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Fernández I, Juncal-Ruiz M, González-Menéndez AM, Paino M. Environmental and psychopathological predictors of clinical high-risk of psychosis in adolescence. J Clin Psychol 2024. [PMID: 38838109 DOI: 10.1002/jclp.23723] [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: 09/27/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES Clinical high-risk psychosis (CHRp) samples can be heterogeneous, consisting essentially of people with not only psychotic-like experiences but also nonspecific symptoms that may reflect common mental disorders such as depression, anxiety, or substance abuse pathologies. Few studies have attempted to analyze and understand psychosis risk in relation to both environmental (ER) and psychopathological risk (PsR) factors. This study aimed to determine the clinical risk of psychosis in adolescents. METHODS A representative sample of 1824 Spanish adolescents from the general population was evaluated using different scales to thoroughly examine the possible interaction of CHRp with various ER and PsR factors. Partial correlations were calculated to assess the relationships between the variables. A series of hierarchical linear regression models were then used to obtain a CHRp predictor model. RESULTS The CHRp predictor model indicated that PsR was the most significant determining factor, explaining 22% of the total associated variance of CHRp. However, the ER factor also emerged as a significant predictor of high-risk psychosis (accounting for 9% of the variance). CONCLUSIONS A predictive model for CHRp in adolescents was found, in which common psychological problems were presented as more determinant risk factors than ER disruptors. Furthermore, certain transdiagnostic processes, such as psychological inflexibility, may play a central role in the development of mental health problems, including psychosis. Specifying the mechanisms underlying the emergence of CHRp in adolescence is the key to optimizing the focus of preventive therapeutic interventions in these early stages.
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Affiliation(s)
| | - Maria Juncal-Ruiz
- Department of Psychiatry (Child and Adolescent Mental Health Unit), Sierrallana Hospital, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
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2
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Șoflău R, Szentágotai-Tătar A, Oltean LE. Childhood Adversity, Resilience, and Paranoia During the COVID-19 Outbreak. The Mediating Role of Irrational Beliefs and Affective Disturbance. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2023:1-16. [PMID: 37360924 PMCID: PMC10221745 DOI: 10.1007/s10942-023-00511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/28/2023]
Abstract
Childhood adversity (CA) and resilience may impact on paranoia, but mechanisms underlying these associations are largely unknown. In this study, we investigated two potential candidates: irrational beliefs and affective disturbance. Moreover, we investigated the potential moderating role of COVID-19 perceived stress in these associations. A community sample (N = 419, m age = 27.32 years, SD = 8.98; 88.10% females) completed self-report measures. Results indicated that paranoia was significantly associated with CA and resilience (p < .05), and both irrational beliefs and affective disturbance (i.e., depressive and anxiety symptoms) mediated the associations between CA and paranoia. Moreover, depressive and anxiety symptoms partially explained the mediating role of irrational beliefs. These predictive models explained up to 23.52% of variance in paranoia (F(3,415) = 42.536, p < .001). Findings on resilience and paranoia replicated these results, and COVID-19 perceived stress moderated the association between resilience and ideas of persecution. Overall, these findings underscore the importance of irrational beliefs, depressive and anxiety symptoms in high CA or low resilience individuals experiencing paranoia. Supplementary Information The online version contains supplementary material available at 10.1007/s10942-023-00511-4.
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Affiliation(s)
- Radu Șoflău
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Aurora Szentágotai-Tătar
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Lia-Ecaterina Oltean
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
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3
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Linden B, Ecclestone A, Stuart H. A scoping review and evaluation of instruments used to measure resilience among post-secondary students. SSM Popul Health 2022; 19:101227. [PMID: 36177483 PMCID: PMC9513163 DOI: 10.1016/j.ssmph.2022.101227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022] Open
Abstract
As mental health problems continue to increase among post-secondary populations, the need to develop effective initiatives designed to bolster students’ resilience has increasingly been identified as a priority. Therefore, access to valid tools with which to measure the efficacy of these interventions is imperative. To date, a comprehensive assessment of existing instruments used to evaluate the construct of resilience among post-secondary student populations has not been conducted. The purpose of this study was to fill this gap by conducting a scoping review of literature detailing the use of resilience instruments and evaluating their quality based on suitability for use in the post-secondary setting and associated psychometric evidence. We identified a total of 78 records published between 2010 and 2022, extracting a total of 12 instruments. Using detailed criteria frameworks, each instrument was assessed in terms of suitability and quality of associated psychometric evidence for validity and reliability. The results of our study suggest that many of the instruments currently being used to assess resilience among post-secondary students may not be appropriate. The majority of the instruments included in our review were developed for use among general adult populations and not specifically designed for use in the post-secondary setting. Most instruments did not assess resilience in a comprehensive, holistic matter that addressed the ability to bounce back from adversity by drawing upon psychological, social, cultural, and environmental resources, as defined by recent research. Further, no instruments included in our review had published evidence in support of a complete psychometric analysis. The results of our evaluation suggest that the Connor-Davidson Resilience Scale (CD-RISC) is the most suitable instrument for measuring resilience among post-secondary populations due to its suitability, comprehensive assessment of the construct of resilience, and demonstrably strong psychometric properties for both the 25- and 10-item versions of the tool. There is a need for access to valid and appropriate tools with which to measure post-secondary students’ resilience. We identified a total of 12 instruments evaluating resilience among post-secondary student populations. The majority of the instruments were not designed for use in the post-secondary setting and were not comprehensive· We recommend the CD-RISC as the most suitable. We recommend the CD-RISC as the most suitable instrument for measuring resilience among post-secondary students.
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Affiliation(s)
- Brooke Linden
- Health Services and Policy Research Institute, Queen's University, 21 Arch Street, Kingston, ON, K7L 3L3, 343-333-6127, Canada
| | - Amy Ecclestone
- Health Services and Policy Research Institute, Queen's University, 21 Arch Street, Kingston, ON, K7L 3L3, 343-333-6127, Canada
| | - Heather Stuart
- Health Services and Policy Research Institute, Departments of Public Health Sciences, Psychiatry and School of Rehabilitation Therapy, Queen's University, Canada
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4
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Li W, Mao Z, Bo Q, Sun Y, Wang Z, Wang C. Pre-pulse inhibition deficits in individuals at clinical high-risk for psychosis: A systematic review and meta-analysis. Early Interv Psychiatry 2021; 15:794-806. [PMID: 32705810 DOI: 10.1111/eip.13015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 06/15/2020] [Accepted: 06/24/2020] [Indexed: 11/29/2022]
Abstract
AIM Neurophysiological markers of schizophrenia may help identify individuals who are at an increased risk of developing psychosis. As an operational measure of sensorimotor gating, pre-pulse inhibition (PPI) deficit has been investigated in clinical high-risk (CHR) individuals. In this study, we performed a systematic review and meta-analysis of studies that investigated PPI in CHR individuals. METHODS Relevant studies published as of July 2019 were retrieved from the PubMed, Cochrane, Embase, PscyINFO, EBSCO and Chinese databases. PPI was evaluated by calculating the standard mean differences (SMDs) between CHR individuals and healthy controls (HC) in meta-analysis. Quality of studies was assessed using the Newcastle-Ottawa Scale. I2 index was used to assess heterogeneity and Egger's test was used to assess publication bias. RESULTS Eight studies were found to be eligible. The meta-analysis included five studies with a combined study population of 184 CHR subjects and 161 HC. CHR individuals showed lower PPI levels compared to HC in 120 ms inter-stimulus interval or stimulus onset asynchrony paradigm (P = .491, SMD = -0.62). No significant heterogeneity was observed in 120 ms PPI paradigm (χ2 = 3.41, P = .491, I2 = 0.0%). CONCLUSION CHR individuals had lower PPI level compared to HC in 120 ms paradigm, which were relatively stable and significant. The results indicate the presence of information processing and inhibitory problems prior to the development of full-blown psychosis. PPI may be clinically used as an objective indicator to supplement the understanding of CHR individuals.
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Affiliation(s)
- Weidi Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhen Mao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhimin Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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5
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Petros N, Cullen AE, Vieira S, Rowland E, King G, Leung WS, Fusar-Poli P, Mechelli A, McGuire P. Examining service-user perspectives for the development of a good outcome checklist for individuals at clinical high risk for psychosis. Early Interv Psychiatry 2021; 15:606-615. [PMID: 32453511 DOI: 10.1111/eip.12991] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/17/2020] [Accepted: 04/28/2020] [Indexed: 01/18/2023]
Abstract
AIMS Around 15% of patients at clinical high risk for psychosis (CHR-P) experience symptomatic remission and functional recovery at follow-up, yet the definition of a good outcome (GO) in this population requires further development. Outcomes are typically designed and rated by clinicians rather than patients, to measure adverse as opposed to GOs. Here we investigate how CHR-P subjects define a GO, with the aim of developing a checklist that could be used to measure GO in this clinical group. METHODS A set of GO-focused questions were designed in collaboration with a service-user. CHR-P patients (n = 48) were asked to rate the importance of items that could indicate short-term (1 year) and long-term (5 years) GO. These items were then ranked using the relative importance index (RII). RESULTS Patients rated improvement in subjective wellbeing (RII = 0.829) and non-specific presenting symptoms (RII = 0.817) amongst the factors most important for indicating GO in the short-term, and improved resilience (RII = 0.879) and negative symptoms (RII = 0.858) as key items for indicating long-term GO. Patients regarded building resilience (RII = 0.842) and having support from mental health services (RII = 0.833) as being protective for their mental health. These measures were included in a preliminary 12-item GO checklist (GO-12) for assessing GO in CHR-P subjects. CONCLUSIONS Patient-defined measures of GO included items that are not incorporated into conventional measures of outcomes in CHR-P subjects, such as subjective wellbeing and resilience. Integrating patient-defined metrics of GO may improve the assessment of outcomes in the CHR-P population.
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Affiliation(s)
- Natalia Petros
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexis E Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sandra Vieira
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Emma Rowland
- Department of Child and Family Health Care, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Georgina King
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Wing See Leung
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK
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6
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Vargas T, Damme KSF, Ered A, Capizzi R, Frosch I, Ellman LM, Mittal VA. Neuroimaging Markers of Resiliency in Youth at Clinical High Risk for Psychosis: A Qualitative Review. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:166-177. [PMID: 32788085 PMCID: PMC7725930 DOI: 10.1016/j.bpsc.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/26/2022]
Abstract
Psychotic disorders are highly debilitating and constitute a major public health burden. Identifying markers of psychosis risk and resilience is a necessary step toward understanding etiology and informing prevention and treatment efforts in individuals at clinical high risk (CHR) for psychosis. In this context, it is important to consider that neural risk markers have been particularly useful in identifying mechanistic determinants along with predicting clinical outcomes. Notably, despite a growing body of supportive literature and the promise of recent findings identifying potential neural markers, the current work on CHR resilience markers has received little attention. The present review provides a brief overview of brain-based risk markers with a focus on predicting symptom course. Next, the review turns to protective markers, examining research from nonpsychiatric and schizophrenia fields to build an understanding of framing, priorities, and potential, applying these ideas to contextualizing a small but informative body of resiliency-relevant CHR research. Four domains (neurocognition, emotion regulation, allostatic load, and sensory and sensorimotor function) were identified and are discussed in terms of behavioral and neural markers. Taken together, the literature suggests significant predictive value for brain-based markers for individuals at CHR for psychosis, and the limited but compelling resiliency work highlights the critical importance of expanding this promising area of inquiry.
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Affiliation(s)
- Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, Illinois.
| | | | - Arielle Ered
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Riley Capizzi
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Isabelle Frosch
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, Illinois; Department of Psychiatry, Northwestern University, Evanston, Illinois; Department of Medical Social Sciences, Northwestern University, Evanston, Illinois; Institute for Policy Research, Northwestern University, Evanston, Illinois; Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, Illinois
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7
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Lee YY, Seet V, Chua YC, Verma SK, Subramaniam M. Growth in the Aftermath of Psychosis: Characterizing Post-traumatic Growth in Persons With First Episode Psychosis in Singapore. Front Psychiatry 2021; 12:784569. [PMID: 35153855 PMCID: PMC8825783 DOI: 10.3389/fpsyt.2021.784569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/13/2021] [Indexed: 01/07/2023] Open
Abstract
Experiencing first episode psychosis (FEP) is a highly traumatic life event. However, there is evidence to show that the outcome of psychosis is more nuanced than was conventionally thought. Young persons with FEP can grow from the experience of psychosis. In this study, we aim to characterize post-traumatic growth (PTG) in persons with FEP over 1 year. A total of 99 FEP clients receiving services from an early psychosis intervention team in Singapore were recruited. The PTG Inventory, among other scales, like Questionnaire on the Process of Recovery and Connor-Davidson Resilience Scale, were administered in this population. A total of 52 participants completed the questionnaire at two timepoints (one year apart). The Reliable Change Index was calculated for participants who completed both timepoints. Repeated measures of correlation were performed, which identified personal recovery and resilience to be associated with PTG in this sample. This clinical population exhibited PTG in the aftermath of psychosis. PTG was associated with personal recovery and resilience, but not clinical indicators, like symptoms and functioning. Data from this study suggests that recovery and growth from first episode psychosis is a possibility. Clinical implications, strengths and limitations of this study are discussed.
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Affiliation(s)
- Ying Ying Lee
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Vanessa Seet
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yi Chian Chua
- Early Psychosis Intervention Programme, Institute of Mental Health, Singapore, Singapore
| | - Swapna Kamal Verma
- Early Psychosis Intervention Programme, Institute of Mental Health, Singapore, Singapore.,Education Office, Duke-NUS Medical School, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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8
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Luther L, Rosen C, Cummins JS, Sharma RP. The multidimensional construct of resilience across the psychosis spectrum: Evidence of alterations in people with early and prolonged psychosis. Psychiatr Rehabil J 2020; 43:225-233. [PMID: 31750682 PMCID: PMC7239739 DOI: 10.1037/prj0000393] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Research has demonstrated that resilience impacts functional outcomes and is often reduced among those with prolonged psychosis. However, little work has examined when during the course of psychosis resilience declines and whether resilience impacts symptoms and functioning similarly in different illness phases. This study examined whether overall resilience (a) differed between those with early compared to relatively prolonged psychosis, (b) differed between the psychosis groups and nonclinical controls, and (c) differentially related to symptoms and functioning in the psychosis groups. METHOD Participants with early (n = 30) and prolonged psychosis (n = 64) and nonclinical controls (n = 58) completed the Resilience Scale. Psychosis participants also completed clinician-rated functioning and symptom measures. Analyses of Variance were used to compare group resilience levels. Pearson's correlations identified relationships between resilience, symptoms, and functioning. RESULTS Overall resilience levels did not significantly differ between the psychosis groups, but both psychosis groups had lower resilience than nonclinical controls. Higher overall resilience was significantly associated with lower negative symptoms in the early psychosis group and lower mood symptoms in the prolonged psychosis group; greater resilience was significantly associated with higher functioning in both psychosis groups. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Resilience may be reduced throughout the course of psychosis but may differentially impact symptom domains in different illness phases. Targeting resilience with psychosocial interventions may be important throughout the course of psychosis and may lead to improvements in functioning as well as negative symptoms and mood symptoms (in early and prolonged psychosis, respectively). (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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9
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Seiler N, Nguyen T, Yung A, O'Donoghue B. Terminology and assessment tools of psychosis: A systematic narrative review. Psychiatry Clin Neurosci 2020; 74:226-246. [PMID: 31846133 DOI: 10.1111/pcn.12966] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022]
Abstract
AIM Phenomena within the psychosis continuum that varies in frequency/duration/intensity have been increasingly identified. Different terms describe these phenomena, however there is no standardization within the terminology. This review evaluated the definitions and assessment tools of seven terms - (i) 'psychotic experiences'; (ii) 'psychotic-like experiences'; (iii) 'psychotic-like symptoms'; (iv) 'attenuated psychotic symptoms'; (v) 'prodromal psychotic symptoms'; (vi) 'psychotic symptomatology'; and (vii) 'psychotic symptoms'. METHODS EMBASE, MEDLINE, and CINAHL were searched during February-March 2019. Inclusion criteria included 1989-2019, full text, human, and English. Papers with no explicit definition or assessment tool, duplicates, conference abstracts, systematic reviews, meta-analyses, or no access were excluded. RESULTS A total of 2238 papers were identified and of these, 627 were included. Definitions and assessment tools varied, but some trends were found. Psychotic experiences and psychotic-like experiences were transient and mild, found in the general population and those at-risk. Psychotic-like symptoms were subthreshold and among at-risk populations and non-psychotic mental disorders. Attenuated psychotic symptoms were subthreshold but associated with distress, risk, and help-seeking. Prodromal psychotic symptoms referred to the prodrome of psychotic disorders. Psychotic symptomatology included delusions and hallucinations within psychotic disorders. Psychotic symptoms was the broadest term, encompassing a range of populations but most commonly involving hallucinations, delusions, thought disorder, and disorganization. DISCUSSION A model for conceptualizing the required terms is proposed and future directions needed to advance this field of research are discussed.
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Affiliation(s)
- Natalie Seiler
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Tony Nguyen
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Alison Yung
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
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10
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Mętel D, Arciszewska A, Daren A, Pionke R, Cechnicki A, Frydecka D, Gawęda Ł. Mediating role of cognitive biases, resilience and depressive symptoms in the relationship between childhood trauma and psychotic-like experiences in young adults. Early Interv Psychiatry 2020; 14:87-96. [PMID: 31099186 DOI: 10.1111/eip.12829] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/28/2019] [Accepted: 04/14/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The present study aimed to test a hypothetical model where causally linked and ordered cognitive biases, resilience and depressive symptoms serve as mediators of the relationship between early traumatic life events and psychotic-like experiences (PLEs) in the general population of young adults. METHODS Two thousand six hundred and fourteen people (1673 females) took part in the online survey. Participants completed self-report questionnaires measuring exposure to early traumatic life events, PLEs, cognitive biases, resilience and depressive symptoms. Correlation and multiple mediation analyses were performed. RESULTS All three mediators turned out to be significantly correlated with early trauma, PLEs and with each other. Mediational analysis demonstrated that hypothesized model of causally linked mediators was significant (P ≤ .001) and accounted for 33% (P < .001) of the explained variance in PLEs in comparison to 11% (P ≤ .001) without mediators. CONCLUSIONS First, our results provide evidence for significant associations between early traumatic life events, cognitive biases, depressive symptoms, psychological resilience and PLEs. Second, they indicate significant indirect effects of early trauma exposure on PLEs through a path consisted of cognitive biases, psychological resilience and depressive symptoms that suggest a possible importance of interventions bolstering resilience in young people in order to minimize the severity of depressive and psychotic psychopathology.
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Affiliation(s)
- Dagmara Mętel
- Department of Community Psychiatry, Chair of Psychiatry, Jagiellonian University Medical College, Cracow, Poland
| | | | - Artur Daren
- Department of Community Psychiatry, Chair of Psychiatry, Jagiellonian University Medical College, Cracow, Poland
| | - Renata Pionke
- Psychopathology & Early Intervention Lab, II Department of Psychiatry, The Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Chair of Psychiatry, Jagiellonian University Medical College, Cracow, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Łukasz Gawęda
- Psychopathology & Early Intervention Lab, II Department of Psychiatry, The Medical University of Warsaw, Warsaw, Poland
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11
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Kim SW, Kim JJ, Lee BJ, Yu JC, Lee KY, Won SH, Lee SH, Kim SH, Kang SH, Kim E, Lee JY, Kim JM, Chung YC. Clinical and psychosocial factors associated with depression in patients with psychosis according to stage of illness. Early Interv Psychiatry 2020; 14:44-52. [PMID: 30919575 DOI: 10.1111/eip.12806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/20/2019] [Accepted: 02/17/2019] [Indexed: 11/29/2022]
Abstract
AIM This study investigated the clinical characteristics and psychosocial factors associated with depression in patients with early psychosis according to stage of illness. METHODS The present study includes patients who fulfil the DSM-5 criteria for schizophrenia spectrum and other psychotic disorders. Patients were divided into two groups according to illness stage (the acute stage of first-episode psychosis and stabilization phase of recent-onset psychosis). Clinically meaningful depression was defined as moderate or severe on the depression dimension of the Clinician-Rated Dimensions of Psychosis Symptom Severity scale in the DSM-5. RESULTS In total, 340 (207 first-episode and 133 recent-onset) patients were recruited in this study. Patients with comorbid depression were characterized by frequent suicidal ideation, a past suicide attempt, and lower scores on the Subjective Well-being Under Neuroleptics and Brief Resilience Scale in both groups. Long duration of untreated psychosis and higher scores on the Early Trauma Inventory Self Report were associated with depression in the acute stage of first-episode psychosis. In the stabilization phase of recent-onset psychosis group, a monthly income and scores for sexual desire and on the Family Adaptability and Cohesion Evaluation Scale-III were significantly lower in patients with depression than in those without depression. CONCLUSION Comorbid depression was associated with high suicidality, lower quality of life and poor resilience in patients with first-episode and recent-onset psychosis. Depression was associated with factors that had been present before the initiation of treatment in patients with first-episode psychosis and with environmental factors in those in the stabilization phase.
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Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jung Jin Kim
- Department of Psychiatry, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Bong Ju Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Je-Chun Yu
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Korea
| | - Kyu Young Lee
- Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea
| | - Seung-Hee Won
- Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Goyang, Korea
| | - Seung-Hyun Kim
- Department of Psychiatry, Korea University College of Medicine, Guro Hospital, Seoul, Korea
| | - Shi-Hyun Kang
- Department of Psychiatry, Seoul National Hospital, Seoul, Korea
| | - Euitae Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Young Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea
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12
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Ortega L, Montalvo I, Monseny R, Vilella E, Labad J. Perceived stress mediates the relationship between social adaptation and quality of life in individuals at ultra high risk of psychosis. Early Interv Psychiatry 2019; 13:1447-1454. [PMID: 30690915 DOI: 10.1111/eip.12791] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/30/2018] [Accepted: 12/26/2018] [Indexed: 01/02/2023]
Abstract
AIM Quality of life (QoL) and social functioning have emerged as good predictors of the outcome of psychotic disorders. Poor QoL and social functioning are usually present before the onset of the first episode of psychosis. Our study aimed to explore the relationship between social adaptation and QoL in young people at risk of psychosis (ultra-high-risk, UHR) and healthy controls (HCs), and to investigate potential mediating effects of stress measures (perceived stress, stressful life events). METHODS The study included 55 UHR subjects and 40 HC. Social functioning was assessed with the Social Adaptation Self-evaluation Scale (SASS). Stress measures included the assessment of stressful life events and perceived stress. We compared stress and QoL measures between UHR and HC, and also compared UHR with low or normal social adaptation. A mediation analysis was performed to explore whether stress measures mediated the relationship between social adaptation and QoL. RESULTS UHR were less frequently employed and reported more stress, poorer QoL and lower social adaptation than HC. QoL and social adaptation were associated with stress measures. UHR with low social adaptation reported more perceived stress and less QoL than UHR with normal social adaptation and HC. Perceived stress mediated the relationship between social adaptation and QoL. CONCLUSIONS Social adaptation is less developed in UHR subjects than in healthy subjects and has a negative impact on quality of life. This association is mediated by perceived stress.
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Affiliation(s)
- Laura Ortega
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.,Nursing Department, Universitat Rovira i Vigili, Tarragona, Spain
| | - Itziar Montalvo
- Parc Taulí Hospital Universitari, I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
| | - Rosa Monseny
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Javier Labad
- Parc Taulí Hospital Universitari, I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
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13
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Abstract
The development of effective intervention and prevention strategies among individuals with psychosis risk syndromes may help to reduce symptomatology and conversion to a psychotic disorder. Although strides have been made in this area, more work is needed, particularly given the setbacks that remain (such as heterogeneity among this group). There has been a shift with the introduction of clinical staging models toward expanding current intervention and prevention efforts to a more developmental and transdiagnostic approach. With this, this article seeks to review treatments both recently and currently discussed in the staging literature, introduce advances in psychosis risk syndrome treatments that may be beneficial to consider in clinical staging heuristics, and pinpoint other promising options.
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Affiliation(s)
- Tina Gupta
- Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - Vijay A Mittal
- Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA.,Department of Psychiatry, Northwestern University, 420 E. Superior Street, Chicago, IL, 60611, USA.,Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL, 60208, USA.,Department of Medical Social Sciences, Northwestern University, 420 E. Superior Street, Chicago, IL, 60611, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, 633 N. St. Claire Street, Chicago, IL, 60611, USA
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14
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Beck K, Andreou C, Studerus E, Heitz U, Ittig S, Leanza L, Riecher-Rössler A. Clinical and functional long-term outcome of patients at clinical high risk (CHR) for psychosis without transition to psychosis: A systematic review. Schizophr Res 2019; 210:39-47. [PMID: 30651204 DOI: 10.1016/j.schres.2018.12.047] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/09/2018] [Accepted: 12/25/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Research on patients at clinical high risk (CHR) for psychosis has so far mainly focused on those with transition to frank psychosis (CHR-T patients). However, the majority of CHR patients do not transition (CHR-NT patients) and relatively little information is available on their clinical and functional outcome. METHODS We conducted a systematic review on clinical and functional long-term outcome of CHR-NT patients. Studies were included if they had an average follow-up period of at least 24 months and reported on long-term outcome of CHR-NT patients in one or more of the following domains: (non-)remission from CHR, prevalence of clinical symptoms and/or clinical diagnoses (axis I and II), and psychosocial functioning. RESULTS Ten publications from seven different single or multicenter studies with average follow-up durations of 2-7.5 years could be included. At the last follow-up assessment 28-71% of CHR-NT patients were not remitted from their CHR and 22-82% still had at least one clinical diagnosis. Approximately half of CHR-NT patients presented with poor psychosocial outcome at 2-year and 6-year follow-up. CONCLUSIONS The results suggest that, in the long-term, the majority of CHR-NT patients are not in full clinical remission and seem to suffer from one or more clinical disorders and psychosocial impairments. Since relatively few studies could be identified, further research is required to better understand the trajectories and clinical needs of CHR-NT patients.
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Affiliation(s)
- Katharina Beck
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland; University of Basel, Division of Clinical Psychology and Epidemiology, Department of Psychology, Basel, Switzerland
| | - Christina Andreou
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
| | - Erich Studerus
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
| | - Ulrike Heitz
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland; University of Basel, Division of Clinical Psychology and Epidemiology, Department of Psychology, Basel, Switzerland
| | - Sarah Ittig
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
| | - Letizia Leanza
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland; University of Basel, Division of Clinical Psychology and Epidemiology, Department of Psychology, Basel, Switzerland
| | - Anita Riecher-Rössler
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland.
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15
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Stainton A, Chisholm K, Kaiser N, Rosen M, Upthegrove R, Ruhrmann S, Wood SJ. Resilience as a multimodal dynamic process. Early Interv Psychiatry 2019; 13:725-732. [PMID: 30126047 DOI: 10.1111/eip.12726] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/15/2018] [Accepted: 07/29/2018] [Indexed: 12/12/2022]
Abstract
AIM Resilience is rapidly gaining momentum in mental health literature. It provides a new understanding of the highly variable trajectories of mental illness, and has consistently been linked with improved mental health outcomes. The present review aims to clarify the definition of resilience and to discuss new directions for the field. METHODS After discussing the definition of resilience, this narrative review synthesizes evidence that identifies the specific protective factors involved in this process. This review also addresses the mechanisms that underlie resilience. RESULTS Recent literature has clarified the three core components of resilience, which are the presence of an adversity or specific risk for mental illness; the influence of protective factors that supersede this risk; and finally, a subsequently more positive outcome than expected. Now that these are largely agreed upon, the field should move on to addressing other topics. Resilience is a dynamic process by which individuals utilize protective factors and resources to their benefit. It can vary within one individual across time and circumstance. It can also refer to good functional outcomes in the context of diagnosable illness. While previous research has focused on psychological resilience, it is essential that resilience is conceptualized across modalities. CONCLUSIONS The field should move towards the development of a multimodal model of resilience. Researchers should now focus on producing empirical research which clarifies the specific protective factors and mechanisms of the process, aligning with the core concepts of resilience. This growing, more homogeneous evidence base, can then inform new intervention strategies.
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Affiliation(s)
- Alexandra Stainton
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Katharine Chisholm
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Nathalie Kaiser
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Rachel Upthegrove
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.,Birmingham Early Intervention in Psychosis Service, Birmingham Women's and Children's NHS Foundation Trust, UK
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Stephen J Wood
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
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16
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Zizolfi D, Poloni N, Caselli I, Ielmini M, Lucca G, Diurni M, Cavallini G, Callegari C. Resilience and recovery style: a retrospective study on associations among personal resources, symptoms, neurocognition, quality of life and psychosocial functioning in psychotic patients. Psychol Res Behav Manag 2019; 12:385-395. [PMID: 31213935 PMCID: PMC6549482 DOI: 10.2147/prbm.s205424] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/17/2019] [Indexed: 01/26/2023] Open
Abstract
Background: Personal resources have been identified as important factors in predicting patient healing or symptoms control in schizophrenia. This observational retrospective study aims to explore the influence of resilience and recovery style on the modalities of clinical presentation of the disease, as well as individual functioning and quality of life. Methods: Participants were patients affected by schizophrenia spectrum disorders assessed at different mental health facilities. The rating scales considered are the following: Resilience Scale 10-items (RS); Recovery Style Questionnaire (RSQ); Montreal Cognitive Assessment (MoCA); Schizophrenia Quality of Life Scale (SQLS); Life Skills Profile (LSP); Positive and Negative Syndrome Scale (PANSS). Results: Forty-four patients fulfilled the inclusion criteria. The mean age was 46 years; the average length of the history of the disease at recruitment was 23 years with an average age at first episode of psychosis (FEP) of 23 years. General psychopathology, neurocognition, and integration recovery style can predict psychosocial functioning and explain ~54% of the LSP variance; RS total score and PANSS general psychopathology score can predict and explain ~29% of the LSP variance. A negative association between PANSS general psychopathology and LSP total score supports the need to reduce first the symptomatology, and then successfully apply other types of interventions. A strong positive association between neurocognition and life functioning was detected, showing that deficits in neurocognition have proved to be important predictors of the functional outcome. Integration was also proven to be significantly associated with a good functional outcome. Psychotic symptoms turn out to be a negative predictive factor, whereas resilience can be hypothesized as a protective factor. Conclusions: Resilience and recovery style "integration" can be considered as two complementary predictive resources for a good outcome; this result supports the need to set up personalized treatments, based on the characteristics of the patients.
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Affiliation(s)
- Daniele Zizolfi
- Department of Medicine and Surgery, Psychiatry, University of Insubria, Varese, VA 21100, Italy
| | - Nicola Poloni
- Department of Medicine and Surgery, Psychiatry, University of Insubria, Varese, VA 21100, Italy
| | - Ivano Caselli
- Department of Medicine and Surgery, Psychiatry, University of Insubria, Varese, VA 21100, Italy
| | - Marta Ielmini
- Department of Medicine and Surgery, Psychiatry, University of Insubria, Varese, VA 21100, Italy
| | - Giulia Lucca
- Department of Medicine and Surgery, Psychiatry, University of Insubria, Varese, VA 21100, Italy
| | - Marcello Diurni
- Department of Medicine and Surgery, Psychiatry, University of Insubria, Varese, VA 21100, Italy
| | - Greta Cavallini
- Department of Medicine and Surgery, Psychiatry, University of Insubria, Varese, VA 21100, Italy
| | - Camilla Callegari
- Department of Medicine and Surgery, Psychiatry, University of Insubria, Varese, VA 21100, Italy
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17
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Jefferies P, McGarrigle L, Ungar M. The CYRM-R: A Rasch-Validated Revision of the Child and Youth Resilience Measure. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2019; 16:70-92. [PMID: 30472932 DOI: 10.1080/23761407.2018.1548403] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The Child and Youth Resilience Measure (CYRM) is one of the most popular measures of resilience. In this paper, we investigate the CYRM using Rasch analysis to explore and improve its psychometric properties, leading to a more robust measure of resilience.Cross-sectional data were obtained from a questionnaire administered to n = 408 individuals in Canada aged 11-19 who were participating in the Pathways to Resilience study. Rasch analysis was applied to these data, resulting in the production of a 17-item, 2-subscale CYRM-R, consisting of intra/interpersonal and caregiver resilience subscales. The subscales demonstrated good fit to the Rasch model by satisfying requirements of unidimensionality, good fit statistics and internal reliability, and a lack of item bias and problematic local dependency. The person separation indices also indicated that the subscales had good ability to differentiate between individuals of varying levels of resilience. In sum, the CYRM-R is a 2-subscale, 17-item Rasch-validated measure of resilience with robust psychometric properties. This revised measure is recommended for researchers and practitioners who are interested in measuring resilience across diverse cultures and contexts.
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Affiliation(s)
- Philip Jefferies
- Resilience Research Centre, Dalhousie University, Halifax, Canada
| | - Lisa McGarrigle
- Geriatric Medicine Research Unit, Dalhousie University, Halifax, Canada
| | - Michael Ungar
- Resilience Research Centre, Dalhousie University, Halifax, Canada
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18
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Santesteban-Echarri O, MacQueen G, Goldstein BI, Wang J, Kennedy SH, Bray S, Lebel C, Addington J. Family functioning in youth at-risk for serious mental illness. Compr Psychiatry 2018; 87:17-24. [PMID: 30193153 DOI: 10.1016/j.comppsych.2018.08.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/19/2018] [Accepted: 08/22/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is evidence that family functioning can be impaired in families of individuals with schizophrenia, first-episode psychosis, bipolar disorder, and recurrent depression, which are considered to be serious mental illnesses (SMI). Poor family functioning is one of the predictors of the course of SMI. However, it is unclear if poor family functioning is a result of illness, or conversely if poor family leads to higher risk of illness. Nonetheless, family functioning may be impaired even before the onset of illness, and little is known about earlier stages of risk and the importance of the family environment for youth at-risk for SMI. OBJECTIVE The present study aimed to examine differences in family functioning in a sample of youth at-risk of SMI across different clinical stages compared to healthy controls (HCs). METHODS Family functioning was evaluated with the Family Adaptability and Cohesion Evaluation Scales-IV (FACES-IV) for 41 non-help seeking youth with risk factors for SMI (Stage 0), 52 help-seeking youth with early mood and anxiety symptoms and distress (Stage 1a), 108 youth with an attenuated psychiatric syndrome (Stage 1b), and 42 HCs. RESULTS Results from multivariate linear regression analyses showed that participants in Stage 1a and Stage 1b significantly differ from participants in Stage 0 and HCs on most of the family functioning scales. However, these results were statistically but not clinically significant as the percentile values for each group fell within the same clinical ranges. The only clinical difference was that participants in stages 1a and 1b were somewhat less satisfied with their family compared to healthy controls and stage 0 participants. CONCLUSIONS An examination of group mean values demonstrated no difference in family functioning between the different groups with all groups in the healthy functioning range. However, family satisfaction is lower in youth at-risk for SMI who present with early signs of mood, anxiety or subthreshold psychotic symptoms than other participants. Early family psychoeducational interventions could be beneficial to improve family functioning.
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Affiliation(s)
- Olga Santesteban-Echarri
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Glenda MacQueen
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Departments of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - JianLi Wang
- Work & Mental health Research Unit, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada; Arthur Sommer Rotenberg Chair in Suicide and Depression Studies, St. Michael's Hospital, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Signe Bray
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Catherine Lebel
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
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19
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Keskinen E, Marttila R, Koivumaa-Honkanen H, Moilanen K, Keinänen-Kiukaanniemi S, Timonen M, Isohanni M, McGrath J, Miettunen J, Jääskeläinen E. Search for protective factors for psychosis - a population-based sample with special interest in unaffected individuals with parental psychosis. Early Interv Psychiatry 2018; 12:869-878. [PMID: 27619055 DOI: 10.1111/eip.12380] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 05/07/2016] [Accepted: 06/12/2016] [Indexed: 01/02/2023]
Abstract
AIM To find factors that are associated with not having psychotic illness in a prospective general population sample, with a special interest in individuals with parental psychosis. METHODS Data from the Northern Finland Birth Cohort 1966 (n = 10 458) and several registers were used to detect individuals with and without parental psychosis. Altogether, 594 persons had parent(s) with psychosis and 48 of them also had psychosis subsequently. Variables related to pregnancy and birth, family and childhood, health and habits in adolescence, school performance and physical activity were studied to identify determinants of unaffected status among individuals with and without parental psychosis. RESULTS In the parental psychosis group, the unaffected persons had more likely a mother who was non-depressed during pregnancy, and who worked outside the home or studied than among those who developed psychosis. CONCLUSIONS Protective factors for psychosis were surprisingly few in this sample. These factors were related to the mother's non-depressed mood and the mother's work outside the home or studies. This could relate to better health and functioning of a mother. This work highlights the need for more research on protective factors for psychosis in order to identify methods for prevention of psychosis.
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Affiliation(s)
- Emmi Keskinen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Riikka Marttila
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Heli Koivumaa-Honkanen
- Institute of Clinical Medicine, Psychiatry, University of Eastern, Finland.,Department of Psychiatry, Kuopio University Hospital (KUH), Kuopio, Finland.,Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland.,Department of Psychiatry, South-Savonia Hospital District, Mikkeli, Finland.,Department of Psychiatry, North Karelia Central Hospital, Joensuu, Finland.,Department of Psychiatry, SOSTERI, Savonlinna, Finland.,Department of Psychiatry, SOTE, Iisalmi, Finland
| | - Kristiina Moilanen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Markku Timonen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Matti Isohanni
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - John McGrath
- Department of Psychiatry, University of Queensland, Brisbane, Queensland, Australia
| | - Jouko Miettunen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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20
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Deng M, Pan Y, Zhou L, Chen X, Liu C, Huang X, Tao H, Pu W, Wu G, Hu X, He Z, Xue Z, Liu Z, Rosenheck R. Resilience and Cognitive Function in Patients With Schizophrenia and Bipolar Disorder, and Healthy Controls. Front Psychiatry 2018; 9:279. [PMID: 30008678 PMCID: PMC6033957 DOI: 10.3389/fpsyt.2018.00279] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/07/2018] [Indexed: 12/22/2022] Open
Abstract
Background: This study compared adaptive resilience among patients with schizophrenia, bipolar disorder, and healthy controls, and examined the relationship of resilience to cognitive function. Methods: A sample of 81 patients diagnosed with schizophrenia, 34 with bipolar disorder, and 52 healthy controls completed the Connor-Davidson Resilience Scale (CD-RISC) and cognitive tests of verbal comprehension, executive functioning, and working memory. Paired comparison of diagnostic groups on CD-RISC and cognitive tests was conducted. Linear regression was used to identify the independent association of clinical diagnoses and neurocognition with resilience deficits. Results: Both patient groups showed significantly lower CD-RISC scores and poorer cognitive function than healthy controls and the schizophrenia group scored lower than bipolar group on these measures as well. CD-RISC scores were positively correlated with all three cognitive measures in the entire sample but not within the diagnostic subgroups. Multiple regression analysis showed differences in CD-RISC between diagnostic groups were not mediated by differences in these three measures of neurocognition. Discussion: Schizophrenia and bipolar disorder are associated with impairments in both resilience and cognitive function but the impairment in resilience appears to be independent of deficits in cognitive function measured here and may reflect unmeasured dimensions of cognitive function, other impairments or environmental factors.
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Affiliation(s)
- Mengjie Deng
- Hunan Key Laboratory of Psychiatry and Mental Health, Department of Psychiatry, Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Yunzhi Pan
- Hunan Key Laboratory of Psychiatry and Mental Health, Department of Psychiatry, Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Li Zhou
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xudong Chen
- Hunan Key Laboratory of Psychiatry and Mental Health, Department of Psychiatry, Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Chang Liu
- Department of Psychiatry, Hunan Brain Hospital, Changsha, China
| | - Xiaojun Huang
- Hunan Key Laboratory of Psychiatry and Mental Health, Department of Psychiatry, Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Haojuan Tao
- Hunan Key Laboratory of Psychiatry and Mental Health, Department of Psychiatry, Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Weidan Pu
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Guowei Wu
- Hunan Key Laboratory of Psychiatry and Mental Health, Department of Psychiatry, Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Xinran Hu
- Hunan Key Laboratory of Psychiatry and Mental Health, Department of Psychiatry, Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Zhong He
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhimin Xue
- Hunan Key Laboratory of Psychiatry and Mental Health, Department of Psychiatry, Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Zhening Liu
- Hunan Key Laboratory of Psychiatry and Mental Health, Department of Psychiatry, Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Robert Rosenheck
- Department of Psychiatry, Yale University, New Haven, CT, United States
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