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McKenna C, Moyo B, Goodwin J. Barriers to using physical exercise as an intervention within inpatient mental health settings: A systematic review. Int J Ment Health Nurs 2024; 33:817-833. [PMID: 38332557 DOI: 10.1111/inm.13302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/05/2024] [Accepted: 01/21/2024] [Indexed: 02/10/2024]
Abstract
Service providers find it difficult to implement Physical Exercise (PE) strategies in routine care within inpatient mental health settings even though they perceive it to be an effective therapy, with a robust evidence base. Identifying barriers that exist can assist with the development of future interventions and support PE services being introduced into mental health inpatient settings. The aim of this systematic review was to synthesise the evidence on the barriers or perceived barriers that exist amongst service users and providers when incorporating PE as an intervention within inpatient mental health settings. Using a narrative synthesis approach, four main themes were identified: (i) Barriers relating to service users' mental and physical health, (ii) Factors relating to service providers, (iii) Environmental factors and (iv) Cultural factors. Both service users and providers need more knowledge on implementing PE in inpatient mental health settings. Tailored programmes for service users are warranted, with specialist roles for staff developed.
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Affiliation(s)
- Catriona McKenna
- Eist Linn, Child and Adolescent Mental Health Unit, Bessborough, Cork, Ireland
| | - Beata Moyo
- Emergency Department, Naas General Hospital, Co. Kildare, Ireland
| | - John Goodwin
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Yip CCH, Fung WTW, Leung DCK, Chan KKS. The impact of stigma on engaged living and life satisfaction among people with mental illness in Hong Kong. Qual Life Res 2023; 32:161-170. [PMID: 36056192 DOI: 10.1007/s11136-022-03218-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE The present study aimed to investigate how the interpersonal (experienced discrimination) and intrapersonal (anticipated stigma and internalized stigma) manifestations of psychiatric stigma may affect engaged living and life satisfaction among people with mental illness. In this study, we developed and evaluated a conceptual model to clarify how experienced discrimination may lead to anticipated stigma and internalized stigma and thereby impede engaged living and reduce life satisfaction. METHODS A total of 205 Hong Kong Chinese people with mental illness completed standardized questionnaire measures of experienced discrimination, anticipated stigma, internalized stigma, engaged living, and life satisfaction. The associations among these variables were analyzed using path analyses and bootstrap analyses. RESULTS Path analyses showed that experienced discrimination was related to higher levels of anticipated stigma and internalized stigma, which were, in turn, linked to lesser engaged living and consequently lower life satisfaction. Bootstrap analyses further revealed that experienced discrimination had significant indirect effects on life satisfaction via anticipated stigma and engaged living and via internalized stigma and engaged living. CONCLUSIONS Theoretically, our study uncovers how the interpersonal and intrapersonal manifestations of psychiatric stigma may adversely affect engaged living and life satisfaction among people with mental illness. Practically, our study points to the importance of developing and implementing stigma-related interventions at societal and individual levels in order to enable people with mental illness to live fulfilling and satisfying lives.
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Affiliation(s)
| | - Winnie Tsz Wa Fung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Donald Chi Kin Leung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Kevin Ka Shing Chan
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong. .,Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, Hong Kong.
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Costanza A, Amerio A, Aguglia A, Magnani L, Huguelet P, Serafini G, Pompili M, Amore M. Meaning-centered therapy in Ukraine's war refugees: An attempt to cope with the absurd? Front Psychol 2022; 13:1067191. [PMID: 36619113 PMCID: PMC9815542 DOI: 10.3389/fpsyg.2022.1067191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), Geneva, Switzerland,Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy,*Correspondence: Andrea Amerio ✉
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luca Magnani
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Philippe Huguelet
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), Geneva, Switzerland,Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Mohi S, Deane FP, Mooney-Reh D, Bailey A, Ciaglia D. Experiential avoidance and depression predict values engagement among people in treatment for borderline personality disorder. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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O'Keeffe D, Keogh B, Higgins A. Meaning in Life in Long-Term Recovery in First-Episode Psychosis: An Interpretative Phenomenological Analysis. Front Psychiatry 2021; 12:676593. [PMID: 34408676 PMCID: PMC8365246 DOI: 10.3389/fpsyt.2021.676593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/09/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Meaning in Life (MIL) is a central aspect of service user defined personal recovery in mental health. It is unclear whether current knowledge regarding MIL is applicable to the lives of those who have experienced psychosis. As it was not possible to locate any study examining service user perspectives on MIL in first-episode psychosis (FEP), conducting in-depth qualitative research in this area offers an opportunity to develop a conceptualisation of MIL that may be transferable to the broad psychosis spectrum. Aim: The aim of the study was to explore how people find, develop, and maintain MIL approximately 21 years after their FEP diagnosis. Materials and Methods: The study aim was addressed using Interpretative Phenomenological Analysis (IPA). Participants were members of an epidemiologically complete FEP incidence cohort in Ireland. Purposive maximum variation sampling enabled the recruitment of a sample balanced across remission status, age at time of FEP onset, and gender. Semi-structured interviews were conducted circa 21 years post FEP with 16 participants. Data analysis was guided by IPA procedures. Results: Participants experienced MIL as awareness of connectedness to context - the interrelated conditions they existed in (their relationships with the self, others, systems, the environment, and time). Awareness of connectedness to context occurred in five main ways: Being myself - de-othering and authenticity (Enacting identity); Becoming significant where the self is witnessed (Belonging in life); Generating meaning within and beyond systems (Independence); Shaping and being shaped by life (Agency and patiency); and Integrating different perspectives of time (Reconciling temporality). Conclusions: Findings offer the first in-depth understanding of how people diagnosed with a FEP experience MIL in mid-later life recovery. Current tripartite MIL theories do not fully represent the array of MIL perspectives articulated by our participants. MIL concepts developed are potential areas for intervention for mental health services seeking to implement the recovery approach. Findings can be used to foster optimism among service users and their supporters for MIL attainment in psychosis and offer guidance for education, clinical practice, policy, and future research.
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Affiliation(s)
- Donal O'Keeffe
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Brian Keogh
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Pérez-Corrales J, Pérez-de-Heredia-Torres M, Martínez-Piedrola R, Sánchez-Camarero C, Parás-Bravo P, Palacios-Ceña D. 'Being normal' and self-identity: the experience of volunteering in individuals with severe mental disorders-a qualitative study. BMJ Open 2019; 9:e025363. [PMID: 30904862 PMCID: PMC6475362 DOI: 10.1136/bmjopen-2018-025363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/14/2019] [Accepted: 01/30/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study sought to explore the views and experiences of a group of people with severe mental disorders (SMDs) who performed volunteer services. DESIGN A qualitative phenomenological study. SETTING Community public mental health services of the Community of Madrid and the province of Barcelona (Spain). PARTICIPANTS Purposive sampling techniques were used between September 2016 and April 2017. The inclusion criteria were: individuals aged 18-65 years who participated in volunteer activities during the performance of this study, based on the regulations of volunteer services in Spain and the community of Madrid; a diagnosis of non-organic psychotic disorder (F20.x, F21, F22, F24, F25, F28, F29, F31.x, F32.3 and F33) according to the International Classification of Diseases, 10th Revision; an evolution of ≥2 years; and a moderate to severe dysfunction of global functioning with scores ≤70 in the Global Assessment of Functioning Scale. Ultimately, 23 people with SMD participated in the study with a mean age of 47 years (SD 8.23). METHODS Data were collected through in-depth interviews and researcher field notes. A thematic analysis was performed following appropriate guidelines for qualitative research. RESULTS Two main themes emerged to describe the experience of participating in volunteer activities: (1) rebuilding self-identity, based on the participant's experience of volunteering, of acquiring a new role and a new perceived identity that made them feel valued and respected; and (2) being a so-called normal person with a 'normal' life, based on recovering a sense of normality, unmarked by the illness, thanks to daily responsibilities and occupations. CONCLUSIONS Qualitative research offers insight into the way people with SMD experience volunteering and may help to improve understanding of the underlying motivations that drive these individuals. These findings may be applied to improve guidance during their process of recovery and subsequent inclusion into society.
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Affiliation(s)
- Jorge Pérez-Corrales
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Marta Pérez-de-Heredia-Torres
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Rosa Martínez-Piedrola
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Carlos Sánchez-Camarero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Paula Parás-Bravo
- Department of Nursing, Nursing Group IDIVAL, Faculty of Nursing, University of Cantabria, Santander, Cantabria, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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The Conceptualization and Measurement of Values: A Review of the Psychometric Properties of Measures Developed to Inform Values Work with Adults. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018. [DOI: 10.1007/s10862-018-9679-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Beck AK, Baker A, Jones S, Lobban F, Kay-Lambkin F, Attia J, Banfield M. Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open 2018; 8:e019203. [PMID: 29391366 PMCID: PMC5829875 DOI: 10.1136/bmjopen-2017-019203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/08/2017] [Accepted: 11/07/2017] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Improving accessible, acceptable recovery-oriented service provision for people with bipolar disorder (BD) is an important priority. Mindfulness and acceptance-based cognitive and behavioural therapies (or 'third -wave' CBT) may prove fruitful due to the considerable overlap between these approaches and key features of personal recovery. Groups also confer therapeutic benefits consistent with personal recovery and may improve recovery-oriented service provision by adding another modality for accessing support. The primary objective of this trial is to explore the feasibility and acceptability of a new recovery-focused group therapy (RfGT) intervention for adults with BD. This is the first published feasibility assessment of a time-limited RfGTrecovery-focused group therapy intervention for BD. METHODS/ ANALYSIS This protocol describes an open feasibility study, utilising a pre-treatment design versus post- treatment design and nested qualitative evaluation. Participants will be recruited from the Central Coast region of New South Wales, Australia, from primary care providers, specialist mental health services, non-government organisations and via self-referral. The primary outcomes are feasibility and acceptability as indexed by recruitment, retention, intervention adherence, adverse events (if any) and detailed consumer feedback. Clinical outcomes and process measures will be assessed to inform future research. Primary outcome data will utiliseuse descriptive statistics (eg, summarizingsummarising recruitment, demographics, attendance, attrition and intervention adherence). Secondary outcomes will be assessed using repeated-measures analysis of covariance across all time points (including change, effect size and variability). ETHICS AND DISSEMINATION Ethical approval has been granted by the Northern Sydney Local Health District HREChuman research ethics committee (HREC) (HREC/16/HAWKE/69) and The University of Newcastle HREC (H-2016-0107). The Ffindings will be used to improve the intervention per user needs and preferences, and inform what amendments and/or information are required before a follow-on trial would be possible. This study contributes to a growing body of innovative, recovery-oriented innovations of psychological treatments for adults with BD. TRIAL REGISTRATION NUMBER ACTRN12616000887471; Pre-results.
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Affiliation(s)
- Alison K Beck
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, Sydney, Australia
| | - Amanda Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, Sydney, Australia
| | - Steven Jones
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Fiona Lobban
- Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, Sydney, Australia
| | - John Attia
- Clinical Research Design, IT, and Statistical Support (CReDITSS) Unit, University of Newcastle, Newcastle, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, Australian National University, Canberra, Australia
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9
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Mohi SR, Deane FP, Bailey A, Mooney-Reh D, Ciaglia D. An exploration of values among consumers seeking treatment for borderline personality disorder. Borderline Personal Disord Emot Dysregul 2018; 5:8. [PMID: 29686876 PMCID: PMC5899834 DOI: 10.1186/s40479-018-0085-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 03/19/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Consumer feedback identifies a new challenge in the treatment of borderline personality disorder (BPD) is to address the discrepancy between clinical treatment targets and the more personally meaningful goals people are seeking in treatment. This highlights the need to increase clarification of people's values and link these to therapy goals. The current study explores ways in which individuals with BPD identify with values across key life domains. METHODS At initial assessment 106 consumer participants attending an outpatient clinic for the treatment of BPD completed the Personal Values Questionnaire by Blackledge and colleagues. This 90-item measure asks participants to respond to different value appraisals such as importance, commitment, desire to improve, success and, motivation across nine life domains. These included: relationships, health & wellbeing, education & personal development, work & career, spirituality, recreation & leisure, and community involvement. RESULTS A consistent pattern of value appraisals was found across all life domains. Specifically, life domains were endorsed as highly important but participants reported significantly lower levels of value commitment, desire to improve and success. Successful value pursuit also related differentially to value motivations (internal vs. external) depending on the particular life domain. Relationships with family, friends and romantic partners, as well as health & wellbeing were most important compared to other life domains. CONCLUSIONS The findings suggest that people with BPD identify with values and prioritise different life domains in terms of importance. Our results show discrepancies between higher importance and lower commitment, desire to improve and success at living in line with what is valued. Identification of such discrepancies provides opportunities to more effectively support consumers with BPD to prioritise goals that are consistent with valued domains. These findings offer new insights for cultivating the personal meaning consumers are currently seeking in BPD treatments.
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Affiliation(s)
- Simone R Mohi
- 1School of Psychology, University of Wollongong, Office: 22.G15, Wollongong, NSW 2522 Australia
| | - Frank P Deane
- 2Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Office: 22.G18, Wollongong, NSW 2522 Australia
| | - Anne Bailey
- Illawarra Shoalhaven Local Health District, Wollongong, NSW Australia
| | - Dianne Mooney-Reh
- Illawarra Shoalhaven Local Health District, Wollongong, NSW Australia
| | - Danielle Ciaglia
- Illawarra Shoalhaven Local Health District, Wollongong, NSW Australia
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Iscan Z, Rakesh G, Rossano S, Yang J, Zhang M, Miller J, Sullivan GM, Sharma P, McClure M, Oquendo MA, Mann JJ, Parsey RV, DeLorenzo C. A positron emission tomography study of the serotonergic system in relation to anxiety in depression. Eur Neuropsychopharmacol 2017; 27:1011-1021. [PMID: 28811068 PMCID: PMC5623123 DOI: 10.1016/j.euroneuro.2017.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 06/02/2017] [Accepted: 07/29/2017] [Indexed: 12/17/2022]
Abstract
Symptoms of anxiety are highly comorbid with major depressive disorder (MDD) and are known to alter the course of the disease. To help elucidate the biological underpinnings of these prevalent disorders, we previously examined the relationship between components of anxiety (somatic, psychic and motoric) and serotonin 1A receptor (5-HT1A) binding in MDD and found that higher psychic and lower somatic anxiety was associated with greater 5-HT1A binding. In this work, we sought to examine the correlation between these anxiety symptom dimensions and 5-HTT binding. Positron emission tomography with [11C]-3-amino-4-(3-dimethylamino-methylphenylsulfanyl)-benzonitrile ([11C]DASB) and a metabolite-corrected arterial input function were used to estimate regional 5-HTT binding in 55 subjects with MDD and anxiety symptoms. Somatic anxiety was negatively correlated with 5-HTT binding in the thalamus (β=-.33, p=.025), amygdala (β=-.31, p=.007) and midbrain (β=-.72, p<.001). Psychic anxiety was positively correlated with 5-HTT binding in midbrain only (β=.46, p=.0025). To relate to our previous study, correlation between 5-HT1A and 5-HTT binding was examined, and none was found. We also examined how much of the variance in anxiety symptom dimensions could be explained by both 5-HTT and 5-HT1A binding. The developed model was able to explain 68% (p<.001), 38% (p=.012) and 32% (p=.038) of the total variance in somatic, psychic, and motoric anxiety, respectively. Results indicate the tight coupling between the serotonergic system and anxiety components, which may be confounded when using aggregate anxiety measures. Uncovering serotonin's role in anxiety and depression in this way may give way to a new generation of therapeutics and treatment strategies.
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Affiliation(s)
- Zafer Iscan
- Centre for Cognition and Decision Making, National Research University, Higher School of Economics, Russian Federation; Cognitive Neuroimaging Unit, CEA DRF/Joliot Institute, INSERM, Université Paris-Sud, Université Paris-Saclay, NeuroSpin Center, 91191 Gif-sur-Yvette, France.
| | | | - Samantha Rossano
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Jie Yang
- Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Mengru Zhang
- Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Jeffrey Miller
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Gregory M Sullivan
- Tonix Pharmaceuticals, Inc., 509 Madison Avenue Suite 306, New York, NY, USA
| | - Priya Sharma
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Matthew McClure
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Maria A Oquendo
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - J John Mann
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA; Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA; New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
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Impact of child maltreatment on meaning in life in psychiatric patients. Psychiatry Res 2017; 251:204-211. [PMID: 28214436 DOI: 10.1016/j.psychres.2017.02.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 01/11/2017] [Accepted: 02/11/2017] [Indexed: 10/20/2022]
Abstract
Child maltreatment (CM) worsens prognosis and quality of life in several psychiatric conditions. Meaning in life is a construct which relates to the sense of purpose that one can perceive in life, and is a key aspect of recovery in psychiatric patients. The lasting impact of CM on meaning in life and its mediating variables have not been studied in patients with chronic persistent psychiatric conditions. One hundred and sixty-six patients with bipolar disorder (N=35), psychotic disorder (N=73), anorexia nervosa (N=30) or borderline personality disorder (N=28) were assessed for meaning in life (revised version of the Life Regard Index (LRI-R)), for CM (Childhood Trauma Questionnaire (CTQ)) and for internalized/externalized psychopathology. CM was associated with a lower LRI score. Structural Equation Modeling showed that internalized psychopathology (depression, hopelessness and low self-esteem) was the main mediator of the impact of CM on meaning in life. The direct effect of CM on meaning in life was not significant. Having suffered from negligence or abuse during childhood is associated with lower meaning in life in adults with persistent and pervasive psychiatric disorders. Treating depressive symptoms and improving self-esteem may improve meaning in life in patients with severe mental disorders who were affected by CM.
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12
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Maleque N, Burklin Y, Hunt DP. The formidable cluster: The challenge of personality disorders among hospitalized patients. J Hosp Med 2016; 11:890-891. [PMID: 27610943 DOI: 10.1002/jhm.2650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 08/09/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Noble Maleque
- Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Yelena Burklin
- Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Daniel P Hunt
- Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
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Kaite CP, Karanikola MN, Vouzavali FJD, Koutroubas A, Merkouris A, Papathanassoglou EDE. The experience of Greek-Cypriot individuals living with mental illness: preliminary results of a phenomenological study. BMC Psychiatry 2016; 16:343. [PMID: 27716117 PMCID: PMC5053043 DOI: 10.1186/s12888-016-1051-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 09/24/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Research evidence shows that healthcare professionals do not fully comprehend the difficulty involved in problems faced by people living with severe mental illness (SMI). As a result, mental health service consumers do not show confidence in the healthcare system and healthcare professionals, a problem related to the phenomenon of adherence to therapy. Moreover, the issue of unmet needs in treating individuals living with SMI is relared to their quality of life in a negative way. METHODS A qualitative methodological approach based on the methodology of van Manen phenomenology was employed through a purposive sampling of ten people living with SMI. The aim was to explore their perceptions and interpretations regarding: a) their illness, b) their self-image throughout the illness, c) the social implications following their illness, and d) the quality of the therapeutic relationship with mental health nurses. Participants were recruited from a community mental health service in a Greek-Cypriot urban city. Data were collected through personal, semi-structured interviews. RESULTS Several main themes were identified through the narratives of all ten participants. Main themes included: a) The meaning of mental illness, b) The different phases of the illness in time, c) The perception of the self during the illness, d) Perceptions about the effectiveness of pharmacotherapy, e) Social and personal consequences for participants following the diagnosis of mental illness, f) Participants' perceptions regarding mental health professionals and services and g) The therapeutic effect of the research interview on the participants. CONCLUSIONS The present study provides data for the enhancement of the empathic understanding of healthcare professionals regarding the concerns and particular needs of individuals living with SMI, as well as the formation of targeted psychosocial interventions based on these needs. Overall, the present data illuminate the necessity for the reconstruction of the provided mental healthcare in Cyprus into a more recovery- oriented approach in order to address personal identity and self-determination issues and the way these are related to management of pharmacotherapy. Qualitative studies aiming to further explore issues of self-identity during ill health and its association with adherence to therapy, resilience and self-determination, are also proposed.
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Affiliation(s)
- Charis P. Kaite
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou str, 3041 Limassol, Cyprus
| | - Maria N. Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou str, 3041 Limassol, Cyprus
| | - Foteini J. D. Vouzavali
- Department of Nursing, Vocational High School of Nurse Assistants & Laboratory Instructor, Technological Educational Institute of Athens, Cholargos, Athens, Greece
| | - Anna Koutroubas
- Children’s Hospital “A & P Kyriakou” Oncology Department, Athens, Greece
| | - Anastasios Merkouris
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou str, 3041 Limassol, Cyprus
| | - Elizabeth D. E. Papathanassoglou
- Faculty of Nursing, University of Alberta, 5–262 Edmonton Clinic Health Academy (ECHA), 11405-87th Ave., Edmonton, AB T6G 1C9 Canada
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