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Evans M, Cuddeback GS, Golin C, Muessig K, Bellamy C, Costa M, O'Connell M, Fisher EB. Diverse elements comprising studies of peer support complicate evidence synthesis. J Ment Health 2024:1-15. [PMID: 38556804 DOI: 10.1080/09638237.2024.2332798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 01/20/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Innovative approaches to care, such as peer support, are needed to address the substantial and frequently unmet needs of people with serious mental illnesses such as schizophrenia. Although peer support services continue to expand in mental healthcare, findings of effectiveness from systematic reviews are mixed. However, the studies evaluated in these reviews consisted of diverse elements which the review methods neglected to consider. AIMS This review aims to demonstrate the substantial diversity in intervention components and measured outcomes among studies of peer support and lay the groundwork for more focused reviews of individual intervention components. METHODS As part of a realist review of the literature, here we synthesize evidence in a way that examines the substantial diversity in intervention components and measured outcomes comprising studies of peer support. RESULTS Seven categories of outcomes were represented, including recovery, symptoms and functioning, and care utilization. Importantly, seven distinct intervention components were represented in 26 studies: "being there," assistance in self-management, linkage to clinical care and community resources, social and emotional support, ongoing support, explicit utilization of shared lived experience or peer support values, and systems advocacy. Reflecting diversity in approaches, no study reported all intervention components, and no component was found among all studies. IMPLICATIONS Peer support services constitute a category of intervention approaches far too varied to evaluate as a single entity. Results suggest intervention components deserving more focused research, including assistance in self-management, "being there," and explicit utilization of shared lived experience or peer support values. PRISMA/PROSPERO As this article reports results from a realist review of the literature, we did not follow the PRISMA guidance which is suitable for systematic reviews. We did follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines.This review was not registered on PROSPERO as it is not a systematic review.
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Affiliation(s)
- Megan Evans
- Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Gary S Cuddeback
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
| | - Carol Golin
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kathryn Muessig
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Chyrell Bellamy
- Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Mark Costa
- Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Maria O'Connell
- Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Edwin B Fisher
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Murphy SM, Flores AT, Wojtalik JA, Keshavan MS, Eack SM. Symptom contributors to quality of life in schizophrenia: Exploratory factor and network analyses. Schizophr Res 2024; 264:494-501. [PMID: 38281419 PMCID: PMC11005863 DOI: 10.1016/j.schres.2024.01.028] [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: 07/14/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 01/30/2024]
Abstract
Individuals with schizophrenia and other associated disorders experience significant disturbance to their quality of life (QoL) due to a multitude of co-occurring symptoms. Popular evidence-based practices (EBPs) devote significant effort to reduce positive symptomatology in order to prevent relapse, while emerging research posits that other symptoms (cognitive deficits, negative and affective symptoms) are more indicative of QoL disturbance. This study sought to examine the impact of symptom constructs on QoL and attempt to infer directionality of influence via network analysis. A total of 102 recovery phase adult outpatients with schizophrenia spectrum disorders were assessed on positive, negative, and affective symptomatology, in addition to QoL and cognitive abilities. Exploratory factor analysis and network analysis were performed to identify associations and infer directed influence between symptom constructs, and a directed acyclic graph was constructed to observe associations between symptom domains and QoL. Factor analysis results indicated that individual measures align with their respective symptom constructs. Strong factor correlations were found between QoL and the negative and affective symptom constructs, with weaker associations found between positive symptoms and cognition. Visualization of the network structure illustrated QoL as the central cluster of the network, and examination of the weighted edges found the strongest connectivity between QoL, negative symptomatology, and affective symptoms. More severe negative and affective symptoms were most directly linked with poorer QoL and may prove to be integral in attaining positive outcomes in schizophrenia treatment. Incorporation of psychosocial treatments in addition to pharmacotherapy may prove effective in targeting negative and affective symptoms.
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Affiliation(s)
- Samuel M Murphy
- School of Social Work, University of Pittsburgh, United States of America; Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America.
| | - Ana T Flores
- School of Social Work, University of Pittsburgh, United States of America; Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Jessica A Wojtalik
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, United States of America
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, United States of America
| | - Shaun M Eack
- School of Social Work, University of Pittsburgh, United States of America; Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
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Petkari E, Nikolaou E, Oberleiter S, Priebe S, Pietschnig J. Which psychological interventions improve quality of life in patients with schizophrenia-spectrum disorders? A meta-analysis of randomized controlled trials. Psychol Med 2024; 54:221-244. [PMID: 37859606 DOI: 10.1017/s0033291723003070] [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: 10/21/2023]
Abstract
Quality of life (QoL) is a major patient reported outcome used to measure the psychological treatments success in people with schizophrenia-spectrum disorders. To date, the specific impact of different interventions on QoL remains undefined. A meta-analysis of Randomized Controlled Trials (RCTs) was carried out for this purpose. We searched Proquest, PUBMED/MEDLINE, PsycINFO, WOS, Scopus, the Cochrane Library for RCTs published until January 2023. We used multilevel meta-analysis to examine differences between intervention effectiveness of experimental and control conditions whilst accounting for data dependencies. By means of subgroup analyses, we investigated influences of intervention types (i.e. psychoeducation v. CBT v. cognitive v. combination of several types v. other, such as psychodynamic, systemic, etc.) and continuous moderators were examined with precision-weighted meta-regressions. The generalizability of results across moderators, their combinations, and analytical approaches was investigated with multiverse meta-analyses. We examined data of 60 independent studies, reporting intervention effects for objective and subjective QoL (k = 19 and 70 effect sizes based on N = 1024 and 6254 participants, respectively). Overall, psychological interventions seemed to be more effective for objective than for subjective QoL. However, specific intervention results were differentiated, suggesting largest effects of psychoeducation on objective and combined interventions on subjective QoL. Our findings suggest that QoL is a valid outcome criterion for testing intervention effectiveness, as it is sensitive to change. Additionally, psychological interventions can improve patients' QoL, though the effects are small. Further testing of less widely used interventions and a shift toward the multidimensional nature of QoL is still necessary.
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Affiliation(s)
- Eleni Petkari
- Faculty of Health Sciences, Universidad Internacional de La Rioja (UNIR), Logroño, Spain
| | - Elena Nikolaou
- Licensed Clinical Psychologist, Independent Practice, Nicosia, Cyprus
| | - Sandra Oberleiter
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Jakob Pietschnig
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
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Jupille J, Harscoet YA, Duval M, Grall-Bronnec M, Moret L, Chirio-Espitalier M. "What makes you well?" Supports of well-being in bipolar disorder. A qualitative study. Int J Qual Stud Health Well-being 2023; 18:2244763. [PMID: 37660342 PMCID: PMC10478622 DOI: 10.1080/17482631.2023.2244763] [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: 01/31/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVE Subjective experience of people living with bipolar disorder is gaining attention in the field of research. Improving well-being could be as important as symptom remission, but this constitutes a vague concept. This study aimed at exploring the boundaries and the determinants of the well-being of people living with bipolar disorder in a French context. METHODS Individual semi-structured interviews were conducted with 16 patients by three professionals. Interviews were transcribed and analysed using the thematic analysis method. RESULTS Various dimensions emerged as contributing to well-being: daily routines, connectedness, regaining a positive identity, and self-awareness for self-management. CONCLUSIONS In addition to those common to the general population, this study highlighted specific determinants of well-being: the construction of a positive identity through acceptance of the diagnosis, the importance of self-awareness and self-management. They are highly intertwined with those of personal recovery and could help caregivers design interventions that directly target these goals. This study aimed to identify specific components of well-being for people living with bipolar disorder. Understanding the determinants of well-being enable caregivers to design tailored interventions that directly target quality of life and help improve bipolar disorder outcomes.
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Affiliation(s)
- Julien Jupille
- CRehab’S, Support Center for Psychosocial Rehabilitation in the Loire Region, Nantes University Hospital and Angevin Mental Health Center, Sainte Gemmes sur Loire, France
| | | | - Mélanie Duval
- Nantes Université, CHU Nantes, UIC Psychiatrie Et Santé Mentale, Nantes, France
| | - Marie Grall-Bronnec
- Nantes Université, CHU Nantes, UIC Psychiatrie Et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Leila Moret
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
- University Hospital Centre Nantes Department of Medical Information Evaluation and Public Health, Nantes, Pays de la Loire, France
| | - Marion Chirio-Espitalier
- Nantes Université, CHU Nantes, UIC Psychiatrie Et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
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Petkari E. Can we really define the effect of psychological interventions on Quality of Life for patients with schizophrenia based on the most recent meta-analysis in the field? Psychiatry Res 2023; 323:115149. [PMID: 37005133 DOI: 10.1016/j.psychres.2023.115149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 04/04/2023]
Affiliation(s)
- Eleni Petkari
- School of Health, Universidad Internacional de la Rioja, Av. de la Paz, 137, 26006 Logroño, Spain.
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Efficacy of Serotonin and Dopamine Activity Modulators in the Treatment of Negative Symptoms in Schizophrenia: A Rapid Review. Biomedicines 2023; 11:biomedicines11030921. [PMID: 36979900 PMCID: PMC10046337 DOI: 10.3390/biomedicines11030921] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Schizophrenia is among the fifteen most disabling diseases worldwide. Negative symptoms (NS) are highly prevalent in schizophrenia, negatively affect the functional outcome of the disorder, and their treatment is difficult and rarely specifically investigated. Serotonin-dopamine activity modulators (SDAMs), of which aripiprazole, cariprazine, brexpiprazole, and lumateperone were approved for schizophrenia treatment, represent a possible therapy to reduce NS. The aim of this rapid review is to summarize the evidence on this topic to make it readily available for psychiatrists treating NS and for further research. We searched the PubMed database for original studies using SDAM, aripiprazole, cariprazine, brexpiprazole, lumateperone, schizophrenia, and NS as keywords. We included four mega-analyses, eight meta-analyses, two post hoc analyses, and 20 clinical trials. Aripiprazole, cariprazine, and brexpiprazole were more effective than placebo in reducing NS. Only six studies compared SDAMs with other classes of antipsychotics, demonstrating a superiority in the treatment of NS mainly for cariprazine. The lack of specific research and various methodological issues, related to the study population and the assessment of NS, may have led to these partial results. Here, we highlight the need to conduct new methodologically robust investigations with head-to-head treatment comparisons and long-term observational studies on homogeneous groups of patients evaluating persistent NS with first- and second-generation scales, namely the Brief Negative Symptom Scale and the Clinical Assessment Interview for Negative Symptoms. This rapid review can expand research on NS therapeutic strategies in schizophrenia, which is fundamental for the long-term improvement of patients’ quality of life.
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Saavedra J, Brzeska J, Matías-García JA, Arias-Sánchez S. Quality of life and psychiatric distress in people with serious mental illness, the role of personal recovery. Psychol Psychother 2023; 96:525-541. [PMID: 36786401 DOI: 10.1111/papt.12451] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/28/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES When considering the personal recovery of people with serious mental illness (SMI), it is essential to examine their reported psychiatric distress and quality of life (QoL). However, there is no consolidated model in the literature that clearly relates these variables. In this study we first analysed the relationships between QoL, psychiatric distress and recovery, and several sociodemographic variables. Second, we analysed the linear effects of psychiatric distress and recovery on QoL. Third, and most important, we tested two hypotheses that considered personal recovery as a moderator or mediator of the relationship between psychiatric distress and QoL. DESIGN AND METHODS 234 volunteers with a diagnosis of SMI completed three self-report questionnaires, The Recovery Assessment Scale-24, The World Health Organization QoL and the Clinical Outcomes in Routine Evaluation-Outcome Measure, which showed very good levels of validity and reliability. The PROCESS macro for SPSS developed by Hayes (Introduction to mediation, moderation, and conditional process analysis: A regression-based approach, The Guilford Press, 2022) was applied using the Bootstrap method to verify our moderation and mediation hypotheses. RESULTS We found a negative linear effect of psychiatric distress on QoL, as well as a positive effect of recovery on said variable. Our results do not confirm the moderating effect of recovery on the relationship between distress and QoL. However, we do confirm the second hypothesis; recovery functioned as a mediating variable between psychiatric distress and QoL. CONCLUSIONS These findings allow us to reflect on how personal recovery affect the relationship between psychiatric distress and QoL and discuss its theoretical and practical implications as public policies.
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Affiliation(s)
- Javier Saavedra
- Department of Experimental Psychology, University of Seville, Sevilla, Spain
| | - Joanna Brzeska
- Department of Experimental Psychology, University of Seville, Sevilla, Spain
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Ogakwu NV, Ede MO, Manafa IF, Okeke CI, Onah SO. Quality of Work-Life and Stress Management in a Rural Sample of Primary School Teachers: An Intervention Study. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2023. [DOI: 10.1007/s10942-022-00494-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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9
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Stefanatou P, Tsompanaki E, Lavdas M, Giannouli E, Ralli I, Kalogerakou S, Anyfandi E, Stylianidis S, Stefanis N, Mavreas V, Konstantakopoulos G. Patient-reported needs predict perceived psychosocial disability and quality of life beyond symptom severity in schizophrenia. Disabil Rehabil 2023; 45:655-663. [PMID: 35191793 DOI: 10.1080/09638288.2022.2040610] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE We examined whether patient-rated or clinician-rated needs are more strongly associated with perceived psychosocial disability (PPD) and subjective quality of life (SQOL) of schizophrenia patients, beyond symptom severity. METHODS Hierarchical regression analyses were computed to test patient and clinician-rated unmet and met needs (estimated by eighty-two patient-clinician pairs) as predictors of PPD and SQOL above and beyond demographics and psychopathology. Needs, symptomatology, PPD and SQOL were estimated using Camberwell Assessment of Need (CAN), PANSS, WHODAS 2.0 and WHOQOL-BREF respectively. RESULTS Needs were significantly associated with all WHODAS 2.0 and WHOQOL-BREF domains above and beyond demographics and PANSS variables. Clinician-rated needs were better predictors of only one WHODAS 2.0 domain, while patient-rated needs were better predictors of all other WHODAS 2.0 and WHOQOL-BREF domains. Patient-rated unmet needs were more strongly than met needs associated with the most WHODAS 2.0 and WHOQOL-BREF subscores. CONCLUSION This study offers the first evidence that patient-rated needs, especially unmet needs, are strongly associated, above and beyond symptomatology, with global and domain-specific PPD of schizophrenia patients. Accordingly, strong relations of patient-rated needs with SQOL emerged. Identifying and addressing patient-reported needs could facilitate PPD and SQOL improvement more effectively than interventions confined solely to symptom remission.IMPLICATIONS FOR REHABILITATIONSchizophrenia is associated with poor rehabilitation and recovery outcomes, i.e., perceived psychosocial disability (PPD) and subjective quality of life (SQOL).Assessment of patients' needs constitutes the basis of determining treatment goals and planning tailor-made interventions to achieve crucial rehabilitative outcomes.Higher levels of patient-reported unmet needs are associated with poorer SQOL and higher global and domain-specific PPD of schizophrenia patients, above and beyond symptom severity.Addressing patient-reported needs through personalized interventions can facilitate more effectively PPD and SQOL improvement, than treatment confined to symptomatic alleviation.
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Affiliation(s)
- Pentagiotissa Stefanatou
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evgenia Tsompanaki
- Department of Statistics, School of Information Sciences and Technology, Athens University of Economics and Business, Athens, Greece
| | - Michalis Lavdas
- Department of Psychosocial Science, Society and Workplace Diversity Research Group, University of Bergen, Bergen, Norway
| | - Eleni Giannouli
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Ralli
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stamatina Kalogerakou
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | - Eleni Anyfandi
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stelios Stylianidis
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece.,Association for Regional Development and Mental Health - EPAPSY, Athens, Greece
| | - Nikos Stefanis
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,University Mental Health, Neurosciences and Precision Medicine Research Institute "Costas Stefanis", Athens, Greece
| | | | - George Konstantakopoulos
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Jun WH, Na H. The Mediating Role of Positive Thinking on the Relationship Between Depression and Functional Recovery in Community-Dwelling People With Schizophrenia. J Psychosoc Nurs Ment Health Serv 2023; 61:44-52. [PMID: 36322868 DOI: 10.3928/02793695-20221027-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Functional recovery as a consumer-centered approach is critical to recovery for community-dwelling people with schizophrenia. The current study investigated the mediating role of positive thinking in the relationship between depression and functional recovery in community-dwelling people with schizophrenia in South Korea. Depression, positive thinking, and functional recovery measures were completed by 158 people with schizophrenia in the community with self-reported questionnaires. Depression had a significantly negative influence on functional recovery. Positive thinking fully mediated the relationship between depression and functional recovery. An effective intervention strategy for functional recovery in this population may reinforce positive thinking and depression management. [Journal of Psychosocial Nursing and Mental Health Services, 61(2), 44-52.].
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Ogakwu NV, Ede MO, Manafa I, Ede KR, Omeke F, Agu PU, Nwosu N, Onah SO, Oneli JO, Okereke GKO. Occupational health coaching for job stress management among technical college teachers: Implications for educational administrators. Medicine (Baltimore) 2023; 102:e32463. [PMID: 36607869 PMCID: PMC9829259 DOI: 10.1097/md.0000000000032463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The need for stress management strategies has been empirically investigated and supported considering demands in workplaces. However, some people in public offices do not seem to have been exposed to occupational health strategies that could reduce the adverse impacts of stress on job productivity and quality of life. Consequently, they become susceptible to mental health disturbances requiring the attention of occupational therapists. Given this, we studied the impact of occupational health coaching for job stress management among technical college teachers. METHODS Using a randomized control design study, 90 technical college teachers were screened and ready to participate. The eligible teachers were included and assigned to intervention and control groups. An occupational stress index was given to the participants before, immediately after, and 2 months after the delivery of occupational coaching program by career counselors while the comparison group received no intervention. Data collected were analyzed using multivariate analysis of variance analysis. RESULTS The results showed a significant improvement in the management of job stress after receiving rational emotive occupational health coaching. According to the multivariate analysis of variance analysis, there were between-group differences immediately after the intervention and 3 months later. As a result, the study suggested that career counselors and school management systems should incorporate rational-emotive behavioral therapy into workforce and workplace programs.
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Affiliation(s)
- Nneka Vera Ogakwu
- Institute for Development Studies, University of Nigeria, Enugu Campus, Nigeria
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Moses Onyemaechi Ede
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Ifeyinwa Manafa
- Department of Educational Foundations, Faculty of Education, Chukwuemeka Odimegwu Ojukwu University, Igbariam, Anambra State, Nigeria
| | - Kelechi Ruth Ede
- Department of Agricultural Education, Faculty of Vocational and Teacher Education, University of Nigeria, Nsukka, Nigeria
| | - Faith Omeke
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Patricia U. Agu
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Nneka Nwosu
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Sebastian Okechukwu Onah
- Department of Sociology and Anthropology, Faculty of Social Sciences, University of Nigeria, Nsukka, Nigeria
| | - Joy Obiageli Oneli
- Teleo Network International School of Theology, Pastoral Ministry Grace Training International Bible Institute, Gambia
- * Correspondence: Joy Obiageli Oneli, Teleo Network International School of Theology, Pastoral Ministry Grace Training International Bible Institute, Duluth 20284, Gambia (e-mail: )
| | - Godwin Keres Okoro Okereke
- Department of Industrial Technical Education, Faculty of Vocational and Teacher Education, University of Nigeria, Nsukka, Nigeria
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Efficacy and acceptability of psychosocial interventions in schizophrenia: systematic overview and quality appraisal of the meta-analytic evidence. Mol Psychiatry 2023; 28:354-368. [PMID: 35999275 DOI: 10.1038/s41380-022-01727-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 01/11/2023]
Abstract
Psychosocial interventions are recommended in schizophrenia and first-episode psychosis/early psychosis (EP). Nevertheless, literature is heterogeneous and often contradictory. We conducted an umbrella review of (network) meta-analyses of randomized controlled trials (RCTs) comparing psychosocial interventions vs treatment as usual (TAU)/active interventions(ACTIVE)/MIXED controls. Primary outcome was total symptoms (TS); secondary outcomes were positive/negative/depressive symptoms (PS/NS/DS), cognition, functioning, relapse, hospitalization, quality of life (QoL), treatment discontinuation. Standardized mean difference (SMD)/odds ratio (OR)/risk ratio (RR) vs TAU/ACTIVE/MIXED were summarized at end-of-treatment (EoT)/follow-up (FU). Quality was rated as high/medium/low (AMSTAR-PLUS). Eighty-three meta-analyses were included (RCTs = 1246; n = 84,925). Against TAU, regarding TS, Early Intervention Services (EIS) were superior EoT/FU in EP (SMD = -0.32/-0.21), cognitive behavioral therapy (CBT) in schizophrenia EoT/FU (SMD = -0.38/-0.19). Regarding secondary outcomes, in EP, EIS were superior for all outcomes EoT except cognition, and at FU for PS/NS/QoL, specific family interventions (FI-s) prevented relapse EoT; in schizophrenia, superiority emerged EoT for CBT for PS/NS/relapse/functioning/QoL; psychoeducation (EDU)/any FI for relapse; cognitive remediation therapy (CRT) for cognition/functioning; and hallucination-focused integrative treatment for PS. Against ACTIVE, in EP, mixed family interventions (FI-m) were superior at FU regarding TS (SMD = -0.61) and for functioning/relapse among secondary outcomes. In schizophrenia, regarding TS, mindfulness and social skills training (SST) were superior EoT, CBT at FU; regarding secondary outcomes superiority emerged at EoT for computerized cognitive drill-and-practice training for PS/DS, CRT for cognition/functioning, EDU for relapse, individual placement and support (IPS) for employment; and at FU CBT for PS/NS. Against MIXED, in schizophrenia, CRT/EDU were superior for TS EoT (d = -0.14/SMD = -0.33), CRT regarding secondary outcomes EoT for DS/social functioning, both EoT/FU for NS/cognition/global functioning; compensatory cognitive interventions for PS/functioning EoT/FU and NS EoT; CBT for PS at FU, and EDU/SST for relapse EoT. In conclusion, mental health services should consider prioritizing EIS/any FI in EP and CBT/CRT/any FI/IPS for schizophrenia, but other interventions may be helpful for specific outcomes.
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Öngün E, Ünsal G, Karaca S. Meta-analysis of the effect of psychosocial skills training on the quality of life of people with schizophrenia. Perspect Psychiatr Care 2022; 58:2272-2285. [PMID: 35194796 DOI: 10.1111/ppc.13057] [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: 12/09/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to synthesize the studies examining the effects of psychosocial skills training (PSST) on the quality of life of people with schizophrenia using a meta-analysis. DESIGN AND METHODS Fifteen studies were included in the meta-analysis according to the inclusion and exclusion criteria. FINDINGS PSST was found to have a moderate effect on the overall score of quality of life of individuals with schizophrenia, a moderate effect on the psychological dimension, and a low effect on the physical dimension. PRACTICE IMPLICATIONS It can be said that psychosocial skills training is an effective intervention that can be used to improve the quality of life of people with schizophrenia.
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Affiliation(s)
- Esen Öngün
- Department of Psychiatric Nursing, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Gül Ünsal
- Department of Psychiatric Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Semra Karaca
- Department of Psychiatric Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
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14
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Carrà G, Crocamo C, Bartoli F, Angermeyer M, Brugha T, Toumi M, Bebbington P. Influence of positive and negative symptoms on hedonic and eudaemonic well-being in people with schizophrenia: A longitudinal analysis from the EuroSc study. Schizophr Res 2022; 244:21-28. [PMID: 35567870 DOI: 10.1016/j.schres.2022.04.009] [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: 09/22/2021] [Revised: 01/11/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Subjective well-being in people with schizophrenia is likely to be impaired by positive and negative psychotic symptoms. However, these may impact differentially on hedonic (satisfaction and interest in life) and eudaemonic (optimal psychological and social functioning) components. AIMS We hypothesized that positive symptoms would influence the hedonic component, while negative symptoms would be linked to eudaemonic well-being. METHODS We tested this using longitudinal data (N = 1208) from the EUROSC study. Measures were repeated after 6, 12, 18 and 24 months. Hedonic and eudaemonic features were identified using the Quality of Life Interview. Positive and negative symptoms were assessed with the Positive and Negative Syndrome Scale. We used latent variable structural equation modelling to investigate the impact of positive and negative symptoms at each of the four data points on well-being components 6 months later, controlling for depressed mood. RESULTS The measurement model yielded acceptable fit. People with higher scores on positive symptoms at a given time-point were more likely to report lower scores for hedonic components six months later (6-, 12-, and 24-month), whereas we found no significant paths from negative symptoms to hedonic or eudaemonic features. CONCLUSIONS Although we found a longitudinal influence of positive symptoms on hedonic well-being, negative symptoms had no effect on either hedonic or eudaemonic components. While symptom reduction strategies may be helpful for hedonic well-being, the amelioration of eudaemonic features may require targeted psychosocial programmes to help individuals attain more rewarding lives.
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Affiliation(s)
- Giuseppe Carrà
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, UK; Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy.
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
| | - Matthias Angermeyer
- Department of Psychiatry, University of Leipzig, Leipzig, Johannisallee 20, 04137 Leipzig, Germany
| | - Traolach Brugha
- Department of Health Sciences, College of Life Sciences, University of Leicester, University Road, Leicester LE1 7RH, UK
| | - Mondher Toumi
- Laboratoire de Santé Publique, Université de la Méditerranée, Marseille, France
| | - Paul Bebbington
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, UK
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15
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Shikuri Y, Tanoue H, Imai H, Nakamura H, Yamaguchi F, Goto T, Kido Y, Tajika A, Sawada H, Ishida Y, Yoshinaga N. Psychosocial interventions for community-dwelling individuals with schizophrenia: study protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e057286. [PMID: 35487709 PMCID: PMC9058762 DOI: 10.1136/bmjopen-2021-057286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Despite the recent global mental health movement of the transition from hospital-centred to integrated community-based services, comprehensive evidence of psychosocial interventions focusing on community-dwelling individuals with schizophrenia is still lacking. To overcome this gap in the current knowledge, we will conduct a systematic review and meta-analysis to assess the efficacy of all types of psychosocial interventions for community-dwelling (non-hospitalised) individuals with schizophrenia when compared with non-active control conditions (eg, treatment as usual). METHODS AND ANALYSIS This study protocol has been developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. By March 2022, the following sources will have been searched, without restrictions for language or publication period: Embase, PubMed, PsycINFO, CINAHL, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. We will also try to identify other potentially eligible studies by searching the reference lists of included studies, other relevant systematic reviews and grey literature. All relevant randomised controlled trials from both high-income and low-income to middle-income countries will be allowed. Two independent reviewers will conduct the selection/screening of studies, data extraction and methodological quality assessment of included studies. The primary outcomes are quality of life and psychiatric hospital admission. Standard pairwise meta-analyses with a random-effects model will be conducted. Subgroup and sensitivity analyses will be performed to assess the robustness of the findings. Risk of bias will be assessed with the Revised Cochrane Risk-of-Bias Tool for Randomised Trials. The Grades of Recommendation Assessment, Development and Evaluation approach will be used to assess the quality of evidence. ETHICS AND DISSEMINATION Ethics approval is not required for this study. The study findings will be disseminated through conference presentations as well as peer-reviewed publications. PROSPERO REGISTRATION NUMBER CRD42021266187.
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Affiliation(s)
- Yuki Shikuri
- Graduate School of Nursing Science, University of Miyazaki, Miyazaki, Japan
| | - Hiroki Tanoue
- School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hissei Imai
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan
| | - Hideki Nakamura
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Fumitake Yamaguchi
- School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Taichi Goto
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Yoshifumi Kido
- Faculty of Nursing, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Aran Tajika
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan
| | - Hirotake Sawada
- School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yasushi Ishida
- Division of Psychiatry, Department of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Naoki Yoshinaga
- School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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16
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Yu Y, Shen M, Niu L, Liu YE, Xiao S, Tebes JK. The relationship between clinical recovery and personal recovery among people living with schizophrenia: A serial mediation model and the role of disability and quality of life. Schizophr Res 2022; 239:168-175. [PMID: 34896871 DOI: 10.1016/j.schres.2021.11.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/28/2021] [Accepted: 11/26/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We examine the relationship between two perspectives on recovery from schizophrenia: clinical recovery and personal recovery. Clinical recovery emphasizes an individual's psychiatric symptoms and functioning, whereas personal recovery emphasizes adaptation to one's illness that includes taking responsibility for one's recovery, establishing an identity apart from the illness, and finding meaning, purpose, and hope in life. METHODS Using serial mediation analysis, we examine the relationship between clinical and personal recovery in the context of two potential mediators, disability and quality of life. Study participants were 356 people with a diagnosis of schizophrenia and living with family in Changsha City of Hunan Province, China. RESULTS Although clinical recovery was modestly associated with personal recovery (r = 0.27, p < 0.001), subsequent serial mediation analysis showed that clinical recovery is not directly related to personal recovery when accounting for disability and quality of life. Clinical recovery was a significant predictor of disability, which predicted quality of life and personal recovery. Among the three mediation paths, quality of life accounted for most of the mediation effect (54%), followed by disability (24%), and disability and quality of life serially (22%). We discuss the implications of these findings for theory development, intervention, and future research.
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Affiliation(s)
- Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China; Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, USA.
| | - Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China
| | - Lu Niu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China
| | - Yu-E Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China; The Affiliated Hainan Hospital, Hainan Medical University, 31 Longhua Road, Longhua District, Haikou City, Hainan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China
| | - Jacob Kraemer Tebes
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, USA.
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17
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Gergov V, Milic B, Löffler-Stastka H, Ulberg R, Vousoura E, Poulsen S. Psychological Interventions for Young People With Psychotic Disorders: A Systematic Review. Front Psychiatry 2022; 13:859042. [PMID: 35401253 PMCID: PMC8987205 DOI: 10.3389/fpsyt.2022.859042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/24/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Psychotic disorders are commonly accompanied by intense psychological burden, and psychological interventions are usually needed in order to reduce the symptoms and help in maintaining or improving the level of psychological and social functioning after the onset of psychosis. The evidence-base for treating young people at risk for psychosis and adults with psychotic disorders is accumulating. Yet, pervasive systematic literature reviews that would include patients from the full age range being the most essential period for the risk of developing a psychotic disorder, a wide range of psychological interventions, and various types of clinical trials, have been lacking. The aim of this systematic review is to fill the gap by presenting the current research evidence from clinical trials on the effectiveness of psychological interventions for treating young people (12-30) with psychotic disorders. METHODS A systematic search was conducted in PubMed and PsycINFO followed by a 3-step screening process based on the PICOS strategy. Risk of bias of the included studies was assessed by the Mixed Methods Appraisal Tool (MMAT). Extracted data from the included studies is reported using a narrative synthesis. RESULTS Of the 1,449 publications screened, 40 from 25 studies were included in the review. Of these, 10 studies reported results from cognitive or behavioral therapy, nine from cognitive remediation therapy (CRT), and six from other types of therapies (i.e., integrative interventions combining psychoeducation and family/group interventions). All but one study found the target interventions to be effective, but the results mostly did not differ significantly from the control conditions in reducing symptoms and improving functioning, preventing relapses and hospitalization, or improving psychological or family variables. The most consistent findings were from CRT, showing more improvement in cognitive functioning compared to control conditions while not being superior in reducing symptom severity. Integrative interventions might be effective in treating young people suffering from psychotic disorders. CONCLUSION There is some evidence that psychological interventions are effective for young people with psychotic disorders. However, with regard to symptom severity, psychotherapy does not outperform control conditions, and the results do not strongly favor any specific type of treatment. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020166756], identifier [CRD42020166756].
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Affiliation(s)
- Vera Gergov
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- *Correspondence: Vera Gergov,
| | - Branka Milic
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Randi Ulberg
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Eleni Vousoura
- Department of Psychiatry, University of Athens, Athens, Greece
| | - Stig Poulsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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18
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Dubreucq J, Gabayet F, Godin O, Andre M, Aouizerate B, Capdevielle D, Chereau I, Clauss-Kobayashi J, Coulon N, D’Amato T, Dorey JM, Dubertret C, Faraldo M, Laouamri H, Leigner S, Lancon C, Leboyer M, Llorca PM, Mallet J, Misdrahi D, Passerieux C, Rey R, Pignon B, Schorr B, Urbach M, Schürhoff F, Szoke A, Fond G, Berna F. Overlap and Mutual Distinctions Between Clinical Recovery and Personal Recovery in People With Schizophrenia in a One-Year Study. Schizophr Bull 2021; 48:382-394. [PMID: 34718808 PMCID: PMC8886587 DOI: 10.1093/schbul/sbab114] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Recovery is a multidimensional construct that can be defined either from a clinical perspective or from a consumer-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. We aimed to longitudinally examine the overlap and mutual distinctions between clinical and personal recovery. Of 1239 people with schizophrenia consecutively recruited from the FondaMental Advanced Centers of Expertise for SZ network, the 507 present at one-year did not differ from those lost to follow-up. Clinical recovery was defined as the combination of clinical remission and functional remission. Personal recovery was defined as being in the rebuilding or in the growth stage of the Stages of Recovery Instrument (STORI). Full recovery was defined as the combination of clinical recovery and personal recovery. First, we examined the factors at baseline associated with each aspect of recovery. Then, we conducted multivariable models on the correlates of stable clinical recovery, stable personal recovery, and stable full recovery after one year. At baseline, clinical recovery and personal recovery were characterized by distinct patterns of outcome (i.e. better objective outcomes but no difference in subjective outcomes for clinical recovery, the opposite pattern for personal recovery, and better overall outcomes for full recovery). We found that clinical recovery and personal recovery predicted each other over time (baseline personal recovery for stable clinical recovery at one year; P = .026, OR = 4.94 [1.30-23.0]; baseline clinical recovery for stable personal recovery at one year; P = .016, OR = 3.64 [1.31-11.2]). In short, given the interaction but also the degree of difference between clinical recovery and personal recovery, psychosocial treatment should target, beyond clinical recovery, subjective aspects such as personal recovery and depression to reach full recovery.
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Affiliation(s)
- Julien Dubreucq
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France,To whom correspondence should be addressed to: Centre Référent de Réhabilitation psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, 8 place du Conseil National de la Résistance, 38400 Saint Martin d’Hères, France; tel: (33 4) 56 58 88 00, e-mail:
| | - Franck Gabayet
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France
| | - Ophélia Godin
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France
| | - Myrtille Andre
- Fondation FondaMental, Créteil, France,IGF, University of Montpellier, CNRS, INSERM, Montpellier, France,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHU Montpellier, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France,Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux, France,INRA, NutriNeuro, University of Bordeaux, Bordeaux, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France,IGF, University of Montpellier, CNRS, INSERM, Montpellier, France,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHU Montpellier, France
| | - Isabelle Chereau
- Fondation FondaMental, Créteil, France,Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Julie Clauss-Kobayashi
- Fondation FondaMental, Créteil, France,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Nathalie Coulon
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France
| | - Thierry D’Amato
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 team, Lyon, France,Centre Hospitalier le Vinatier, Centre Expert Dépression Résistante, Lyon, France
| | - Jean-Michel Dorey
- INSERM U1028, CNRS, UMR 5292, Lyon Neuroscience Research Center, EDUWELL Team, Lyon 2 University, Lyon, France,Centre Hospitalier le Vinatier, Pôle PsyPA, Lyon, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France,AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, Service de Psychiatrie et Addictologie. Hôpital Louis Mourier, Colombes, France,Université de Paris INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Mégane Faraldo
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France
| | | | - Sylvain Leigner
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France
| | - Christophe Lancon
- Fondation FondaMental, Créteil, France,AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, Service de Psychiatrie et Addictologie. Hôpital Louis Mourier, Colombes, France,Université de Paris INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France,Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France,AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, Service de Psychiatrie et Addictologie. Hôpital Louis Mourier, Colombes, France,Université de Paris INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France,Pôle de psychiatrie Générale et Universitaire, Centre Hospitalier Charles Perrens, Université de Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France,Service Universitaire de Psychiatrie d’Adultes et d’Addictologie, Centre Hospitalier de Versailles, Le Chesnay, France,DisAP-DevPsy-CESP, INSERM UMR1018, Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, Villejuif, France
| | - Romain Rey
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 team, Lyon, France,Centre Hospitalier le Vinatier, Centre Expert Dépression Résistante, Lyon, France
| | - Baptiste Pignon
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris, France
| | - Benoit Schorr
- Fondation FondaMental, Créteil, France,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Mathieu Urbach
- Fondation FondaMental, Créteil, France,Service Universitaire de Psychiatrie d’Adultes et d’Addictologie, Centre Hospitalier de Versailles, Le Chesnay, France,DisAP-DevPsy-CESP, INSERM UMR1018, Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, Villejuif, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris, France
| | - Andrei Szoke
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris, France
| | | | - Guillaume Fond
- Fondation FondaMental, Créteil, France,AP-HM, Aix-Marseille Univ, School of medicine—La Timone Medical Campus, EA 3279: CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Fabrice Berna
- Fondation FondaMental, Créteil, France,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
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19
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Caballero R, Valiente C, Espinosa R. Predictors of subjective well-being among individuals with severe psychiatric conditions. Compr Psychiatry 2021; 110:152266. [PMID: 34333165 DOI: 10.1016/j.comppsych.2021.152266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 07/07/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
- Rocío Caballero
- Department of Psychology, Complutense University of Madrid, Somosaguas Campus, 28223 Madrid, Spain.
| | - Carmen Valiente
- Department of Psychology, Complutense University of Madrid, Somosaguas Campus, 28223 Madrid, Spain
| | - Regina Espinosa
- Department of Psychology, Camilo José Cela University of Madrid, Villafranca del Castilla, 28692 Madrid, Spain
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20
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Harmanci P, Budak FK. The Effect of Psychoeducation Based on Motivational Interview Techniques on Medication Adherence, Hope, and Psychological Well-Being in Schizophrenia Patients. Clin Nurs Res 2021; 31:202-216. [PMID: 34596461 DOI: 10.1177/10547738211046438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was conducted to determine the effect of psychoeducation based on motivational interview techniques on medication adherence, hope, and psychological well-being in schizophrenia patients. There are many studies using Motivational Interviewing for individuals with schizophrenia. However, there are no studies on whether the concept of "adherence to treatment," which is clearly shown to be corrected with 6 to 8 weeks of motivational interviewing, will positively affect concepts such as "hope and well-being," which require longer interventions, in a shorter time. In this context, there are not enough studies in which motivational interviewing techniques are integrated into psychoeducational interventions that can be organized with more individuals. The study was conducted with a pretest-posttest control group design. The sample size of the study was determined as 150 schizophrenia patients including 75 in the experimental group and 75 in the control group based on power analysis. The researcher provided the patients in the experimental group with a six-session psychoeducation program based on motivational interview techniques. A "Descriptive Characteristics Form," the "Herth Hope Index," the "Morisky Medication Adherence Scale," and the "Psychological Well-Being Scale" were used to collect the data. In the study, psychoeducation based on motivational interview techniques created a statistically significant difference in the medication adherence, hope and psychological well-being levels of the patients in the experimental and control groups (p < .05). Psychoeducation based on motivational interview techniques provided for schizophrenia patients was found to be effective in enhancing their medication adherence, hope, and psychological well-being levels.
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21
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Dellazizzo L, Potvin S, Phraxayavong K, Giguère S, Hamidi LN, Dumais A. L’amélioration de la qualité de vie chez les patients atteints d’une schizophrénie réfractaire ayant suivi la Thérapie assistée par la Réalité Virtuelle : une analyse de contenu. SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1081514ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectifs La schizophrénie, en particulier la schizophrénie résistante aux traitements (SRT), est considérée comme l’un des troubles psychiatriques les plus invalidants en termes d’effets indésirables sur la qualité de vie (QV) des patients. La QV subjective est devenue une cible particulièrement cruciale qui devrait être améliorée avec le traitement, car une QV améliorée peut entraîner le rétablissement chez les patients atteints de schizophrénie. Il existe cependant peu de preuves des effets des interventions psychosociales recommandées sur les mesures non symptomatiques comme la QV. À cet égard, le traitement de la schizophrénie peut être renforcé si, en plus du traitement des symptômes, l’accent thérapeutique est mis sur d’autres sphères importantes pour les patients. Avec les progrès technologiques, la Thérapie assistée par la Réalité Virtuelle (TRV) permet aux entendeurs de voix d’entrer en dialogue direct avec un avatar, animé entièrement par le thérapeute, qui représente leur voix la plus persécutrice. Ceci dans le but de leur permettre d’acquérir un meilleur contrôle sur leurs voix et de travailler sur leur estime de soi. Au-delà de la symptomatologie, les résultats des projets pilotes sur cette thérapie innovante ont montré des résultats significatifs sur la QV.
Méthode Afin de peaufiner les résultats quantitatifs trouvés, cet article a exploré les thèmes émergents d’une analyse de contenu découlant du discours spontané de 10 patients ayant bien répondu à la TRV.
Résultats Quatre thèmes généraux ont émergé : 1) impact de la thérapie sur les voix ; 2) relations interpersonnelles ; 3) bien-être psychologique ; et 4) mode de vie. Cette analyse de contenu a permis d’identifier plusieurs sphères de vie qui sont davantage améliorées chez les patients ayant une SRT à l’aide de la TRV.
Conclusion : La TRV met en évidence l’avenir des approches adaptées aux objectifs des patients qui intègrent plusieurs processus pertinents pour potentiellement améliorer leur QV. La TRV peut avoir des implications potentiellement immenses sur la santé et la qualité de vie des patients. Cette étude fut une première étape vers l’exploration des effets subjectifs de la TRV sur la vie des patients au-delà des symptômes.
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Affiliation(s)
- Laura Dellazizzo
- Centre de recherche de l’Institut Universitaire en Santé mentale de Montréal, Montréal, Canada ; Faculté de Médecine, Université de Montréal, Montréal, Canada
| | - Stéphane Potvin
- Centre de recherche de l’Institut Universitaire en Santé mentale de Montréal, Montréal, Canada ; Faculté de Médecine, Université de Montréal, Montréal, Canada
| | | | - Sabrina Giguère
- Centre de recherche de l’Institut Universitaire en Santé mentale de Montréal, Montréal, Canada ; Faculté de Médecine, Université de Montréal, Montréal, Canada
| | - Lyna-Nour Hamidi
- Centre de recherche de l’Institut Universitaire en Santé mentale de Montréal, Montréal, Canada ; Faculté de Médecine, Université de Montréal, Montréal, Canada
| | - Alexandre Dumais
- Centre de recherche de l’Institut Universitaire en Santé mentale de Montréal, Montréal, Canada ; Faculté de Médecine, Université de Montréal, Montréal, Canada ; Services et Recherches Psychiatriques AD, Montréal, Canada ; Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada
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22
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Degnan A, Berry K, Humphrey C, Bucci S. The relationship between stigma and subjective quality of life in psychosis: A systematic review and meta-analysis. Clin Psychol Rev 2021; 85:102003. [DOI: 10.1016/j.cpr.2021.102003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/20/2021] [Accepted: 02/23/2021] [Indexed: 12/24/2022]
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Kızılırmak Tatu M, Demir S. Effect of Group Psychoeducation on Treatment Adherence, Quality of Life and Well-Being of Patients Diagnosed with Schizophrenia. Issues Ment Health Nurs 2021; 42:256-266. [PMID: 32783665 DOI: 10.1080/01612840.2020.1793244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Psychoeducation offers a holistic approach that focuses on the philosophy of health, cooperation, coping and empowerment, but it is known that experimental studies used in psychoeducation in schizophrenia are insufficient. The study was conducted with 42 schizophrenia patients using a quasi-experimental research design. Patients were evaluated using a pretest, post-test, follow-up test, "Medication Adherence Rating Scale", "Quality of Life Scale for Schizophrenia" and "Flourishing Scale". There was a significant difference between the experimental group and the control group in terms of pretest and post-test, pretest and follow-up test scores (p < 0.05). The post-test and follow-up test scores of the patients in the experimental group were determined to increase their quality of life and well-being score (p < 0.05). This study is an important contribution to the literature due to its assessment of the relationship between psychoeducation and change in treatment adherence, quality of life and levels of well-being.
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Affiliation(s)
| | - Satı Demir
- Faculty Department of Nursing, Gazi University Health Science, Ankara, Turkey
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24
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Psychological Adjustment in Spain during the COVID-19 Pandemic: Positive and Negative Mental Health Outcomes in the General Population. SPANISH JOURNAL OF PSYCHOLOGY 2021; 24:e8. [PMID: 33551011 DOI: 10.1017/sjp.2021.7] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In the midst of the COVID-19 epidemic, Spain was one of the countries with the highest number of infections and a high mortality rate. The threat of the virus and consequences of the pandemic have a discernible impact on the mental health of citizens. This study aims to (a) evaluate the levels of anxiety, depression and well-being in a large Spanish sample during the confinement, (b) identify potential predictor variables associated to experiencing both clinical levels of distress and well-being in a sample of 2,122 Spanish people. By using descriptive analyses and logistic regression results revealed high rates of depression, anxiety and well-being. Specifically, our findings revealed that high levels of anxiety about COVID-19, increased substance use and loneliness as the strongest predictors of distress, while gross annual incomes and loneliness were strongest predictors of well-being. Finding of the present study provide a better insight about psychological adjustment to a pandemic and allows us to identify which population groups are at risk of experiencing higher levels of distress and which factors contribute to greater well-being, which could help in the treatments and prevention in similar stressful and traumatic situations.
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25
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Caballero R, Valiente C, Espinosa R. The perception of well-being: Do people with severe psychiatric conditions and their therapists put themselves in each other’s shoes? JOURNAL OF POSITIVE PSYCHOLOGY 2021. [DOI: 10.1080/17439760.2021.1871943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Rocío Caballero
- Department of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Carmen Valiente
- Department of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Regina Espinosa
- Department of Psychology, Camilo José Cela University of Madrid, Madrid, Spain
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26
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Valiente C, Espinosa R, Contreras A, Trucharte A, Caballero R, Peinado V. The feasibility and acceptability study of a positive psychology group intervention for people with severe psychiatric conditions. JOURNAL OF POSITIVE PSYCHOLOGY 2021. [DOI: 10.1080/17439760.2021.1871940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Carmen Valiente
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Regina Espinosa
- Department of Psychology, School of Education and Health, Camilo José Cela University, Madrid, Spain
| | - Alba Contreras
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Almudena Trucharte
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Rocío Caballero
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Vanesa Peinado
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
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27
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Pina I, Braga CDM, de Oliveira TFR, de Santana CN, Marques RC, Machado L. Positive psychology interventions to improve well-being and symptoms in people on the schizophrenia spectrum: a systematic review and meta-analysis. BRAZILIAN JOURNAL OF PSYCHIATRY 2020; 43:430-437. [PMID: 33331497 PMCID: PMC8352741 DOI: 10.1590/1516-4446-2020-1164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/18/2020] [Indexed: 01/07/2023]
Abstract
Objective: Positive psychology interventions (PPIs) incorporate principles of personal strengths with the view that mental health recovery transcends symptom relief. Severe psychiatric conditions, such as schizophrenia, may benefit from such interventions. This study aims to gather the current evidence on the impact of PPIs on increasing well-being in patients on the schizophrenia spectrum and assess reductions in negative or positive symptoms. Methods: A systematic review of PPI studies with schizophrenia-spectrum patients was carried out following PRISMA recommendations. The PubMed, PsycINFO, Web of Science, and Scopus databases were searched for relevant publications in order to understand the possible effects of these interventions on well-being measures and psychotic symptoms in this population. Results: Nine studies (four controlled) were included. Meta-analysis of the controlled studies showed a significant effect (p = 0.04) for improvement of well-being (Z = 2.01). Overall, the reviewed evidence suggests well-being improvement. The effect on reduction of negative symptoms was unclear. Conclusion: Used as an adjunctive therapy, PPIs appear to be a promising resource for patients on the schizophrenia spectrum, with possible effects on well-being and symptom reduction.
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Affiliation(s)
- Isabela Pina
- Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Catarina de M Braga
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, UFPE, Recife, PE, Brazil
| | | | - Camila N de Santana
- Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Rodrigo C Marques
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, UFPE, Recife, PE, Brazil
| | - Leonardo Machado
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, UFPE, Recife, PE, Brazil
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28
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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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Bambini V, Arcara G, Bosinelli F, Buonocore M, Bechi M, Cavallaro R, Bosia M. A leopard cannot change its spots: A novel pragmatic account of concretism in schizophrenia. Neuropsychologia 2020; 139:107332. [PMID: 31923528 DOI: 10.1016/j.neuropsychologia.2020.107332] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/01/2020] [Accepted: 01/06/2020] [Indexed: 11/29/2022]
Abstract
Concretism is a well-known feature of schizophrenia, tracing back to the early descriptions of the disease and commonly associated with the literal interpretation of figurative expressions such as proverbs, metaphors, and idioms. However, figurative expressions are not all alike in terms of linguistic and pragmatic processes. Determining if some figurative types are more impaired than others and if the type of task affects the performance constitutes an open issue with implications for the description of the clinical profile and for treatment. We run a fine-grained assessment of figurative language comprehension by comparing 47 patients with schizophrenia and 39 controls in three figurative types (idioms, metaphors, proverbs) presented in two response formats (multiple-choice, verbal-explanation), considering also the role of cognitive and clinical variables and the impact on quality of life. Mixed-effects models analysis revealed that: i) patients performed worse than controls across figurative types and response formats, indicating a diffuse impairment; ii) there is an interplay of figurative type and response format, which makes verbal-explanation of proverbs especially challenging; iii) in patients, problems in figurative language are largely connected with formal thought disorder and global IQ. Moreover, multiple-choice of metaphors was associated with patients' quality of life. This study offers a novel account of concretism, framed in pragmatics and figurative language processing. Adopting this perspective allowed us to describe the nuances of concretism, which areas in the figurative domain are especially challenging for patients and which ones capture differences in functioning, in order to guide intervention programs and integration in society.
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Affiliation(s)
- Valentina Bambini
- Center for Neurocognition, Epistemology and Theoretical Syntax (NEtS), University School for Advanced Studies IUSS Pavia, Pavia, Italy.
| | | | - Francesca Bosinelli
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mariachiara Buonocore
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Cavallaro
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marta Bosia
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
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30
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Thomas S, Höfler M, Schäfer I, Trautmann S. Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta-analysis. Acta Psychiatr Scand 2019; 140:295-312. [PMID: 31357235 DOI: 10.1111/acps.13077] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Childhood maltreatment (CM) plays an important role in the aetiology and course of psychotic disorders and is associated with characteristics that could be relevant for treatment. We aimed to conduct a systematic review and meta-analysis on the association between CM and treatment outcome in psychotic disorders. METHODS Treatment outcome was defined as change in psychotic symptoms or in social or occupational functioning between first and last reported measurement in the course of a pharmacological and/or psychological treatment. RESULTS Twelve treatment results from seven studies (636 patients, average treatment duration: 59.2 weeks) were included. CM was related to poorer treatment outcomes in psychotic disorders (OR = 1.51, 95% CI = [1.08, 2.10]). There is evidence that this association might increase with illness duration and increasing age and might be stronger in schizophrenia samples. CONCLUSIONS Childhood maltreatment is highly understudied with regard to treatment outcome in psychotic disorders. The need for more studies is emphasized by the fact that this meta-analysis reveals evidence for a poorer treatment response in patients with CM. If this association is confirmed, the identification of patients with CM and the consideration of associated clinical and biological conditions could contribute to improve treatment outcome in psychotic disorders.
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Affiliation(s)
- S Thomas
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - I Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychology, Medical School Hamburg, Hamburg, Germany
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