysfunctional, the potential influence of social support is especially important to explore. The primary objective of this study was to examine whether perceived social support predicts psychological distress in a sample of Canadian adults who have self-reported ME symptoms within the last 12-months. Using a cross-sectional, national datafile, 220 Canadians between 20 and 64 years who met the criteria for a ME within the last 12-months were investigated using the Social Provisions Scale (SPS), and the Kessler Psychological Distress Scale (K10). Results indicated that the ME sample experienced significantly higher distress and significantly lower perceived social support than the adult Canadian population. Further, social support in the form of reassurance of worth was associated with lower levels of psychological distress, but only for the male ME sample, and the overall (male and female combined) ME sample. Despite some limitations, this study adds to the research on mania as its own experience outside of comorbidities and indicates the important and specific role social support plays in terms of psychological well-being.
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Pinho LG, Pereira A, Chaves C, Sequeira C, Sampaio F, Correia T, Gonçalves A, Ferré‐Grau C. Affectivity in schizophrenia: Its relations with functioning, quality of life, and social support satisfaction. J Clin Psychol 2020; 76:1408-1417. [DOI: 10.1002/jclp.22943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Lara G. Pinho
- Escola Superior de Enfermagem São João de Deus Universidade de Évora Évora Portugal
- Escola Superior de Saúde do Instituto Politécnico de Portalegre Portalegre Portugal
- Comprehensive Health Research Centre (CHRC) Évora Portugal
- Universitat Rovira i Virgili Tarragona Spain
| | | | - Cláudia Chaves
- Instituto de Ciências Biomédicas Abel Salazar/SIGMA – Phi Xi Chapter Porto Portugal
- CI&DETS/Politécnico de Viseu Viseu Portugal
| | - Carlos Sequeira
- Escola Superior de Enfermagem do Porto, NURSID: CINTESIS Porto Portugal
| | - Francisco Sampaio
- Faculdade de Ciências da Saúde da Universidade Fernando Pessoa, Porto/NURSID: CINTESIS Porto Portugal
| | - Tânia Correia
- Instituto de Ciências Biomédicas Abel Salazar Porto Portugal
- NURSID: CINTESIS Porto Portugal
| | - Amadeu Gonçalves
- Politécnico de Viseu Viseu Portugal
- NURSID: CINTESIS/CI&DETS Porto Portugal
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Yang F, Cao X, Sun X, Wen H, Qiu J, Xiao H. Hair Cortisol Is Associated With Social Support and Symptoms in Schizophrenia. Front Psychiatry 2020; 11:572656. [PMID: 33192700 PMCID: PMC7541838 DOI: 10.3389/fpsyt.2020.572656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Psychosocial stressors may worsen psychotic symptoms in schizophrenia, while social support could protect against the effects of stress in schizophrenia. Hypothalamus-pituitary-adrenal axis dysfunction has been associated with schizophrenia. Hair cortisol concentrations (HCC) allow assessment of cumulative cortisol secretion over the preceding 3 months. The relationship between HCC, psychosocial stressors, social support, and the clinical characteristics of schizophrenia needs to be explored. METHODS One hundred nine schizophrenia patients and 86 healthy controls between the ages of 18 and 60 were enrolled in the study. Three-centimeter samples of hair were collected from the scalp and HCC were measured using ELISA kits. Linear regression and factor analysis were employed to examine the relationship between HCC, childhood trauma, the number of stressful life events (SLE), the amount of social support in the 3 months prior to the hair cortisol assessment and clinical characteristics of schizophrenia. RESULTS Schizophrenia patients experience more SLE in their lifetime, receive less social support, and have lower HCC in the recent 3 months compared to healthy controls. In the schizophrenia patients, HCC are positively associated with the amount of social support and negatively associated with the severity of delusions. The interaction between social support and SLE predicts decreased HCC. Factor analysis shows that a subgroup of schizophrenia patients who experience childhood trauma and SLE are characterized by decreased HCC. CONCLUSIONS Findings indicate social support could be a moderator for the relationship between SLE and HCC which may attenuate the effects of SLE in schizophrenia.
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Affiliation(s)
- Fuzhong Yang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xinyi Cao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiujia Sun
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Wen
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hua Xiao
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
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WITHDRAWN: The aspects of recovery from Schizophrenia: From The Indonesian Survivor’s Perspective. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Lima RJD, Pimenta CJL, Frazão MCLDO, Ferreira GRS, Costa TFD, Viana LRDC, Martins KP, Costa KNDFM. Functional capacity and social support to people affected by cerebrovascular accident. Rev Bras Enferm 2019; 72:868-873. [PMID: 31432940 DOI: 10.1590/0034-7167-2017-0854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 10/15/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate the functional capacity and its relationship with the level of social support to people affected by cerebrovascular accident. METHODS Cross-sectional and quantitative research, conducted with 108 individuals with sequelae of cerebrovascular accident in João Pessoa/PB. Data were collected through interviews, using a sociodemographic instrument - the Barthel Index and the Social Support Scale. RESULTS We observed the prevalence of functional dependency in 93.5%, and the mild dependency stood out in 40.7%. Medium social support was the most found, with 48.2%. The predominant dimensions of social support were the material dimension, followed by the emotional. There was a significant association (p ≤ 0.05) between very serious dependency and high social support. CONCLUSION The results found allow us to reflect on the need for involvement of health professionals in strengthening the social support of patients with disabling diseases, such as the cerebrovascular accident.
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Berry C, Othman E, Tan JC, Gee B, Byrne RE, Hodgekins J, Michelson D, Ng ALO, Marsh NV, Coker S, Fowler D. Assessing social recovery of vulnerable youth in global mental health settings: a pilot study of clinical research tools in Malaysia. BMC Psychiatry 2019; 19:188. [PMID: 31221136 PMCID: PMC6585120 DOI: 10.1186/s12888-019-2164-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 05/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A social recovery approach to youth mental health focuses on increasing the time spent in valuable and meaningful structured activities, with a view to preventing enduring mental health problems and social disability. In Malaysia, access to mental health care is particularly limited and little research has focused on identifying young people at risk of serious socially disabling mental health problems such as psychosis. We provide preliminary evidence for the feasibility and acceptability of core social recovery assessment tools in a Malaysian context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample. METHODS Nine vulnerable young people from low-income backgrounds were recruited from a non-government social enterprise and partner organisations in Peninsular Malaysia. Participants completed a battery of social recovery assessment tools (including time use, unusual experiences, self-schematic beliefs and values). Time for completion and completion rates were used as indices of feasibility. Acceptability was examined using qualitative interviews in which participants were asked to reflect on the experience of completing the assessment tools. Following a deductive approach, the themes were examined for fit with previous UK qualitative accounts of social recovery assessments. RESULTS Feasibility was indicated by relatively efficient completion time and high completion rates. Qualitative interviews highlighted the perceived benefits of social recovery assessments, such as providing psychoeducation, aiding in self-reflection and stimulating goal setting, in line with findings from UK youth samples. CONCLUSIONS We provide preliminary evidence for the feasibility and acceptability of social recovery assessment tools in a low-resource context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample. We also suggest that respondents may derive some personal and psychoeducational benefits from participating in assessments (e.g. of their time use and mental health) within a social recovery framework.
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Affiliation(s)
- Clio Berry
- School of Psychology, Pevensey I, University of Sussex, Falmer, Brighton, East Sussex, BN1 9QH, UK. .,Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HY, UK.
| | - Ellisha Othman
- SOLS HEALTH, SOLS 24/7, 1Petaling Commerz and Residential Condos, #G-8, Jalan, 1C/149, Off Jalan Sungai Besi, Sungai Besi, 57100 Kuala Lumpur, Malaysia
| | - Jun Chuen Tan
- SOLS HEALTH, SOLS 24/7, 1Petaling Commerz and Residential Condos, #G-8, Jalan, 1C/149, Off Jalan Sungai Besi, Sungai Besi, 57100 Kuala Lumpur, Malaysia
| | - Brioney Gee
- 0000 0001 1092 7967grid.8273.eClinical Psychology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk NR4 7TJ UK ,grid.451148.dResearch & Development, Norfolk & Suffolk NHS Foundation Trust, 80 St Stephens Road, Norwich, NR1 3RE UK
| | - Rory Edward Byrne
- 0000 0004 0430 6955grid.450837.dPsychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Psychosis Research UnitHarrop House, Prestwich Hospital, Bury New Road, Manchester, M25 3BL UK
| | - Joanne Hodgekins
- 0000 0001 1092 7967grid.8273.eClinical Psychology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk NR4 7TJ UK ,grid.451148.dResearch & Development, Norfolk & Suffolk NHS Foundation Trust, 80 St Stephens Road, Norwich, NR1 3RE UK
| | - Daniel Michelson
- 0000 0004 1936 7590grid.12082.39School of Psychology, Pevensey I, University of Sussex, Falmer, Brighton, East Sussex BN1 9QH UK
| | - Alvin Lai Oon Ng
- SOLS HEALTH, SOLS 24/7, 1Petaling Commerz and Residential Condos, #G-8, Jalan, 1C/149, Off Jalan Sungai Besi, Sungai Besi, 57100 Kuala Lumpur, Malaysia ,grid.430718.9Department of Psychology, Faculty of Science and Technology, Sunway University, No. 5, Jalan Universiti, Bandar Sunway, Petaling Jaya, Selangor Malaysia
| | - Nigel V. Marsh
- grid.456586.cDepartment of Psychology, James Cook University, 149 Sims Drive, Singapore, 387380 Singapore
| | - Sian Coker
- SOLS HEALTH, SOLS 24/7, 1Petaling Commerz and Residential Condos, #G-8, Jalan, 1C/149, Off Jalan Sungai Besi, Sungai Besi, 57100 Kuala Lumpur, Malaysia ,0000 0001 1092 7967grid.8273.eClinical Psychology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk NR4 7TJ UK ,grid.430718.9Department of Psychology, Faculty of Science and Technology, Sunway University, No. 5, Jalan Universiti, Bandar Sunway, Petaling Jaya, Selangor Malaysia
| | - David Fowler
- 0000 0004 1936 7590grid.12082.39School of Psychology, Pevensey I, University of Sussex, Falmer, Brighton, East Sussex BN1 9QH UK
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Choo CC, Chew PKH, Tan P, Choo JQ, Choo AMH, Ho RC, Quah TC. Health-Related Quality of Life in Pediatric Patients with Leukemia in Singapore: A Cross-Sectional Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122069. [PMID: 31212740 PMCID: PMC6617504 DOI: 10.3390/ijerph16122069] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 11/17/2022]
Abstract
There has been a paradigm shift in health service delivery to a more holistic approach, which considers Quality of Life (QoL) and overall functioning. Health-Related Quality of Life (HRQoL) is a multidimensional construct that encompasses physical functioning as well as psychosocial aspects of emotional and social functioning. This study explored factors related to HRQoL in Asian pediatric patients with leukemia in Singapore. The available variables included: age, treatment duration, household income, gender, ethnicity, religion, diagnosis, and phase of treatment. It is hypothesized that the relationships will be significant. In the current study, there were 60 patients (60% males) with leukemia; their ages ranged from 1 to 21 years (Mean = 8.03, Standard Deviation = 4.55). The hypothesis was partially supported. Age had a significant positive relationship with physical functioning, r(60) = 0.28, p < 0.05, physical health, r(60) = 0.28, p < 0.05, and the total HRQoL score, r(60) = 0.29, p < 0.05. Treatment duration had a positive relationship with school functioning, r(60) = 0.28, p < 0.05. All other correlations were statistically non-significant. The effects of the available psychosocial variables of gender, ethnicity, and religion were examined on scores from the Pediatric Quality of Life Inventory (PedsQL). Ethnicity had a significant effect on social functioning, U = 292.00, p < 0.05, r = 0.3 (medium effect size). Specifically, Chinese (Median = 85.00, n = 33) had significantly higher scores on social functioning than others (Median = 70.00, n = 27). The remaining comparisons were statistically non-significant. The current findings added to QoL research, and provided an impetus for more research in the area of HRQoL for children with leukemia in Singapore.
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Affiliation(s)
- Carol C Choo
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore.
| | - Peter K H Chew
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore.
| | - Pinhong Tan
- Department of Pediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Jessica Q Choo
- Department of Pediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Amanda M H Choo
- Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SP, UK.
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 117599, Singapore.
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam.
- Faculty of Education, Huaibei Normal University, 100 Dongshan Road, Huaibei 235000, China.
| | - Thuan Chong Quah
- Department of Pediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
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Filipčić I, Šimunović Filipčić I, Grošić V, Bakija I, Šago D, Benjak T, Uglešić B, Bajić Ž, Sartorius N. Patterns of chronic physical multimorbidity in psychiatric and general population. J Psychosom Res 2018; 114:72-80. [PMID: 30314582 DOI: 10.1016/j.jpsychores.2018.09.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE A growing body of evidence has demonstrated the high prevalence and complexity of chronic physical multimorbidity defined as ≥2 chronic physical illness in people with psychiatric disorders. The present study aimed to assess differences in the prevalence and patterns of self-reported chronic physical illness and multimorbidity in the general and psychiatric populations. METHODS We performed a latent class analysis of 15 self-reported chronic physical illnesses on a sample of 1060 psychiatric patients and 837 participants from the general population. RESULTS Self-reported chronic physical illness and multimorbidity were significantly more prevalent in the population of psychiatric patients than in the general population (P < .001). Psychiatric patients had 27% (CI95% 24% - 30%) higher age-standardized relative risk for chronic physical illness and a 31% (CI95% 28% - 34%) higher for multimorbidity (P < .001). The number of chronic physical illnesses combinations was 52% higher in the psychiatric than in general population (255 vs 161 combinations respectively; P < .001). We identified four distinct latent classes: "Relatively healthy", "Musculoskeletal", "Hypertension and obesity", and "Complex multimorbidity" with no significant differences in the nature of multimorbidity latent classes patterns. The class "Relatively healthy" was significantly less (ARI = -25% (CI95% -30% -21%), and the class "Hypertension and obesity" was significantly more prevalent in the population of psychiatric patients (ARI = 20% (CI95% 17% - 23%). CONCLUSIONS These findings indicate that mental disorders are associated with an increased risk of a wide range of chronic physical illnesses and multimorbidity. There is an urgent need for the development of the guidelines regarding the physical healthcare of all individuals with mental disorders with multimorbidity in focus.
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Affiliation(s)
- Igor Filipčić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| | | | | | - Ivana Bakija
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Daniela Šago
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | | | - Boran Uglešić
- Department of Psychiatry, University Hospital Center Split, Split, Croatia
| | - Žarko Bajić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
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Lu L, Zeng LN, Zong QQ, Rao WW, Ng CH, Ungvari GS, Li J, An FR, Xiang YT. Quality of life in Chinese patients with schizophrenia: A meta-analysis. Psychiatry Res 2018; 268:392-399. [PMID: 30125870 DOI: 10.1016/j.psychres.2018.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/27/2018] [Accepted: 07/04/2018] [Indexed: 12/19/2022]
Abstract
The impact of schizophrenia on quality of life (QOL) is significantly influenced by sociocultural factors. This meta-analysis systematically compared QOL between patients with schizophrenia and healthy controls in China. PubMed, PsycINFO, Embase, Chinese National Knowledge Infrastructure (CNKI), SinoMed and WanFang databases were searched to identify case-control studies. Standardized mean differences (SMDs) and 95% confidence interval (CI) were calculated using random effect models. Eighteen case-control studies comparing QOL between schizophrenia patients (n = 2,425) and healthy controls (n = 2,072) were included in the analyses. Compared with healthy controls, schizophrenia patients had significantly poorer overall QOL [11 studies; SMD:-1.07 (95%CI:-1.44, -0.70), P < 0.001] as well as in the physical, psychological, social and environmental QOL domains. Subgroup analyses revealed that poorer QOL was significantly associated with diagnostic criteria, study location, female gender, older age and inpatient status. Older schizophrenia patients had lower physical and psychological QOL, while inpatients had lower psychological QOL. In conclusion, compared with healthy controls, schizophrenia patients in China have significantly lower QOL.
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Affiliation(s)
- Li Lu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Liang-Nan Zeng
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qian-Qian Zong
- School of Nursing, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Gabor S Ungvari
- University of Notre Dame Australia & Graylands Hospital, Perth, Australia
| | - Jun Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China.
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Hamilton JE, Heads AM, Meyer TD, Desai PV, Okusaga OO, Cho RY. Ethnic differences in the diagnosis of schizophrenia and mood disorders during admission to an academic safety-net psychiatric hospital. Psychiatry Res 2018; 267:160-167. [PMID: 29908484 DOI: 10.1016/j.psychres.2018.05.043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 03/24/2018] [Accepted: 05/18/2018] [Indexed: 01/26/2023]
Abstract
U.S. Hispanics, now the single largest minority group in the country, face unique mental health disparities. The current study utilizes Andersen's Behavioral Model of Health Service Use to examine ethnic disparities in receiving a schizophrenia or mood disorder diagnosis at psychiatric hospital admission. Our retrospective cohort study examined electronic health record data at an academic safety-net psychiatric hospital for adult patients (n = 5571) admitted between 2010 and 2013. Logistic regression with block-wise entry of predisposing, enabling and need variables was used to examine ethnic disparities in receiving a schizophrenia diagnosis at admission. The block of need factors was the strongest predictor of receiving a schizophrenia diagnosis compared to predisposing and enabling factors. Compared to non-Hispanic whites, Hispanics and African Americans had a greater likelihood of receiving a schizophrenia diagnosis at admission. Additionally, patients diagnosed with schizophrenia had elevated positive and negative symptoms and were more likely to be male, single/unmarried, homeless, high inpatient service utilizers, involuntarily hospitalized, and to exhibit functional impairment at psychiatric hospital admission. To address elevated positive and negative symptoms of schizophrenia, functional impairment, social withdrawal, and high inpatient service utilization, promising psychosocial interventions should be adapted for racial and ethnic minority populations and utilized as an adjuvant to antipsychotic medication.
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Affiliation(s)
- Jane E Hamilton
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA; UTHealth Harris County Psychiatric Center, Houston, TX, USA.
| | - Angela M Heads
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Thomas D Meyer
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Pratikkumar V Desai
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Olaoluwa O Okusaga
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston,TX, USA
| | - Raymond Y Cho
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston,TX, USA
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Costa R, Bastos T, Probst M, Seabra A, Vilhena E, Corredeira R. Autonomous motivation and quality of life as predictors of physical activity in patients with schizophrenia. Int J Psychiatry Clin Pract 2018; 22:184-190. [PMID: 29421942 DOI: 10.1080/13651501.2018.1435821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM Being physically active is a complex behaviour in patients with schizophrenia. Several factors were identified as barriers to achieving active behaviours in this population. Therefore, the purpose of this study was to investigate among a number of barriers what predicts the most on physical activity (PA) in patients with schizophrenia. METHODS A total of 114 patients (28♀) with schizophrenia were included. Body mass index (BMI) was calculated. Autonomous and controlled motivation (Behavioural Regulation in Exercise Questionnaire - 3), self-esteem (Rosenberg Self-esteem scale), quality of life (World Health Organization Quality of Life Scale - Brief version) and functional exercise capacity (6-minute walk test - 6MWT) were evaluated. Multiple Regression Analysis was applied to assess the effect of these variables on Total PA per week (International Physical Activity Questionnaire - short version). RESULTS Autonomous motivation and domains of quality of life were positively correlated with Total PA per week. Stepwise multiple regression analyses showed that of all the candidate factors to predict PA, autonomous motivation and global domain of quality of life were found as significant predictors. CONCLUSION Our findings help to understand the importance of autonomous motivation and quality of life for PA in patients with schizophrenia. Knowledge about these predictors may provide guidance to improve PA behaviour in this population.
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Affiliation(s)
- Raquel Costa
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport , University of Porto , Porto , Portugal
| | - Tânia Bastos
- b Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport , University of Porto , Porto , Portugal.,c Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD , University Institute of Maia, ISMAI , Maia , Portugal
| | - Michel Probst
- d Faculty of Kinesiology and Rehabilitation Sciences, Research Group for Adapted Physical Activity and Psychomotor Rehabilitation , KU Leuven , Leuven , Belgium
| | - André Seabra
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport , University of Porto , Porto , Portugal
| | - Estela Vilhena
- e Technology School, Polytechnic Institute of Cavado and Ave; EPIUnit-ISPUP , University of Porto , Porto , Portugal
| | - Rui Corredeira
- a Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport , University of Porto , Porto , Portugal
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Association of lifestyle-related factors and psychological factors on quality of life in people with schizophrenia. Psychiatry Res 2018; 267:382-393. [PMID: 29960260 DOI: 10.1016/j.psychres.2018.06.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 06/09/2018] [Accepted: 06/10/2018] [Indexed: 02/07/2023]
Abstract
In people with schizophrenia several factors are associated with poor quality of life (QoL), namely, lifestyle-related factors and psychological factors. However, there has been little research on the impact of these factors on QoL. Therefore, the relation between lifestyle-related factors, psychological factors, and QoL in people with schizophrenia was assessed. A cross-sectional study was conducted among 115 patients (25% women, 50% inpatients). QoL was measured by World Health Organisation Quality of Life- Brief Version. Lifestyle-related factors were assessed, namely physical activity (International Physical Activity Questionnaire- Short Form), sleep quality (Pittsburgh Sleep Quality Index) and dietary intake (Mediterranean Diet score). Psychological factors such as self-esteem (Rosenberg Self-Esteem Scale) and autonomous motivation (Behavioural Regulation Questionnaire- version 3) were also measured. Regression analyses were performed to identify significant predictors of QoL. Results showed that self-esteem predicted better global, physical, psychological and environmental QoL. Physical activity predicted better global and physical QoL, while sedentary time predicted poor social and environmental QoL. Identifying predictors of QoL has implication for the effective design and delivery of lifestyles interventions, including physical activity, dietary education and smoking cessation in people with schizophrenia. Adopting healthy lifestyles may lead to improved physical health, psychological well-being and QoL in this population.
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Abstract
PURPOSE OF REVIEW Schizophrenia has a heterogeneous range of end states, from severe cases requiring repeated hospitalization to cases in which a single illness episode is followed by complete remission. The purpose of the present review is to examine recent literature on recovery in schizophrenia, focusing on the predictive factors and on the possibility to achieve it. RECENT FINDINGS Roughly half of schizophrenia patients recovered or significantly improved over the long term, suggesting that functional remission is possible. Several factors predict the course of schizophrenia, including demographic, clinical, and treatment characteristics, as well as socioeconomic variables. Antipsychotics are a fundamental element of schizophrenia treatment, although the available antipsychotics have significant limitations. In this context, psychosocial interventions are supported by substantial evidence of efficacy in many outcome measures and rehabilitation interventions should be considered as an evidence-based practice and need to become a part of the standard treatment of schizophrenia. SUMMARY As recovery is a multidimensional concept, some authors suggested that at least two areas should be taken into account: clinical remission and social functioning. Functional outcome should be a priority target for therapeutic interventions in schizophrenia and in this perspective measuring treatment response, remission and functional recovery is essential. Only an integrated and multifaceted approach involving pharmacotherapy, psychosocial interventions, and attention to environmental circumstances can improve outcome in schizophrenia.
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Choo CC, Chew PKH, Ho CS, Ho RC. Quality of Life in Patients With a Major Mental Disorder in Singapore. Front Psychiatry 2018; 9:727. [PMID: 30713508 PMCID: PMC6346635 DOI: 10.3389/fpsyt.2018.00727] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/10/2018] [Indexed: 11/29/2022] Open
Abstract
Background: There has been a paradigm shift in mental health service delivery, from a focus on reducing symptoms to a more holistic approach, which considers Quality of Life (QoL). Method: This study aimed to explore prediction of Quality of Life (QoL) in Asian patients with a major mental disorder i.e., depression or schizophrenia in Singapore. In the current study, there were 43 patients (65.1% females) with depression. Their ages ranged from 18 to 65 (M = 44.63, SD = 12.22). The data were combined with the data on patients with schizophrenia, where there were 43 patients (65.1% females) with schizophrenia, their ages ranging from 18 to 65 (M = 44.60, SD = 12.19). Results: The components of QoL were examined i.e., Physical Component Summary (PCS) and Mental Component Summary (MCS). For all patients, social support and age accounted for 17.3% of the variance in PCS, F (2, 83) = 8.66, p < 0.001. For patients with depression, disorder severity, age, and duration of treatment accounted for 48.3% of the variance in PCS, F (3, 39) = 12.15, p < 0.001. For patients with schizophrenia, education (Primary or Lower vs. Post-Secondary or Higher) and emotional coping accounted for 21.3% of the variance in PCS, F (2, 40) = 5.40, p < 0.01. For all patients, self-efficacy and age accounted for 27.0% of the variance in MCS, F (2, 83) = 15.37, p < 0.001. For patients with depression, disorder severity accounted for 45.6% of the variance in MCS, F (1, 41) = 34.33, p < 0.001. For patients with schizophrenia, number of hospitalizations accounted for 18.5% of the variance in MCS, F (1, 41) = 9.29, p < 0.01. Conclusion: The findings were discussed in regards to implications in interventions to enhance QoL of patients with schizophrenia and depression in Singapore.
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Affiliation(s)
- Carol C Choo
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore, Singapore
| | - Peter K H Chew
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore, Singapore
| | - Cyrus S Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
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Choo CC, Chew PKH, Ho CS, Ho RC. Prediction of Quality of Life in Asian Patients with Schizophrenia: A Cross-sectional Pilot Study. Front Psychiatry 2017; 8:198. [PMID: 29051741 PMCID: PMC5634161 DOI: 10.3389/fpsyt.2017.00198] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/21/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There has been a shift in mental health services from an emphasis on treatment focused on reducing symptoms to a more holistic approach involving quality of life (QOL) and overall well-being. Many psychosocial variables are associated with QOL but a parsimonious framework is needed to deepen our understanding about the contribution of psychosocial factors in influencing the QOL of Asian patients with schizophrenia in Singapore. The study aimed to address the current gap in literature by analysis of QOL using available predictors in Asian patients with schizophrenia in Singapore. METHODS 43 Singaporean patients diagnosed with schizophrenia were recruited at a large teaching hospital in Singapore from January to May 2010 and were invited to complete questionnaires. Of the sample, 65.1% were females, ages ranged from 18 to 65 (M = 44.60, SD = 12.19). Available variables were subjected to regression analysis. FINDINGS The data were analyzed using SPSS Version 23 with the alpha level set at 0.05. The final model with five predictors was significant in predicting QOL. Positive Re-appraisal, Social Support, Avoidant Coping, Duration of Hospitalization, and Education accounted for 47.2% of the variance (Adjusted R2 = 40.0%) in QOL, F (5, 37) = 6.60, p < 0.001. Those with post-secondary or higher education had higher QOL than those with secondary or lower education. Duration of hospitalization negatively predicted QOL. CONCLUSION The findings were discussed in regards to clinical implications for informing interventions to enhance QOL in patients with schizophrenia.
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Affiliation(s)
- Carol C Choo
- College of Healthcare Sciences, James Cook University Singapore, Singapore, Singapore
| | - Peter K H Chew
- College of Healthcare Sciences, James Cook University Singapore, Singapore, Singapore
| | - Cyrus S Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Roger C Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
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