1
|
Gülırmak Güler K, Güleç Keskin S, Terzi M. Transformative impact of positive psychotherapy-based hope placement program on life goals and hope level of individuals with multiple sclerosis. Public Health Nurs 2024. [PMID: 39105489 DOI: 10.1111/phn.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 07/17/2024] [Accepted: 07/21/2024] [Indexed: 08/07/2024]
Abstract
AIM This study aimed to assess the impact of a positive psychotherapy-based hope placement program on life goal setting and hope levels in individuals diagnosed with multiple sclerosis (MS). METHOD A Solomon Four-Group experimental design was used, involving 50 individuals diagnosed with MS who sought treatment at a university hospital's neurology outpatient clinic. Experimental (1-2) and control (1-2) groups were randomized, and pretests were administered exclusively to the experimental and control groups. Data were collected using a Personal Information Form, the Herth Hope Scale, and the Scale for Determining Life Goals in the Context of Positive Psychotherapy. A 5-week/10-session Positive Psychotherapy-Based Hope Placement Program was conducted online for the Experimental groups. The research was conducted in the form of group therapy. Post-tests were administered to all groups upon program completion. RESULTS The experimental 1-2 group exhibited statistically significant improvements in the Scale for Identifying Life Goals in the Context of Positive Psychotherapy and Herth Hope Scale scores (p < .05). The Positive Psychotherapy-Based Hope Placement Program effectively enhances hope levels and life goal setting for individuals diagnosed with MS. CONCLUSION The results indicate that the program increased the sense of purpose in life and elevated levels of hope among MS patients. These findings suggest that positive psychotherapy-based interventions significantly improve the quality of life for MS patients. CLINICAL OR METHODOLOGICAL SIGNIFICANCE OF THIS ARTICLE This study examines the impact of a Positive Psychotherapy-based hope placement program on determining hope and life purpose in patients with Multiple Sclerosis (MS). This research shows that HOPP (Hope Placement Program), an intervention based on Positive Psychotherapy, can significantly improve the quality of life of MS patients. These findings support the consideration of Positive Psychotherapy-based approaches as a potential therapeutic option that can positively influence the life experiences of MS patients. Therefore, this article makes an important contribution to researchers interested in using Positive Psychotherapy-based interventions in clinical practice and related research.
Collapse
Affiliation(s)
- Kübra Gülırmak Güler
- Faculty of Health Sciences, Department of Psychiatric Nursing, Ondokuz Mayıs University, Samsun, Turkey
| | - Serap Güleç Keskin
- Faculty of Health Sciences, Department of Psychiatric Nursing, Ondokuz Mayıs University, Samsun, Turkey
| | - Murat Terzi
- Faculty of Medicine, Department of Neurology, Ondokuz Mayıs University, Samsun, Turkey
| |
Collapse
|
2
|
Riches S, Yusuf-George M, Steer N, Fialho C, Vasile R, Nicholson SL, Waheed S, Fisher HL, Zhang S. Videoconference-based Creativity Workshops for mental health staff during the COVID-19 pandemic. Arts Health 2024; 16:134-146. [PMID: 36912215 DOI: 10.1080/17533015.2023.2184402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 01/03/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND COVID-19 presented significant challenges to psychiatric staff, while social distancing and remote working necessitated digital communications. NHS England prioritised staff wellbeing. Arts-based creativity interventions appear to improve psychological wellbeing, so this study evaluated online Creativity Workshops as a staff support response for COVID-19-related stress. METHODS Participants were staff from a South London NHS psychiatric hospital. Group Creativity Workshops were facilitated via Microsoft Teams. Acceptability data on pre- and post-workshop mood and attitudes were self-reported by participants. Feasibility data were gathered from adherence to number of workshop components delivered. RESULTS Eight workshops were delivered in May-September 2020 (N = 55) with high adherence to components. Participants reported significantly increased positive mood and attitudes towards themselves and others; and decreased stress and anxiety. CONCLUSIONS Online Creativity Workshops appear feasible and acceptable in reducing stress in psychiatric staff. Integrating a programme of Creativity Workshops within healthcare staff support may benefit staff wellbeing.
Collapse
Affiliation(s)
- Simon Riches
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Meirion Yusuf-George
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Natalie Steer
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
- The Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK
| | - Carolina Fialho
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Ruxandra Vasile
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
- The Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK
| | - Sarah L Nicholson
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Saira Waheed
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Helen L Fisher
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Shuo Zhang
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
- King's College London, Department of Child Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| |
Collapse
|
3
|
Gülırmak Güler K, Güleç Keskin S, Albayrak E. The power of virtual connections: A randomized controlled trial of online positive psychotherapy training on effective communication skills of nursing students. Nurse Educ Pract 2024; 77:103967. [PMID: 38615450 DOI: 10.1016/j.nepr.2024.103967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/16/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024]
Abstract
AIM This research aimed to assess the impact of the online "Positive Psychotherapy- Based Key Model of Courtesy and Integrity" (KMCI)" program on the effective communication skills of nursing students. BACKGROUND With the growing integration of virtual platforms in psychotherapy education, there is a burgeoning interest in understanding their influence on nursing student's communication abilities. Recognizing how online positive psychotherapy education shapes these skills is pivotal for enriching nursing education and practice. DESIGN The study adopted a pre-test-post-test randomized controlled design and involved 64 undergraduate nursing students from a state university's nursing department during the 2021-2022 academic year, all enrolled in psychiatric nursing courses. METHODS Students were divided into experimental and control groups through simple randomization. Pre-tests, encompassing a "Personal Information Form" and an "Effective Communication Skills Scale," were administered to both groups. Subsequently, the experimental group received the "Positive Psychotherapy- Based Key Model of Courtesy and Integrity" program online for five weeks, while no intervention was provided to the control group during this period. Post-tests were then conducted for both groups after five weeks. RESULTS The findings revealed a significant increase (p<0.05) in the total scores of sub-dimensions, including "Ego-Enhancing Language, Active Listening, Self-Disclosure and Recognition, Empathy and Self-Language Scale" in the experimental group in both intra-group and inter-group comparisons. CONCLUSION In conclusion, the "Positive Psychotherapy- Based Key Model of Courtesy and Integrity" program effectively enhances practical communication skills among nursing students. Equipping students with the ability to integrate courtesy and integrity isn't effective.
Collapse
Affiliation(s)
- Kübra Gülırmak Güler
- Ondokuz Mayıs University, Faculty of Health Sciences Department of Psychiatric Nursing, Samsun, Turkey.
| | - Serap Güleç Keskin
- Ondokuz Mayıs University, Faculty of Health Sciences Department of Psychiatric Nursing, Samsun, Turkey
| | - Eda Albayrak
- Erciyes University, Faculty of Health Sciences, Mental Health and Disease Nursing, Kayseri, Turkey
| |
Collapse
|
4
|
Simonsen C, Åsbø G, Slade M, Wold KF, Widing L, Flaaten CB, Engen MJ, Lyngstad SH, Gardsjord E, Bjella T, Romm KL, Ueland T, Melle I. A good life with psychosis: rate of positive outcomes in first-episode psychosis at 10-year follow-up. Psychol Med 2024:1-10. [PMID: 38389456 DOI: 10.1017/s0033291724000205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
BACKGROUND More knowledge about positive outcomes for people with first-episode psychosis (FEP) is needed. An FEP 10-year follow-up study investigated the rate of personal recovery, emotional wellbeing, and clinical recovery in the total sample and between psychotic bipolar spectrum disorders (BD) and schizophrenia spectrum disorders (SZ); and how these positive outcomes overlap. METHODS FEP participants (n = 128) were re-assessed with structured clinical interviews at 10-year follow-up. Personal recovery was self-rated with the Questionnaire about the Process of Recovery-15-item scale (total score ⩾45). Emotional wellbeing was self-rated with the Life Satisfaction Scale (score ⩾5) and the Temporal Experience of Pleasure Scale (total score ⩾72). Clinical recovery was clinician-rated symptom-remission and adequate functioning (duration minimum 1 year). RESULTS In FEP, rates of personal recovery (50.8%), life satisfaction (60.9%), and pleasure (57.5%) were higher than clinical recovery (33.6%). Despite lower rates of clinical recovery in SZ compared to BD, they had equal rates of personal recovery and emotional wellbeing. Personal recovery overlapped more with emotional wellbeing than with clinical recovery (χ2). Each participant was assigned to one of eight possible outcome groups depending on the combination of positive outcomes fulfilled. The eight groups collapsed into three equal-sized main outcome groups: 33.6% clinical recovery with personal recovery and/or emotional wellbeing; 34.4% personal recovery and/or emotional wellbeing only; and 32.0% none. CONCLUSIONS In FEP, 68% had minimum one positive outcome after 10 years, suggesting a good life with psychosis. This knowledge must be shared to instill hope and underlines that subjective and objective positive outcomes must be assessed and targeted in treatment.
Collapse
Affiliation(s)
- Carmen Simonsen
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Gina Åsbø
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham NG7 2TU, UK
- Faculty of Nursing and Health Sciences, Health and Community Participation Division, Nord University, 7801 Namsos, Norway
| | - Kristin Fjelnseth Wold
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Line Widing
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Camilla Bärthel Flaaten
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Magnus Johan Engen
- Nydalen DPS, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Siv Hege Lyngstad
- Nydalen DPS, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erlend Gardsjord
- Section for Treatment of Early Psychosis, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Thomas Bjella
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin Lie Romm
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
5
|
Kloos N, Kraiss J, Ten Klooster P, Bohlmeijer E. First validation of the model of sustainable mental health: Structural model validity and the indirect role of adaptation. J Clin Psychol 2023; 79:2650-2667. [PMID: 37543726 DOI: 10.1002/jclp.23574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/22/2023] [Accepted: 07/16/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVES There is a growing interest in mental well-being as a vital outcome in clinical practice in addition to mental illness. The model of sustainable mental health (SMH) was recently introduced to delineate how interventions can improve mental health by targeting barriers and resources of adaptation to life stressors, improving the ability to adapt and thereby reducing mental illness and improving mental well-being. The aim of the current study is to empirically validate the conceptual model of SMH as well as the assumed indirect role of ability to adapt. METHODS This study used an existing dataset of the general population with self-reported reduced well-being due to the corona crisis (n = 849, mean age 53 years, SD = 15). Measurements of mental illness (depression and anxiety), mental well-being, ability to adapt, a specific barrier for adaptation (i.e., repetitive negative thinking), and a specific resource for adaptation (i.e., positive reframing) were included. Structural equation modeling was used to assess both the structural validity of the model and the indirect effect of ability to adapt. RESULTS An acceptable to good fit was found for the model of SMH and all paths between the proposed elements of the model were significant and in the hypothesized direction. Ability to adapt served as an indirect pathway trough which repetitive negative thinking (B = 0.149, 95% confidence interval [CI] = 0.016-0.028) and positive reframing (B = 0.163, 95% CI = 0.065-0.123) were linked with mental illness and mental well-being. CONCLUSION The current study provides the first empirical support of the internal validity of the model of SMH in a sample of the general population with reduced well-being, suggesting that barriers and resources to adaptation have an effect on mental illness and mental well-being through the ability to adapt. The model of SMH may therefore be a good model to use in research and clinical practice for developing, implementing, and evaluating a balanced treatment approach targeting both barriers and resources for adaptation.
Collapse
Affiliation(s)
- Noortje Kloos
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
- Radboud Alzheimer Center, Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Jannis Kraiss
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Peter Ten Klooster
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Ernst Bohlmeijer
- Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| |
Collapse
|
6
|
Gruppenarbeit mit chronisch psychisch erkrankten Menschen – Entwicklung und Evaluation eines ressourcenorientierten Gruppenprogramms. GRUPPENPSYCHOTHERAPIE UND GRUPPENDYNAMIK 2023. [DOI: 10.13109/grup.2023.59.1.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
|
7
|
Bighelli I, Wallis S, Reitmeir C, Schwermann F, Salahuddin NH, Leucht S. Effects of psychological treatments on functioning in people with Schizophrenia: a systematic review and meta-analysis of randomized controlled trials. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01526-1. [PMID: 36477405 DOI: 10.1007/s00406-022-01526-1] [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: 07/19/2021] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
Functioning is recognized as a key treatment goal in alleviating the burden of schizophrenia. Psychological interventions can play an important role in improving functioning in this population, but the evidence on their efficacy is limited. We therefore aimed to evaluate the effect of psychological interventions in functioning for patients with schizophrenia. To conduct this systematic review and meta-analysis, we searched for published and unpublished randomized controlled trials (RCTs) in EMBASE, MEDLINE, PsycINFO, BIOSIS, Cochrane Library, WHO International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov and the Study register of the Cochrane Schizophrenia Group. The outcome functioning was measured with validated scales. We performed random-effects pairwise meta-analysis to calculate standardized mean differences (SMDs) with 95% confidence intervals (CIs). We included 58 RCTs (5048 participants). Psychological interventions analyzed together (SMD = - 0.37, 95% CI - 0.49 to - 0.25), cognitive behavioral therapy (30 RCTs, SMD = - 0.26, 95% CI - 0.39 to - 0.12), and third wave cognitive-behavioral therapies (15 RCTs, SMD = - 0.60, 95% CI - 0.83 to - 0.37) were superior to control in improving functioning, while creative therapies (8 RCTs, SMD = 0.01, 95% CI - 0.38 to 0.39), integrated therapies (4 RCTs, SMD = - 0.21, 95% CI - 1.20 to 0.78) and other therapies (4 RCTs, SMD = - 0.74, 95% CI - 1.52 to 0.04) did not show a benefit. Psychological interventions, in particular cognitive behavioral therapy and third wave cognitive behavioral therapies, have shown a therapeutic effect on functioning. The confidence in the estimate was evaluated as very low due to risk of bias, heterogeneity and possible publication bias.
Collapse
Affiliation(s)
- Irene Bighelli
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany.
| | - Sofia Wallis
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
| | - Cornelia Reitmeir
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
| | - Felicitas Schwermann
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
| | - Nurul Husna Salahuddin
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
| |
Collapse
|
8
|
Lim YJ. Psychometric Properties of the Mental Health Continuum-Short Form (MHC-SF): A Study With Individuals With Schizophrenia Living in the Community. Psychiatry Investig 2022; 19:1021-1026. [PMID: 36588436 PMCID: PMC9806510 DOI: 10.30773/pi.2022.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/03/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The Mental Health Continuum-Short Form (MHC-SF) is widely used to measure positive mental health. This study is the first to examine the psychometric properties of the MHC-SF in persons with schizophrenia living in the community. METHODS Two hundred thirty-one individuals with schizophrenia living in the community in South Korea filled out the MHC-SF. Confirmatory factor analysis (CFA), bifactor CFA, exploratory structural equation modeling (ESEM), and bifactor ESEM were undertaken to examine the factor structure of the MHC-SF. RESULTS Results showed that a three-factor bifactor ESEM model yielded better fit than the other alternative models. Indices of internal consistency reliability were acceptable. CONCLUSION The results suggest that bifactor ESEM is an appropriate analysis for examining the factor structure of the MHC-SF in individuals with schizophrenia. The findings support the use of the overall MHC-SF scale rather than the use of the subscales in people with schizophrenia.
Collapse
Affiliation(s)
- Young-Jin Lim
- Department of Psychology, Daegu University, Gyeongsan, Republic of Korea
| |
Collapse
|
9
|
Blodgett JM, Birch JM, Musella M, Harkness F, Kaushal A. What Works to Improve Wellbeing? A Rapid Systematic Review of 223 Interventions Evaluated with the Warwick-Edinburgh Mental Well-Being Scales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15845. [PMID: 36497919 PMCID: PMC9737992 DOI: 10.3390/ijerph192315845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) is a commonly used scale of mental wellbeing focusing entirely on the positive aspect of mental health. It has been widely used in a broad range of clinical and research settings, including to evaluate if interventions, programmes or pilots improve wellbeing. We aimed to systematically review all interventions that used WEMWBS and evaluate which interventions are the most effective at improving wellbeing. METHODS Eligible populations included children and adults, with no health or age restrictions. Any intervention study was eligible if the wellbeing outcome was measured using the 7 or 14-item WEMWBS scale assessed both pre- and post-intervention. We identified eligible intervention studies using three approaches: a database search (Medline, EMBASE, CINAHL, PyschInfo and Web of Science from January 2007 to present), grey literature search, and by issuing a call for evidence. Narrative synthesis and random-effects meta-analysis of standardised mean differences in the intervention group were used to summarise intervention effects on WEMWBS score. RESULTS We identified 223 interventions across 209 studies, with a total of 53,834 participants across all studies. Five main themes of interventions were synthesised: psychological (n = 80); social (n = 54); arts, culture and environment (n = 29); physical health promotion (n = 18); and other (n = 28). Psychological interventions based on resilience, wellbeing or self-management techniques had the strongest effect on wellbeing. A broad range of other interventions were effective at improving mental wellbeing, including other psychological interventions such as cognitive behavioural therapy, psychoeducation and mindfulness. Medium to strong effects were also seen for person-centred support/advice (social), arts-based, parenting (social) and social prescribing interventions. However, a major limitation of the evidence was that only 75 (36%) of studies included a control group. CONCLUSIONS WEMWBS has been widely used to assess wellbeing across a diverse range of interventions, settings and samples. Despite substantial heterogeneity in individual intervention design, delivery and groups targeted, results indicate that a broad range of intervention types can successfully improve wellbeing. Methodological changes, such as greater use of control groups in intervention evaluation, can help future researchers and policy makers further understand what works for mental wellbeing.
Collapse
Affiliation(s)
- Joanna M. Blodgett
- Kohlrabi Consulting, Manchester SK4 3HJ, UK
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London W1T 7HA, UK
| | - Jack M. Birch
- Kohlrabi Consulting, Manchester SK4 3HJ, UK
- Homerton College, University of Cambridge, Cambridge CB2 8PH, UK
| | | | | | - Aradhna Kaushal
- Kohlrabi Consulting, Manchester SK4 3HJ, UK
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| |
Collapse
|
10
|
Aci OS, Kutlu FY. The effect of salutogenic approach-based interviews on sense of coherence and resilience in people with schizophrenia: A randomized controlled trial. Perspect Psychiatr Care 2022; 58:1754-1762. [PMID: 34911139 DOI: 10.1111/ppc.12985] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to determine the effect of interviews based on a salutogenic approach on the sense of coherence and resilience in schizophrenic patients. DESIGN AND METHODS A pretest-posttest randomized controlled experimental trial was conducted with 49 patients. FINDINGS The posttest and follow-up mean scores of the subscales and the overall scale of sense of coherence and resilience differed in favor of the intervention group (p < 0.01). In the intra-group comparison, the pretest, posttest, and 1-month follow-up all the subscales and the total mean scores of the sense of coherence and resilience differed in the intervention group (p < 0.001). PRACTICAL IMPLICATIONS The salutogenic approach-based interview is an effective intervention to increase the sense of coherence and resilience.
Collapse
Affiliation(s)
- Ozgur Sema Aci
- Department of Mental Health and Psychiatric Nursing, Institute of Graduate Studies, Istanbul University-Cerrahpasa, İstanbul, Turkey
| | - Fatma Yasemin Kutlu
- Department of Mental Health and Psychiatric Nursing, Florence Nightingale Nursing Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
11
|
Kouvaras S, Guiotto M, Schrank B, Slade M, Riches S. Character Strength-Focused Positive Psychotherapy on Acute Psychiatric Wards: A Feasibility and Acceptability Study. Psychiatr Serv 2022; 73:1051-1055. [PMID: 35378993 DOI: 10.1176/appi.ps.202100316] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE A manualized single-session positive psychotherapy intervention was developed and tested on acute psychiatric wards. METHODS Participants were invited in 2018-2019 to identify positive experiences, link them to a personal character strength, and plan a strengths-based activity. The intervention's feasibility was evaluated through fidelity to session components, character strengths identification, and activity completion. Acceptability was evaluated with self-reported pre- and postsession mood ratings, a postsession helpfulness rating, and narrative feedback. RESULTS Participants (N=70) had complex and severe mental health conditions. In 18 group sessions, 89% of components were delivered with fidelity; 80% of the participants identified a character strength, of whom 71% identified a strengths-based activity, and 58% completed the activity. The mean±SD helpfulness rating (N=23) was 8.5±1.5 (on a 10-point Likert scale), and positive mood significantly increased postsession (5.9 presession vs. 7.2 postsession). CONCLUSIONS Positive psychotherapy is feasible in challenging inpatient settings, and service users with severe and complex mental health conditions find it helpful.
Collapse
Affiliation(s)
- Stef Kouvaras
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
| | - Martina Guiotto
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
| | - Beate Schrank
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
| | - Mike Slade
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
| | - Simon Riches
- South London and Maudsley NHS Foundation Trust, Beckenham, Kent, United Kingdom (Kouvaras, Guiotto, Riches); Salomons Institute of Applied Psychology, Faculty of Social and Applied Sciences, Canterbury Christ Church University, Tunbridge Wells, Kent, United Kingdom (Kouvaras); Department of Psychiatry, Karl Landsteiner University of Health Sciences, Krems, Austria (Schrank); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Social, Genetic and Developmental Psychiatry Centre and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London (Riches)
| |
Collapse
|
12
|
Chu MHW, Lau B, Leung J, Chan SC, Tang B, Lau C, Newby C, Chiu R, Lo WTL, Schrank B, Slade M. Positive psychotherapy for psychosis in Hong Kong: A randomized controlled trial. Schizophr Res 2022; 240:175-183. [PMID: 35030447 DOI: 10.1016/j.schres.2021.12.044] [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: 04/22/2021] [Revised: 11/21/2021] [Accepted: 12/25/2021] [Indexed: 10/19/2022]
Abstract
Recovery-oriented practice has been advocated in mental health services in Hong Kong since 2009. Well-being has become an important area of focus for mental health services. Positive Psychotherapy for Psychosis (PPP) is a well-being-focused intervention for use in psychosis, with preliminary evidence from a randomized controlled trial in the United Kingdom of impact on well-being and symptomatology. The aim of this study was to test the effectiveness of PPP on the well-being of people with psychosis in Hong Kong. The study was a randomized controlled trial with two-arm parallel groups. Both groups received treatments as usual, and in addition the intervention group received a 13-session intervention based on a Cantonese Chinese translation of the PPP manual. Intention-to-treat analysis was used. The trial was registered (ANZCTR: ACTRN12620000464965). A total of 154 participants (78 intervention, 76 control) were recruited. As compared to control group, intervention group participants showed significant changes over time on the primary outcome of well-being assessed using the Chinese Short Warwick-Edinburgh Mental Well-being Scale (p = 0.001) and on secondary outcomes of hope (Agency subscale: p = 0.029) and self-efficacy (p = 0.001). Positive Psychotherapy for Psychosis was found to be an effective treatment in improving the well-being and other mental health outcomes for people with psychosis. It can be recommended for use in mental health services to promote recovery.
Collapse
Affiliation(s)
- Menza Hon-Wai Chu
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China.
| | - Bien Lau
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Joey Leung
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Sheung Chun Chan
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Betty Tang
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Charles Lau
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | | | - Rose Chiu
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - William Tak-Lam Lo
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Beate Schrank
- Karl Landsteiner University of Health Sciences, Department of Psychiatry, Krems, Austria
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, United Kingdom
| |
Collapse
|
13
|
Steele P, Cheng N, Phillips LJ, Bryce S, Alvarez-Jimenez M, Allott K. Cognitive strengths in first episode psychosis: a thematic analysis of clinicians' perspectives. BMC Psychiatry 2021; 21:612. [PMID: 34876068 PMCID: PMC8653580 DOI: 10.1186/s12888-021-03627-y] [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: 08/28/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive deficits are associated with poor functional outcomes in individuals recovering from a first episode of psychosis (FEP). Existing treatments that target cognitive deficits in FEP may enhance cognitive function, but improvements to real-world functioning are less consistent. Furthermore, these treatments may not adequately address the personal recovery goals of young people attending FEP services. A novel cognitive strengths-based approach may overcome these shortcomings. METHODS This qualitative study used semi-structured interviews to explore clinicians' (N = 12) perspectives toward the potential development of a cognitive strengths-based assessment or treatment in FEP. The interviews were analysed using thematic analysis. RESULTS Five higher-order themes emerged: (1) pro-strengths attitude despite unfamiliarity and minimal use, (2) default to a cognitive deficit lens, (3) potential benefits of a cognitive strengths approach, (4) potential risks and barriers, and (5) considerations for successful implementation. While clinicians acknowledged their current deficit approach, they supported implementing a cognitive strengths assessment or treatment and highlighted their potential benefits for the personal recovery needs of young people with FEP. CONCLUSIONS These findings suggest that a deficit-focused approach to cognitive function amongst clinicians may be common practice in FEP services. Nevertheless, a cognitive strengths approach was viewed favourably by clinicians and may represent a novel method of supporting personal recovery. Thus, the design and implementation of a cognitive strengths approach may be worthwhile. Future exploration of other stakeholder perspectives, such as young people with FEP, is essential.
Collapse
Affiliation(s)
- Peter Steele
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Nicholas Cheng
- grid.488501.0Orygen, Parkville, Victoria Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Lisa J. Phillips
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Shayden Bryce
- grid.488501.0Orygen, Parkville, Victoria Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Mario Alvarez-Jimenez
- grid.488501.0Orygen, Parkville, Victoria Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia. .,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
| |
Collapse
|
14
|
Bohlmeijer E, Westerhof G. The Model for Sustainable Mental Health: Future Directions for Integrating Positive Psychology Into Mental Health Care. Front Psychol 2021; 12:747999. [PMID: 34744925 PMCID: PMC8566941 DOI: 10.3389/fpsyg.2021.747999] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
This position paper proposes a model for systematic integration of positive psychology interventions (PPIs) in mental healthcare. On the one hand, PPIs can contribute to the decrease of dysfunctional processes underlying mental illness. This evidence is at the core of the new domains of positive clinical psychology and positive psychiatry. On the other hand, a growing number of studies demonstrate that mental health is not merely the absence of mental illness. Mental wellbeing represents a related but separate dimension of mental health. Mental wellbeing reduces the risk of future incidence of mental illness and is highly valued by people receiving psychological treatment as an important aspect of personal and complete recovery and personal growth. This makes mental wellbeing a vital outcome of mental healthcare. PPIs can directly increase mental wellbeing. The model of sustainable mental health is presented integrating the science of positive psychology and mental wellbeing into mental healthcare. This heuristic model can guide both practitioners and researchers in developing, implementing, and evaluating a more balanced, both complaint- and strength-oriented, treatment approach. The role of gratitude interventions is discussed as an example of applying the model. Also, three potential modalities for implementing PPIs as positive psychotherapy in treatment are as: positive psychotherapy as primary treatment, as combinatorial treatment, and as intervention for personal recovery of people with severe or persistent mental disorder. Finally, we argue that longitudinal studies are needed to substantiate the model and the processes involved.
Collapse
Affiliation(s)
- Ernst Bohlmeijer
- University of Twente, Enschede, Netherlands.,Center for eHealth and well-being, Enschede, Netherlands
| | - Gerben Westerhof
- University of Twente, Enschede, Netherlands.,Center for eHealth and well-being, Enschede, Netherlands
| |
Collapse
|
15
|
Dubovsky SL, Ghosh BM, Serotte JC, Cranwell V. Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:160-177. [PMID: 33166960 DOI: 10.1159/000511348] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/30/2020] [Indexed: 11/19/2022]
Abstract
Psychotic depression was initially considered to be at one end of a continuum of severity of major depression. Subsequent experience demonstrated that psychosis is an independent trait that may accompany mood disorders of varying severity. While much has been learned about the impact of severe mood congruent delusions and hallucinations on the course and treatment response of depression, less is known about fleeting or mild psychosis, mood incongruent features, or psychotic symptoms that reflect traumatic experiences. Acute treatment of psychotic unipolar depression generally involves the combination of an antidepressant and an antipsychotic drug or electroconvulsive therapy. There is inadequate information about maintenance treatment of unipolar psychotic depression and acute and chronic treatment of psychotic bipolar disorder. Decision-making therefore still must rely in part on clinical experience.
Collapse
Affiliation(s)
- Steven L Dubovsky
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA, .,Departments of Psychiatry and Medicine, University of Colorado School of Medicine, Denver, Colorado, USA,
| | - Biswarup M Ghosh
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Jordan C Serotte
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Victoria Cranwell
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| |
Collapse
|
16
|
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: 5] [Impact Index Per Article: 1.7] [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.
Collapse
|
17
|
Kasperek‐Zimowska B, Bednarek A, Giguere M, Parnowska D, Żochowska A, Malewicz‐Sawicka M. The impact of positive psychotherapy of psychoses on the subjective well‐being of people suffering from chronic schizophrenia—Preliminary report. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Agata Bednarek
- Daily Psychiatric Ward Institute of Psychiatry and Neurology Warsaw Poland
| | - Marta Giguere
- Daily Psychiatric Ward Institute of Psychiatry and Neurology Warsaw Poland
| | | | | | | |
Collapse
|
18
|
Hoppen TH, Morina N. Efficacy of positive psychotherapy in reducing negative and enhancing positive psychological outcomes: a meta-analysis of randomised controlled trials. BMJ Open 2021; 11:e046017. [PMID: 34489269 PMCID: PMC8422317 DOI: 10.1136/bmjopen-2020-046017] [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] [Received: 10/19/2020] [Accepted: 08/09/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Positive psychotherapy (PPT) aims at increasing positive affect, meaning and engagement. We aimed to synthesise the available evidence on PPT efficacy. DESIGN We conducted a preregistered systematic literature search and meta-analysis of randomised controlled trials examining the efficacy of PPT for increasing positive (eg, satisfaction with life) or decreasing negative psychological outcomes (eg, depression). DATA SOURCES Medline, PsycINFO and Web of Science from 2006 (ie, inception of PPT) to February 2020 as well as related systematic reviews and meta-analyses. RESULTS We included 20 randomised controlled trial with a total of 1360 participants. Moderate effect sizes were found for increasing positive outcomes (g=-0.72, 95% CI: -1.31 to -0.14, k=10, numbers needed to treat (NNT)=2.55) and reducing negative outcomes (g=0.48, 95% CI: 0.18 to 0.78, k=8, NNT=3.76) when PPT was compared with waitlist control conditions at post-treatment assessment. When compared with active control conditions, PPT yielded large effect sizes for increasing positive outcomes (g=-0.92, 95% CI: -1.74 to -0.11, k=6, NNT=2.05) and reducing depression (g=0.94, 95% CI: 0.18 to 1.70, k=6, NNT=2.03) at post-treatment assessment. No significant differences in efficacy were found when compared with established treatments such as cognitive-behavioural therapy. Evidence was found to support an association between trial quality and effect sizes. For positive outcomes, higher trial quality was related to larger effect size. Whereas higher trial quality was associated with smaller effect size for depression. Follow-up assessments remained too scarce for most planned analyses. CONCLUSIONS Our findings support the short-term efficacy of PPT. However, results are to be regarded with due caution in the light of low number of trials. More high-quality trials that assess efficacy at follow-ups are needed to draw firmer conclusions on the long-term efficacy of PPT. PROSPERO REGISTRATION NUMBER CRD42020173567.
Collapse
Affiliation(s)
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
| |
Collapse
|
19
|
Halverson TF, Meyer-Kalos PS, Perkins DO, Gaylord SA, Palsson OS, Nye L, Algoe SB, Grewen K, Penn DL. Enhancing stress reactivity and wellbeing in early schizophrenia: A randomized controlled trial of Integrated Coping Awareness Therapy (I-CAT). Schizophr Res 2021; 235:91-101. [PMID: 34332429 DOI: 10.1016/j.schres.2021.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/14/2021] [Accepted: 07/19/2021] [Indexed: 11/18/2022]
Abstract
Individuals with schizophrenia spectrum disorders (SSD) are at heightened risk for exposure to stressful life events which can lead to increased sensitivity to stress and a dysregulated stress response, which are in turn associated with poor long-term functioning. Stress reactivity is thus a promising treatment target in the early stages of SSD. Integrated-Coping Awareness Therapy (I-CAT) is a manualized intervention integrating mindfulness and positive psychology to target a dysregulated stress response in SSD. The current study is a preliminary randomized-controlled trial (RCT) comparing I-CAT (n = 18) with treatment as usual (TAU; n = 18) in individuals in the early stages of SSD. I-CAT was hypothesized to be more effective than TAU on primary outcomes: increasing positive emotions, decreasing negative emotions, reducing stress, and improving functioning and quality of life; and secondary outcomes: reducing symptoms, increasing mindfulness, and improving overall well-being. Excellent therapy attendance rates, low study attrition, and positive participant feedback demonstrated that I-CAT was a feasible and well-tolerated psychosocial intervention. Results suggest I-CAT led to greater reduction in symptoms (i.e., overall, negative, and disorganized symptoms), increased observational mindfulness, increased endorsement of a sense of purpose in life, and preservation of work abilities and school social functioning compared with TAU. Future work should replicate and extend these findings in a larger-scale RCT.
Collapse
Affiliation(s)
- Tate F Halverson
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, United States of America.
| | - Piper S Meyer-Kalos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, United States of America
| | - Diana O Perkins
- Department of Psychiatry, The University of North Carolina at Chapel Hill, United States of America
| | - Susan A Gaylord
- Department of Physical Medicine and Rehabilitation, The University of North Carolina at Chapel Hill, United States of America
| | - Olafur S Palsson
- Department of Medicine, The University of North Carolina at Chapel Hill, United States of America
| | - Lana Nye
- College of Social Work, The University of Utah, United States of America
| | - Sara B Algoe
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, United States of America
| | - Karen Grewen
- Department of Psychiatry, The University of North Carolina at Chapel Hill, United States of America
| | - David L Penn
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, United States of America; School of Behavioural and Health Sciences, Australian Catholic University, Australia
| |
Collapse
|
20
|
Özdemir AA, Kavak Budak F. The Effects of Mindfulness-Based Stress Reduction Training on Hope, Psychological Well-Being, and Functional Recovery in Patients with Schizophrenia. Clin Nurs Res 2021; 31:183-193. [PMID: 34382427 DOI: 10.1177/10547738211039069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study tested the effects of mindfulness-based stress reduction (MBSR) training on multiple outcomes in patients with schizophrenia. We compared MBSR, psychoeducation, and control groups in a randomized controlled research design. Outcome measures assessed hope, psychological wellbeing, and functional recovery over three time points in 137 participants. The results of this study indicate that MBSR training was more effective in terms of increasing the level of hope, psychological well-being, and functional recovery of schizophrenia patients when compared with psychoeducation and control patients.
Collapse
|
21
|
A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat Hum Behav 2021; 5:631-652. [PMID: 33875837 DOI: 10.1038/s41562-021-01093-w] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
Collapse
|
22
|
Slade M. Management of a High-Performing Mental Health Recovery Research Group. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4007. [PMID: 33920382 PMCID: PMC8070016 DOI: 10.3390/ijerph18084007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022]
Abstract
A personal perspective is given on the processes involved in managing and sustaining a high-performing mental health recovery research group. The broader context of scholarship in the United Kingdom is outlined, in which academic productivity is commodified specifically in relation to peer-reviewed journal papers. Four leadership choices in developing a high-performing research group are discussed: optimal group size; sharing the workload; maintaining a programmatic focus; and performance expectations. Approaches to maximising innovation are identified, including emotional and intellectual engagement of team members, working with diverse stakeholders and convening communities of practice. We use a highly managed approach to publications from inception to acceptance, which is described in detail. The use of these approaches is illustrated in relation to the Recovery Research Team which was formed in 2009. Specific recovery-related issues covered include demonstrating the ability to develop a significant recovery research portfolio (our four current large [>UK£2 m] studies relate to recovery narratives, global mental health peer support work, digital interventions and Recovery Colleges); the positive implications of actively recruiting researchers with mental health lived experience; how performance issues are managed; our approach to involving lived experience co-authors in papers; and our decision to conduct mixed-methods rather than solely qualitative studies.
Collapse
Affiliation(s)
- Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham NG7 2TU, UK
| |
Collapse
|
23
|
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
| |
Collapse
|
24
|
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
| |
Collapse
|
25
|
Tong J, Yu W, Fan X, Sun X, Zhang J, Zhang J, Zhang T. Impact of Group Art Therapy Using Traditional Chinese Materials on Self-Efficacy and Social Function for Individuals Diagnosed With Schizophrenia. Front Psychol 2021; 11:571124. [PMID: 33551897 PMCID: PMC7855174 DOI: 10.3389/fpsyg.2020.571124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/16/2020] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to examine the effect of group art therapy using traditional Chinese materials on improving the self-efficacy and social function of individuals diagnosed with schizophrenia. In China, little research has been conducted on patients to measure the effectiveness of group art therapy, especially using traditional Chinese materials. To address this research gap, 104 individuals diagnosed with schizophrenia were tested in a group art therapy program that included 30 treatment sessions and used a wide variety of materials, including traditional Chinese materials, such as Chinese calligraphy, traditional Chinese painting, Chinese embroidery, and Chinese beads. The effect of art therapy was analyzed using the General Self-Efficacy Scale (GSES) and Scale of Social Skills for Psychiatric Inpatients (SSPI). This study demonstrates that group art therapy using traditional Chinese materials can improve self-efficacy and social function, reducing social and life function problems, and promote the recovery of individuals diagnosed with schizophrenia.
Collapse
Affiliation(s)
| | - Wei Yu
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | | | | | | | | | | |
Collapse
|
26
|
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.
Collapse
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
| |
Collapse
|
27
|
Geerling B, Kraiss J, Kelders S, Stevens A, Kupka R, Bohlmeijer E. The effect of positive psychology interventions on well-being and psychopathology in patients with severe mental illness: A systematic review and meta-analysis. THE JOURNAL OF POSITIVE PSYCHOLOGY 2020. [DOI: 10.1080/17439760.2020.1789695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- B. Geerling
- Dimence, SCBS Centre for Bipolar Disorders, Deventer, The Netherlands
- Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - J.T. Kraiss
- Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - S.M. Kelders
- Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - A.W.M.M. Stevens
- Dimence, SCBS Centre for Bipolar Disorders, Deventer, The Netherlands
| | - R.W. Kupka
- VU Medisch Centrum, Public Health Research Institute, Afdeling Psychiatrie, GGZ inGeest, Amsterdam UMC, Amsterdam, The Netherlands
| | - E.T. Bohlmeijer
- Dimence, SCBS Centre for Bipolar Disorders, Deventer, The Netherlands
| |
Collapse
|
28
|
Lim MH, Penn DL, Thomas N, Gleeson JFM. Is loneliness a feasible treatment target in psychosis? Soc Psychiatry Psychiatr Epidemiol 2020; 55:901-906. [PMID: 31127348 DOI: 10.1007/s00127-019-01731-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/13/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE Loneliness is a challenge for individuals with psychosis; however, interventions rarely target loneliness in this group. METHOD We developed a pilot positive psychology group intervention designed to reduce loneliness in psychosis and examined its feasibility and acceptability. RESULTS Sixteen participants attended 5.38 (SD = 0.70) out of six sessions, with a dropout rate of 10%. Participants were significantly less lonely at post-treatment (p < 0.001, d = 1.51), and maintained their improvements from post-treatment to follow-up (p = 0.81, d = 0.07). CONCLUSIONS Loneliness may be a feasible and acceptable treatment target within psychosocial treatments.
Collapse
Affiliation(s)
- M H Lim
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia. .,Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Australia.
| | - D L Penn
- Department of Psychology and Neurosciences, University of North Carolina Chapel Hill, Chapel Hill, USA.,School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Australia
| | - N Thomas
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - J F M Gleeson
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Australia
| |
Collapse
|
29
|
A pilot digital intervention targeting loneliness in young people with psychosis. Soc Psychiatry Psychiatr Epidemiol 2020; 55:877-889. [PMID: 30874828 DOI: 10.1007/s00127-019-01681-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 02/25/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Loneliness has been identified as a significant challenge for people with psychosis. Interventions targeting loneliness are lacking but adopting a positive psychology approach may reduce loneliness, promote well-being, and support meaningful social interactions. Together with youth mental health consumers, we developed a digital smartphone application (app) called +Connect, which delivers positive psychology content daily for 6 weeks. MATERIALS AND METHODS Twelve participants diagnosed with a psychotic disorder were recruited from early psychosis services. Loneliness was assessed pre-intervention, post-intervention, and 3-month post-intervention. Acceptability, feasibility, and usability were measured post-intervention, including a semi-structured interview on the user's experience of +Connect. RESULTS We found evidence for the feasibility of +Connect. All but two participants completed the +Connect program, completing 95% (40.10 out of 42 days) of the program. Furthermore, 66.67% (8 out of the 12 participants) remained engaged with the program 3-months post-intervention. Our data indicates preliminary evidence that +Connect may reduce loneliness, with scores from pre-intervention (M = 50.00, SD = 8.47) to post-intervention (M = 48.10, SD = 10.38) and 3-months post-intervention (M = 42.89, SD = 7.04). We found that positive reinforcement of in-game rewards and evidence of positive mood changes added to the feasibility of the app. Regarding acceptability, while 10% (1/10 participants) reported not finding +Connect useful or enjoyable, 90% of participants agreed that +Connect helped them to increase their social confidence, enjoy life, look forward to being with other people, and feel more connected with others. Participant interviews supported these results, with participants highlighting the app's strengths in providing useful information, stimulating self-reflection, fostering positive affect, and encouraging transfer of skills into their social interactions. DISCUSSION While preliminary findings indicated that +Connect yielded high levels of acceptability and feasibility, it is important to consider that we recruited a small and selected sample of lonely young people. Further iterations of this proof of concept app, which can incorporate participant feedback such preferences for increased personalisation, in-app feedback, and gamification, may allow an opportunity to test an improved version in the future.
Collapse
|
30
|
Allott K, Steele P, Boyer F, de Winter A, Bryce S, Alvarez-Jimenez M, Phillips L. Cognitive strengths-based assessment and intervention in first-episode psychosis: A complementary approach to addressing functional recovery? Clin Psychol Rev 2020; 79:101871. [DOI: 10.1016/j.cpr.2020.101871] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 05/14/2020] [Accepted: 05/24/2020] [Indexed: 12/14/2022]
|
31
|
Positive intervention for depression and teacher-student relationship in Iranian high school girl students with moderate/mild depression: a pilot randomized controlled trial. Child Adolesc Psychiatry Ment Health 2020; 14:25. [PMID: 32518587 PMCID: PMC7271528 DOI: 10.1186/s13034-020-00331-9] [Citation(s) in RCA: 4] [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: 09/14/2019] [Accepted: 05/26/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Positive intervention (PI) is a modern and therapeutic approach broadly based on the principles of positive psychology (Rashid in J Posit Psychol 1:25-40, 2014). PI effects at schools have received little attention to date. However, since PI offers a focus on the positive aspects of human experience (Seligman and Csikszentmihalyi in Am Psychol 55:5-14, 2000), we hypothesized that it could exert positive changes in the teacher-student relationship (TSR) and depression symptoms. Therefore, the mentioned pilot study conducted in this article aimed at evaluating PI effects on depression and TSR among Iranian high school girl students with moderate/mild depression. METHOD In this research, 60 eligible female students (aged 15-18) with a Beck Depression Inventory-II (BDI-II) mild-moderate depression diagnosis, were randomly divided into PI (n = 30) and control groups (n = 30) at the time of entering the study and 2 months later following their assessments through the Inventory of TSR (IT-SR) and BDI-II. The intervention group participated in 8-week 2 h group sessions of PI and the control group was evaluated without any intervention. RESULTS The study was completed with a total number of 49 girls [PI group (n = 24), and control group (n = 25)] and everybody participate in 8 sessions. The intervention group was effective on the variables of BDI-II and IT-SR in a way that the involved girls increased their communication (p = 0.001, d = 0.17), trust (p = 0.001 d = 0.14) after PI training and decreased alienation (p = 0.012, d = 0.11) and depression (p = 0.001, d = 0.15) among other high school students. CONCLUSION This intervention could function as an unspecific component of a stepped care approach for teenage girls suffering from depression. This study recommends more RCT with large sample sizes among high school boys students and follow-up.
Collapse
|
32
|
Aktary ML, Caron-Roy S, Sajobi T, O'Hara H, Leblanc P, Dunn S, McCormack GR, Timmins D, Ball K, Downs S, Minaker LM, Nykiforuk CI, Godley J, Milaney K, Lashewicz B, Fournier B, Elliott C, Raine KD, Prowse RJ, Olstad DL. Impact of a farmers' market nutrition coupon programme on diet quality and psychosocial well-being among low-income adults: protocol for a randomised controlled trial and a longitudinal qualitative investigation. BMJ Open 2020; 10:e035143. [PMID: 32371514 PMCID: PMC7228519 DOI: 10.1136/bmjopen-2019-035143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/19/2020] [Accepted: 04/02/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Low-income populations have poorer diet quality and lower psychosocial well-being than their higher-income counterparts. These inequities increase the burden of chronic disease in low-income populations. Farmers' market subsidies may improve diet quality and psychosocial well-being among low-income populations. In Canada, the British Columbia (BC) Farmers' Market Nutrition Coupon Programme (FMNCP) aims to improve dietary patterns and health among low-income participants by providing coupons to purchase healthy foods from farmers' markets. This study will assess the impact of the BC FMNCP on the diet quality and psychosocial well-being of low-income adults and explore mechanisms of programme impacts. METHODS AND ANALYSIS In a parallel group randomised controlled trial, low-income adults will be randomised to an FMNCP intervention (n=132) or a no-intervention control group (n=132). The FMNCP group will receive 16 coupon sheets valued at CAD$21/sheet over 10-15 weeks to purchase fruits, vegetables, dairy, meat/poultry/fish, eggs, nuts and herbs at farmers' markets and will be invited to participate in nutrition skill-building activities. Overall diet quality (primary outcome), diet quality subscores, mental well-being, sense of community, food insecurity and malnutrition risk (secondary outcomes) will be assessed at baseline, immediately post-intervention and 16 weeks post-intervention. Dietary intake will be assessed using the Automated Self-Administered 24-hour Dietary Recall. Diet quality will be calculated using the Healthy Eating Index-2015. Repeated measures mixed-effect regression will assess differences in outcomes between groups from baseline to 16 weeks post-intervention. Furthermore, 25-30 participants will partake in semi-structured interviews during and 5 weeks after programme completion to explore participants' experiences with and perceived outcomes from the programme. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Calgary Conjoint Health Research Ethics Board, Rutgers University Ethics and Compliance, and University of Waterloo Office of Research Ethics. Findings will be disseminated through policy briefs, conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT03952338.
Collapse
Affiliation(s)
- Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | | | - Tolulope Sajobi
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Heather O'Hara
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Peter Leblanc
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Sharlette Dunn
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Gavin R McCormack
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Calgary, Alberta, Canada
| | - Dianne Timmins
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
| | - Shauna Downs
- School of Public Health, Rutgers University, Newark, New Jersey, USA
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Jenny Godley
- Department of Sociology, University of Calgary, Calgary, Alberta, Canada
| | - Katrina Milaney
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Fournier
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Charlene Elliott
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Communication Media and Film, University of Calgary, Calgary, Alberta, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Rachel Jl Prowse
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Dana Lee Olstad
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| |
Collapse
|
33
|
Vaingankar JA, Chong SA, Abdin E, Siva Kumar FD, Chua BY, Sambasivam R, Shafie S, Jeyagurunathan A, Seow E, Subramaniam M. Understanding the relationships between mental disorders, self-reported health outcomes and positive mental health: findings from a national survey. Health Qual Life Outcomes 2020; 18:55. [PMID: 32131837 PMCID: PMC7057535 DOI: 10.1186/s12955-020-01308-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 02/26/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The link between mental illness and mental health is gaining focus in research and practice. This study aimed to investigate the association of mental disorders with positive mental health (PMH), overall health and quality of life. In addition, the role of PMH in mediating the relationships between mental disorders and health outcomes was assessed. METHODS The study sample comprised 2270 residents aged 18 years and above who participated in a nationally representative, cross-sectional survey estimating the lifetime prevalence of mood, anxiety and alcohol use disorders, and health outcomes (self-reported overall health, quality of life and PMH) in Singapore. The Positive Mental Health Instrument was used to estimate the level of Total PMH among the respondents with and without mental disorders. Associations between mental disorders and health outcomes were assessed through regression models. Path analyses were conducted to investigate mediating role of PMH. RESULTS Total PMH (Mean ± SD) was significantly lower among individuals having any of the studied lifetime mental disorders (4.23 ± 0.64 versus 4.50 ± 0.67 among those without these disorders). Although having a mood or anxiety disorder was associated with significantly lower Total PMH even after controlling for socio-demographic characteristics, similar relationship was not observed for alcohol use disorders. History of any mental disorders was also associated with lower overall health and quality of life. Total PMH mediated the relationships between mental disorders and overall health and quality of life by reducing the effect sizes for the associations between mental disorders and these health outcomes. CONCLUSIONS Mental disorders were associated with poor health outcomes in affected individuals. This study showed that PMH can mediate the relationships between mental disorders and health outcomes, and act as an underlying mechanism to improve overall health and quality of life in individuals with mental disorders. Findings thus highlight the significance of incorporating mental health promotion and interventions in clinical populations.
Collapse
Affiliation(s)
- Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Fiona Devi Siva Kumar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Rajeswari Sambasivam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Esmond Seow
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| |
Collapse
|
34
|
Kang SJ, Ko SH, Kim JY, Kim SR. Effects of a mental fitness positive psychology intervention program on inpatients with schizophrenia in South Korea: A feasibility study. Perspect Psychiatr Care 2020; 56:6-13. [PMID: 30430580 DOI: 10.1111/ppc.12332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/30/2018] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study investigated the effects of a mental fitness positive psychology intervention program on the self-esteem and interpersonal relationship ability of inpatients with schizophrenia. DESIGN AND METHODS A pretest-posttest nonequivalent control group quasi-experimental design was used. Participants (N = 60) completed scales measuring self-esteem and interpersonal relationship ability. FINDINGS The program effectively improved participants' self-esteem and interpersonal relationship ability. PRACTICE IMPLICATIONS Psychiatric nurses can use this program as a nursing intervention to enhance the self-esteem and interpersonal skills of inpatients with schizophrenia in mental health facilities.
Collapse
Affiliation(s)
- Se Jin Kang
- Department of Nursing, Sungil Mental Hospital, Namwon-si, Republic of Korea
| | - Sung Hee Ko
- Department of Nursing, Chonbuk Research Institute of Nursing Science, Chonbuk National University, Jeonju-si, Republic of Korea
| | - Ji Young Kim
- Department of Nursing, Chonbuk Research Institute of Nursing Science, Chonbuk National University, Jeonju-si, Republic of Korea
| | - Sung Reul Kim
- Department of Nursing, Korea University, Seoul, Republic of Korea
| |
Collapse
|
35
|
Thompson A, Elahi F, Realpe A, Birchwood M, Taylor D, Vlaev I, Leahy F, Bucci S. A Feasibility and Acceptability Trial of Social Cognitive Therapy in Early Psychosis Delivered Through a Virtual World: The VEEP Study. Front Psychiatry 2020; 11:219. [PMID: 32269534 PMCID: PMC7109496 DOI: 10.3389/fpsyt.2020.00219] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 03/05/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Addressing specific social cognitive difficulties is an important target in early psychosis and may help address poor functional outcomes. However, structured interventions using standard therapy settings including groups suffer from difficulties in recruitment and retention. AIMS To address these issues, we aimed to modify an existing group social cognitive intervention entitled 'Social Cognition and Interaction Training' (SCIT) to be delivered through a virtual world environment (Second Life ©). METHODS A single arm nonrandomized proof-of-concept trial of SCIT-VR was conducted. Five groups of three to five individuals per group were recruited over 6 months. Eight sessions of SCIT-VR therapy were delivered through the virtual world platform Second Life© over a 5-week intervention window. Feasibility was examined using recruitment rates and retention. Acceptability was examined using qualitative methods. Secondary outcomes including social cognitive indices, functioning, and anxiety were measured pre- and postintervention. RESULTS The SCIT-VR therapy delivered was feasible (36% consent rate and 73.3% intervention completion rate), acceptable (high overall postsession satisfaction scores) and safe (no serious adverse events), and had high levels of participant satisfaction. Users found the environment immersive. Prepost changes were found in emotion recognition scores and levels of anxiety. There were no signs of clinical deterioration on any of the secondary measures. CONCLUSION This proof-of-concept pilot trial suggested that delivering SCIT-VR through a virtual world is feasible and acceptable. There were some changes in prepost outcome measures that suggest the intervention has face validity. There is sufficient evidence to support a larger powered randomized controlled trial. CLINICAL TRIAL REGISTRATION ISRCTN, identifier 41443166.
Collapse
Affiliation(s)
- Andrew Thompson
- Orygen, the Centre for Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Farah Elahi
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Alba Realpe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Max Birchwood
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - David Taylor
- Department of Surgery & Cancer, Faculty of Medicine, Imperial College London, University of London, London, United Kingdom
| | - Ivo Vlaev
- Behavioural Science Group, Warwick Business School, University of Warwick, Coventry, United Kingdom
| | - Fiona Leahy
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Sandra Bucci
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, Manchester Academic Health Sciences, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| |
Collapse
|
36
|
Seo MA, Lim YJ. Optimism and life satisfaction in persons with schizophrenia living in the community. Int J Soc Psychiatry 2019; 65:615-620. [PMID: 31387431 DOI: 10.1177/0020764019868256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND This study aimed at examining the relationships between optimism and life satisfaction in persons with schizophrenia living in the community. METHOD In total, 108 persons with schizophrenia who live in the community, ranging in age from 20 to 67 years, completed measures of optimism, perceived stress and life satisfaction. RESULTS Results showed that optimism significantly predicted life satisfaction even after controlling for gender, age, onset age, employment and perceived stress. CONCLUSION Findings add further support to the growing body of evidence implicating that the intervention for enhancing life satisfaction in persons with schizophrenia dwelling in the community could focus on increasing optimism.
Collapse
Affiliation(s)
- Myeong-Ah Seo
- Department of Psychology, Daegu University, Gyeongsan-si, Korea
| | - Young-Jin Lim
- Department of Psychology, Daegu University, Gyeongsan-si, Korea
| |
Collapse
|
37
|
Comparison of the Effect of Dialectical Behavior Therapy, Mindfulness Based Cognitive Therapy and Positive Psychotherapy on Perceived Stress and Quality of Life in Patients with Irritable Bowel Syndrome: a Pilot Randomized Controlled Trial. Psychiatr Q 2019; 90:565-578. [PMID: 31152288 DOI: 10.1007/s11126-019-09643-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study aimed to compare dialectical behavior therapy (DBT), mindfulness based cognitive therapy (MBCT) and positive psychotherapy (PPT) effects on perceived stress (PS) and quality of life (QOL) among patients with irritable bowel syndrome (IBS). Seventy six eligible patients with a Rome- IV diagnosis were randomly allocated in DBT (n = 18), MBCT (n = 20), PPT (n = 18), and control groups (n = 20). All the patients were evaluated for PS by perceived stress scale (PSS) and QOL by irritable bowel syndrome quality of life (IBS-QOL) on the studied groups at the time of their inclusion in the study and 8 weeks after it. Each of the intervention groups took part in 8 group sessions. Conversely, the control group were evaluated without any intervention. 46 female and 27 male in 4 groups completed the study. The results showed significant differences between the groups based on the variables of the PSS and IBS-QOL (p < 0.05). In addition, levels of PS were significantly lower for the MBCT intervention compared with the other groups; besides, the significant effects of the QOL variables represented the higher scores of the PPT compared to the treatment groups. The interventions could not be generalized to other samples. Some other limitations included the lack of conducting a follow-up plan. This study provides initial evidence that MBCT and PPT are more effective than other treatment groups on PS decrease and QOL improvement among patients with IBS, respectively.
Collapse
|
38
|
Caccamo F, Capani A, Marogna C. Evaluation of Symptoms and Alexithymia in Psychiatric Patients: A Naturalistic Longitudinal Study in a Day Hospital. Int J Group Psychother 2019; 69:328-344. [PMID: 38449196 DOI: 10.1080/00207284.2019.1604142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aimed to examine the effectiveness of a time-limited (10 months), combined individual and group treatment in a Day Hospital (DH) setting. Participants (N = 73) completed measures of general symptoms and alexithymia. We hypothesized improvements in these symptoms at the end of the overall therapeutic treatment. Results showed significant improvement in ability to identify and describe emotions and feelings, and in general symptoms. Differences in age and personality disorders were found at the end of the treatment: younger patients had less difficulty in identifying emotions, and psychotic patients have higher difficulty to describe feelings compared to patients with personality disorders. Furthermore, patients with schizophrenia had lower pathological symptoms compared to patients with mood disorders. This naturalistic longitudinal study demonstrates that DH treatments in group setting increase the patient's ability to symbolize and to connect their symptoms to thought and emotions.
Collapse
|
39
|
The challenge of well-being and quality of life: A meta-analysis of psychological interventions in schizophrenia. Schizophr Res 2019; 208:16-24. [PMID: 30833133 DOI: 10.1016/j.schres.2019.01.040] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 11/08/2018] [Accepted: 01/27/2019] [Indexed: 02/03/2023]
Abstract
Well-being is a critical outcome in the recovery from psychosis and the prevention of symptoms. Previous reviews of the effectiveness of psychological interventions have focused on psychotic symptoms and general psychopathology, not recognising well-being as an essential outcome. This study conducted a meta-analysis of the effects of psychological interventions on the well-being and quality of life (QoL) of people with schizophrenia and analysed some critical moderating factors. A systematic literature search was conducted yielding 12986 published reports, 2043 of which were clinical trials. After a detailed review, 36 articles were included in the analyses. Measures of related concepts, well-being and quality of life were included in the present meta-analysis to reflect the current state of the literature and to ensure the representativeness of RCTs that have evaluated the effect of psychological interventions on the extent to which people with schizophrenia experience a good life. Our findings reflect a significant, small, treatment effect on the outcomes of well-being. Subgroup analysis also suggested a significant moderating effect when the primary aim of the intervention was well-being. These findings suggest that symptom or functional improvement does not necessarily lead to an improvement in well-being and would imply the need to focus specifically on those. We recommend psychological interventions that target well-being as a complementary strategy in mental health promotion and treatment. In addition, we stress the need to include well-being outcome measure in RCT as well as to clearly identify the different domains of well-being being measured.
Collapse
|
40
|
Favrod J, Nguyen A, Chaix J, Pellet J, Frobert L, Fankhauser C, Ismailaj A, Brana A, Tamic G, Suter C, Rexhaj S, Golay P, Bonsack C. Improving Pleasure and Motivation in Schizophrenia: A Randomized Controlled Clinical Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2019; 88:84-95. [PMID: 30783071 PMCID: PMC6518864 DOI: 10.1159/000496479] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 12/30/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Negative symptoms are frequent in patients with schizophrenia and are associated with marked impairments in social functioning. The efficacy of drug-based treatments and psychological interventions on primary negative symptoms remains limited. The Positive Emotions Programme for Schizophrenia (PEPS) is designed to improve pleasure and motivation in schizophrenia patients by targeting emotion regulation and cognitive skills relevant to apathy and anhedonia. The main hypothesis of this study is that patients who attend 8 one-hour sessions of PEPS and treatment as usual (TAU) will have lower total apathy-avolition and anhedonia-asociality composite scores on the Scale for the Assessment of Negative Symptoms (SANS) than patients who attend only TAU. METHODS Eighty participants diagnosed with schizophrenia or schizoaffective disorder were randomized to receive either TAU or PEPS + TAU. The participants were assessed by independent evaluators before randomization (T0), in a post-test after 8 weeks of treatment (T1) and at a 6-month follow-up (T2). RESULTS The post-test results and 6-month follow-up assessments according to an intention-to-treat analysis showed that the apathy and anhedonia composite scores on the SANS indicated statistically greater clinical improvements in PEPS participants than in non-PEPS participants. In the post-test, anhedonia but not apathy was significantly improved, thus favouring the PEPS condition. These results were sustained at the 6-month follow-up. CONCLUSIONS PEPS is an effective intervention to reduce anhedonia in schizophrenia. PEPS is a short, easy-to-use, group-based, freely available intervention that is easy to implement in a variety of environments (ClinicalTrials.gov ID: NCT02593058).
Collapse
Affiliation(s)
- Jérôme Favrod
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland,
| | - Alexandra Nguyen
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Joséphine Chaix
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Joanie Pellet
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Laurent Frobert
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Caroline Fankhauser
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland,Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | | | | | | | - Caroline Suter
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Shyhrete Rexhaj
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Charles Bonsack
- Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| |
Collapse
|
41
|
Dong A, Zhang X, Zhou H, Chen S, Zhao W, Wu M, Guo J, Guo W. Applicability and cross-cultural validation of the Chinese version of the Warwick-Edinburgh mental well-being scale in patients with chronic heart failure. Health Qual Life Outcomes 2019; 17:55. [PMID: 30922342 PMCID: PMC6440095 DOI: 10.1186/s12955-019-1120-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 03/13/2019] [Indexed: 12/02/2022] Open
Abstract
Background The mental well-being of patients with chronic heart failure is likely to influence their health-related quality of life and decrease the utilization of public health resources. This study assessed the mental well-being of patients with chronic heart failure and evaluated the reliability and validity of the Warwick-Edinburgh Mental Well-Being Scale. Methods We conducted a cross-sectional survey from July 2016 to July 2017 among 191 patients with chronic heart failure, and examined psychometric properties of the Warwick-Edinburgh Mental Well-Being Scale, such as internal consistency, reliability, test-retest reliability, and factorial validity of the Chinese version of the Warwick-Edinburgh Mental Well-Being Scale. Results One-dimensional construct validity was demonstrated by confirmatory factor analysis. The psychometric properties of the Chinese version of the Warwick-Edinburgh Mental Well-Being Scale were satisfactory in our sample of patients with chronic heart failure. The internal consistency reliability was .948 and the test-retest reliability .925. The item-total correlations ranged from .405 to .872. There was a strong correlation (r = .79) between the Chinese version of the Warwick-Edinburgh Mental Well-Being Scale and the five-item World Health Organization Well-Being Index. The Chinese version of the Warwick-Edinburgh Mental Well-Being Scale appears acceptable for use in patients with chronic heart failure, and we were able to verify its reliability and validity with our sample. Conclusions The Chinese version of the Warwick-Edinburgh Mental Well-Being Scale is a reliable quantitative tool for evaluating mental well-being in patients with chronic heart failure in clinical settings, and this has important implications for overall assessments of mental well-being in patients with chronic heart failure. Electronic supplementary material The online version of this article (10.1186/s12955-019-1120-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Aishu Dong
- Emergency Department, the Second Affiliated Hospital of Wenzhou Medical University, College West Road 109, 0577, Wenzhou, Zhejiang, People's Republic of China
| | - Xiuxia Zhang
- Emergency Department, the Second Affiliated Hospital of Wenzhou Medical University, College West Road 109, 0577, Wenzhou, Zhejiang, People's Republic of China
| | - Haitao Zhou
- Cardiac Department, the Second Affiliated Hospital of Wenzhou Medical University, College West Road 109, 0577, Wenzhou, Zhejiang, People's Republic of China
| | - Siyi Chen
- Cardiac Department, the Second Affiliated Hospital of Wenzhou Medical University, College West Road 109, 0577, Wenzhou, Zhejiang, People's Republic of China
| | - Wei Zhao
- Cardiac Department, the Second Affiliated Hospital of Wenzhou Medical University, College West Road 109, 0577, Wenzhou, Zhejiang, People's Republic of China
| | - Minmin Wu
- Cardiac Department, the Second Affiliated Hospital of Wenzhou Medical University, College West Road 109, 0577, Wenzhou, Zhejiang, People's Republic of China
| | - Junyi Guo
- Chemoradiotherapy Department, the Second Affiliated Hospital of Wenzhou Medical University, College West Road 109, 0577, Wenzhou, Zhejiang, People's Republic of China
| | - Wenjian Guo
- Hematology Department, the Second Affiliated Hospital of Wenzhou Medical University, College West Road 109, 0577, Wenzhou, Zhejiang, People's Republic of China.
| |
Collapse
|
42
|
Meyer-Kalos PS, Ludwig KA, Gaylord S, Perkins DO, Grewen K, Palsson OS, Burchinal M, Penn DL. Enhancing stress reactivity and wellbeing in early schizophrenia: A pilot study of individual coping awareness therapy (I-CAT). Schizophr Res 2018; 201:413-414. [PMID: 29735201 DOI: 10.1016/j.schres.2018.04.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/20/2018] [Accepted: 04/29/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Piper S Meyer-Kalos
- Minnesota Center for Chemical and Mental Health, The University of Minnesota, St. Paul, MN, USA.
| | - Kelsey A Ludwig
- The Department of Psychology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Susan Gaylord
- The Department of Physical Medicine and Rehabilitation, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Diana O Perkins
- The Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen Grewen
- The Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Olafur S Palsson
- Center for Functional GI & Motility Disorders, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Margaret Burchinal
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David L Penn
- The Department of Psychology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Australian Catholic University, School of Psychology, Melbourne, VIC, Australia
| |
Collapse
|
43
|
Chakhssi F, Kraiss JT, Sommers-Spijkerman M, Bohlmeijer ET. The effect of positive psychology interventions on well-being and distress in clinical samples with psychiatric or somatic disorders: a systematic review and meta-analysis. BMC Psychiatry 2018; 18:211. [PMID: 29945603 PMCID: PMC6020379 DOI: 10.1186/s12888-018-1739-2] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 05/11/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Although positive psychology interventions (PPIs) show beneficial effects on mental health in non-clinical populations, the current literature is inconclusive regarding its effectiveness in clinical settings. We aimed to examine the effects of PPIs on well-being (primary outcome), depression, anxiety, and stress (secondary outcomes) in clinical samples with psychiatric or somatic disorders. METHODS A systematic review and meta-analysis was conducted following PRISMA guidelines. PsycINFO, PubMed, and Scopus were searched for controlled studies of PPIs in clinical samples between Jan 1, 1998 and May 31, 2017. Methodological quality of each study was rated. We used Hedges' adjusted g to calculate effect sizes and pooled results using random-effect models. RESULTS Thirty studies were included, representing 1864 patients with clinical disorders. At post-intervention, PPIs showed significant, small effect sizes for well-being (Hedges' g = 0.24) and depression (g = 0.23) compared to control conditions when omitting outliers. Significant moderate improvements were observed for anxiety (g = 0.36). Effect sizes for stress were not significant. Follow-up effects (8-12 weeks), when available, yielded similar effect sizes. Quality of the studies was low to moderate. CONCLUSION These findings indicate that PPIs, wherein the focus is on eliciting positive feelings, cognitions or behaviors, not only have the potential to improve well-being, but can also reduce distress in populations with clinical disorders. Given the growing interest for PPIs in clinical settings, more high quality research is warranted as to determine the effectiveness of PPIs in clinical samples. TRIAL REGISTRATION PROSPERO CRD42016037451.
Collapse
Affiliation(s)
- Farid Chakhssi
- Scelta, GGNet, Apeldoorn, The Netherlands. .,Centre for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands.
| | - Jannis T. Kraiss
- 0000 0004 0399 8953grid.6214.1Centre for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands
| | - Marion Sommers-Spijkerman
- 0000 0004 0399 8953grid.6214.1Centre for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands
| | - Ernst T. Bohlmeijer
- 0000 0004 0399 8953grid.6214.1Centre for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands
| |
Collapse
|
44
|
Browne J, Estroff SE, Ludwig K, Merritt C, Meyer-Kalos P, Mueser KT, Gottlieb JD, Penn DL. Character strengths of individuals with first episode psychosis in Individual Resiliency Training. Schizophr Res 2018; 195:448-454. [PMID: 29033282 DOI: 10.1016/j.schres.2017.09.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/16/2017] [Accepted: 09/23/2017] [Indexed: 02/04/2023]
Abstract
Positive psychology interventions that integrate a person's strengths into treatment result in improvements in life satisfaction and well-being. Character strengths classified within six core virtues (wisdom/knowledge, courage, humanity, justice, temperance, and transcendence) have been the subject of substantial research. Though a number of studies have been conducted in the general population, little is known about the character strengths of individuals with first episode psychosis (FEP). Moreover, positive psychology principles, in particular a focus on personal strengths, have been increasingly integrated into FEP treatment and was a core component of Individual Resiliency Training (IRT), the individual therapy component of NAVIGATE tested in the Recovery After an Initial Schizophrenia Episode Early Treatment Program. As such, the present study offers an examination of character strengths among 105 FEP clients in specialized early intervention treatment. The present study included two primary aims: 1) to conduct a descriptive analysis of character strengths of FEP individuals and 2) to examine exploratory associations between character strengths and changes in symptomatic and recovery variables over six months. Results revealed that the most commonly identified strengths were: Honesty, Authenticity, and Genuineness (40.95%), Kindness and generosity (37.14%), Fairness, equity, and justice (29.52%), Gratitude (29.52%), and Humor and playfulness (29.52%). Three virtues (Humanity, Justice, and Transcendence) were significantly associated with improvements in symptoms, psychological well-being, and interpersonal relations over six months. Overall, the present study offers a glimpse into how persons with FEP view their strengths and how certain clusters of strengths are related to important outcomes.
Collapse
Affiliation(s)
- Julia Browne
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Sue E Estroff
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Kelsey Ludwig
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carrington Merritt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Piper Meyer-Kalos
- Minnesota Center for Chemical and Mental Health, University of Minnesota, School of Social Work, St. Paul, MN, USA
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation and Departments of Occupational Therapy, Psychology, & Psychiatry, Boston University, Boston, MA, USA
| | - Jennifer D Gottlieb
- Center for Psychiatric Rehabilitation and Departments of Occupational Therapy, Psychology, & Psychiatry, Boston University, Boston, MA, USA
| | - David L Penn
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Australian Catholic University, School of Psychology, Melbourne, VIC, Australia
| |
Collapse
|
45
|
Lim MH, Gleeson JFM, Alvarez-Jimenez M, Penn DL. Loneliness in psychosis: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2018; 53:221-238. [PMID: 29327166 DOI: 10.1007/s00127-018-1482-5] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 12/31/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim of the review is to understand the relationships between loneliness and related psychological and social factors in individuals with psychosis. Loneliness is poorly understood in people with psychosis. Given the myriad of social challenges facing individuals with psychosis, these findings can inform psychosocial interventions that specifically target loneliness in this vulnerable group. METHODS We adhered to the PRISMA guidelines and systematically reviewed empirical studies that measured loneliness either as a main outcome or as an associated variable in individuals with psychosis. RESULTS A total of ten studies examining loneliness in people diagnosed with a psychotic disorder were examined. Heterogeneity in the assessment of loneliness was found, and there were contradictory findings on the relationship between loneliness and psychotic symptomatology. In individuals with psychosis, loneliness may be influenced by psychological and social factors such as increased depression, psychosis, and anxiety, poor social support, poor quality of life, more severe internalised stigma and perceived discrimination, and low self-esteem. CONCLUSIONS The relationship between loneliness and psychosis remains poorly understood due to a lack of rigorous studies. Although having strong social relationships is crucial to facilitate recovery from serious mental illness, psychosocial interventions that specifically target loneliness in individuals with psychosis are lacking and sorely needed. Interventions targeting loneliness in those with psychosis will also need to account for additional barriers associated with psychosis (e.g., social skill deficits, impoverished social networks, and negative symptoms).
Collapse
Affiliation(s)
- Michelle H Lim
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, 3122, Australia.
| | - John F M Gleeson
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - David L Penn
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia.,Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
46
|
Langer ÁI, Schmidt C, Mayol R, Díaz M, Lecaros J, Krogh E, Pardow A, Vergara C, Vergara G, Pérez-Herrera B, Villar MJ, Maturana A, Gaspar PA. The effect of a mindfulness-based intervention in cognitive functions and psychological well-being applied as an early intervention in schizophrenia and high-risk mental state in a Chilean sample: study protocol for a randomized controlled trial. Trials 2017; 18:233. [PMID: 28545578 PMCID: PMC5445512 DOI: 10.1186/s13063-017-1967-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 05/02/2017] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND According to the projections of the World Health Organization, 15% of all disabilities will be associated with mental illnesses by 2020. One of the mental disorders with the largest social impacts due to high personal and family costs is psychosis. Among the most effective psychological approaches to treat schizophrenia and other psychotic disorders at the world level is cognitive behavioral therapy. Recently, cognitive behavioral therapy has introduced several tools and strategies that promote psychological processes based on acceptance and mindfulness. A large number of studies support the effectiveness of mindfulness in dealing with various mental health problems, including psychosis. This study is aimed at determining the efficiency of a mindfulness-based program in increasing cognitive function and psychological well-being in patients with a first episode of schizophrenia and a high risk mental state (those at risk of developing an episode of psychosis). METHODS AND DESIGN This is an experimentally designed, multi-center randomized controlled trial, with a 3-month follow-up period. The study participants will be 48 patients diagnosed with schizophrenia (first episode) and 48 with a high-risk mental state, from Santiago, Chile, aged between 15 and 35 years. Participants will be submitted to a mindfulness-based intervention (MBI), which will involve taking part in eight mindfulness workshops adapted for people with psychosis. Workshops will last approximately 1.5 hours and take place once a week, over 8 weeks. The primary outcome will be the cognitive function through Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) and the secondary outcome will be psychological well-being measured by self-reporting questionnaires. DISCUSSION The outcomes of this trial will add empirical evidence to the benefits and feasibility of MBIs for the psychotherapeutic treatment of patients with schizophrenia and high-risk mental states in reducing cognitive impairment in attention, working memory, and social cognition, as well as increasing the psychological well-being by empowering the patients' personal resources in the management of their own symptoms and psychotic experiences. TRIAL REGISTRATION ISRCTN registration number ISRCTN24327446 . Registered on 12 September 2016.
Collapse
Affiliation(s)
- Álvaro I Langer
- Escuela de Psicología, Facultad de Medicina, Universidad Austral de Chile, Campus Isla Teja s/n., Valdivia, Chile. .,Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile. .,Instituto Milenio para la Investigación en Depresión y Personalidad, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile.
| | - Carlos Schmidt
- Escuela de Psicología, Facultad de Medicina, Universidad Austral de Chile, Campus Isla Teja s/n., Valdivia, Chile
| | - Rocío Mayol
- Clínica Psiquiátrica Universitaria, Hospital Clínico y Facultad de Medicina, Universidad de Chile, Recoleta, Santiago, RM, Chile.,Biomedical Neuroscience Institute, Independencia, Santiago, Chile
| | - Marcela Díaz
- Clínica Psiquiátrica Universitaria, Hospital Clínico y Facultad de Medicina, Universidad de Chile, Recoleta, Santiago, RM, Chile
| | - Javiera Lecaros
- Escuela de Psicología, Universidad Adolfo Ibáñez, Diagonal Las Torres 2640, Santiago, Chile
| | - Edwin Krogh
- Instituto de Neurociencias Clínicas, Facultad de Medicina, Universidad Austral de Chile, Campus Isla Teja s/n., Valdivia, Chile
| | - Aída Pardow
- Red de Salud Mental REDGESAM, Santiago, Chile
| | - Carolina Vergara
- Red de Salud Mental REDGESAM, Santiago, Chile.,Servicio de Psiquiatría Hospital del Pino, San Bernardo, Santiago, Chile
| | - Guillermo Vergara
- Red de Salud Mental REDGESAM, Santiago, Chile.,Servicio de Psiquiatría Hospital del Pino, San Bernardo, Santiago, Chile
| | | | - María José Villar
- Clínica Psiquiátrica Universitaria, Hospital Clínico y Facultad de Medicina, Universidad de Chile, Recoleta, Santiago, RM, Chile
| | - Alejandro Maturana
- Clínica Psiquiátrica Universitaria, Hospital Clínico y Facultad de Medicina, Universidad de Chile, Recoleta, Santiago, RM, Chile
| | - Pablo A Gaspar
- Clínica Psiquiátrica Universitaria, Hospital Clínico y Facultad de Medicina, Universidad de Chile, Recoleta, Santiago, RM, Chile.,Biomedical Neuroscience Institute, Independencia, Santiago, Chile.,Departamento de Neurociencias, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| |
Collapse
|
47
|
Kim J, Na H. Effects of a Positive Psychotherapy Program on Positive Affect, Interpersonal Relations, Resilience, and Mental Health Recovery in Community-Dwelling People with Schizophrenia. J Korean Acad Nurs 2017; 47:638-650. [DOI: 10.4040/jkan.2017.47.5.638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 09/22/2017] [Accepted: 09/24/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Jinhee Kim
- Department of Nursing, Dong-A University, Busan, Korea
| | - Hyunjoo Na
- Department of Nursing, Dong-A University, Busan, Korea
| |
Collapse
|
48
|
Broyd A, Jolley S, Johns L. Determinants of subjective well-being in people with psychosis referred for psychological therapy in South London. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2016; 55:429-440. [DOI: 10.1111/bjc.12112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 03/31/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Annabel Broyd
- Department of Psychology; Institute of Psychiatry, Psychology and Neuroscience (IoPPN); King's College, London; UK
| | - Suzanne Jolley
- Department of Psychology; Institute of Psychiatry, Psychology and Neuroscience (IoPPN); King's College, London; UK
| | - Louise Johns
- Department of Psychology; Institute of Psychiatry, Psychology and Neuroscience (IoPPN); King's College, London; UK
- Department of Psychiatry; Oxford University; UK
| |
Collapse
|
49
|
Vaingankar JA, Abdin E, Chong SA, Sambasivam R, Jeyagurunathan A, Seow E, Picco L, Pang S, Lim S, Subramaniam M. Psychometric properties of the positive mental health instrument among people with mental disorders: a cross-sectional study. Health Qual Life Outcomes 2016; 14:19. [PMID: 26868835 PMCID: PMC4751680 DOI: 10.1186/s12955-016-0424-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 02/04/2016] [Indexed: 11/10/2022] Open
Abstract
Background The Positive Mental Health (PMH) instrument was developed and validated to assess the level of PMH and its six dimensions in a multi-ethnic general population sample. This cross-sectional study examines the psychometric properties of the instrument for assessing the level of PMH among help-seeking patients with mental disorders. Methods The PMH instrument was tested among 360 out-patients with schizophrenia, depression or anxiety spectrum disorders, seeking treatment at a tertiary psychiatric hospital and its affiliated clinics in Singapore. All participants completed the PMH instrument along with measures of life satisfaction, mental and overall health and happiness. Reliability (internal consistency), construct (Exploratory Structural Equation Modeling (ESEM)) and criterion (convergent and divergent) validity of the PMH instrument were tested in this population. Items were also tested for item response theory and differential item functioning (IRT-DIF). Results ESEM on the PMH instrument showed good fit with the model reflecting six factors (general coping, personal growth and autonomy, spirituality, interpersonal skills, emotional support, and global affect). Internal consistency was high (Cronbach’s alpha >0.85) for the instrument and its six subscales. The PMH instrument fulfilled expected correlations with related constructs and demonstrated adequate item discrimination and difficulty estimates; however, significant DIF was noted for few items for age, gender and ethnicity groups. Conclusions The PMH instrument is a reliable and valid instrument for measuring PMH dimensions in patients with mental disorders. Further studies in larger samples are needed to assess the impact of DIF on PMH scores. The implications for the shift in focus from just the negative aspects of mental disorders to including positive components in the assessment of patients with mental disorders are immense, and can be applied in routine mental health practice and policy making.
Collapse
Affiliation(s)
- Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore
| | - Rajeswari Sambasivam
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore
| | - Esmond Seow
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore
| | - Louisa Picco
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore
| | - Shirlene Pang
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore
| | - Susan Lim
- Ambulatory Services, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore
| |
Collapse
|
50
|
Lay B, Drack T, Bleiker M, Lengler S, Blank C, Rössler W. Preventing Compulsory Admission to Psychiatric Inpatient Care: Perceived Coercion, Empowerment, and Self-Reported Mental Health Functioning after 12 Months of Preventive Monitoring. Front Psychiatry 2015; 6:161. [PMID: 26635637 PMCID: PMC4650287 DOI: 10.3389/fpsyt.2015.00161] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/26/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the effects of a preventive monitoring program targeted to reduce compulsory rehospitalization and perceived coercion in patients with severe mental disorder. We analyze patient outcomes in terms of perceived coercion, empowerment, and self-reported mental health functioning at 12 months. METHODS The program consists of individualized psychoeducation, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring. In total, 238 psychiatric inpatients who had had compulsory admission(s) during the past 24 months were included in the trial. T1-assessment 12 months after baseline was achieved for 182 patients. RESULTS Study participants reported lower levels of perceived coercion, negative pressures, and process exclusion, a higher level of optimism, and a lesser degree of distress due to symptoms, interpersonal relations, and social role functioning (significant time effects). However, improvements were not confined to the intervention group, but seen also in the treatment-as-usual group (no significant group or interaction effects). Altered perceptions were linked to older age, shorter illness duration, female sex, non-psychotic disorder, and compulsory hospitalization not due to risk of harm to others. CONCLUSION Our findings suggest that changes in the subjective perspective were fueled primarily by participation in this study rather than by having received the specific intervention. The study contributes to a better understanding of the interaction between "objective" measures (compulsory readmissions) and patients' perceptions and highlights the need for treatment approaches promoting empowerment in individuals with a history of involuntary psychiatric hospitalizations.
Collapse
Affiliation(s)
- Barbara Lay
- Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich , Zurich , Switzerland ; The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich , Zurich , Switzerland
| | - Thekla Drack
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich , Zurich , Switzerland
| | - Marco Bleiker
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich , Zurich , Switzerland
| | - Silke Lengler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich , Zurich , Switzerland
| | - Christina Blank
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich , Zurich , Switzerland
| | - Wulf Rössler
- Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich , Zurich , Switzerland ; The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University Hospital of Psychiatry Zurich , Zurich , Switzerland ; Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo , São Paulo , Brazil
| |
Collapse
|