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BEATVIC, a body-oriented resilience therapy for individuals with psychosis: Short term results of a multi-center RCT. PLoS One 2022; 17:e0279185. [PMID: 36542671 PMCID: PMC9770373 DOI: 10.1371/journal.pone.0279185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Individuals with a psychotic disorder are at an increased risk of victimization, but evidenced-based interventions are lacking. AIMS A body-oriented resilience therapy ('BEATVIC') aimed at preventing victimization was developed and its effectiveness was assessed in a multicenter randomized controlled trial. METHODS 105 people with a psychotic disorder were recruited from six mental health centers. Participants were randomly allocated to 20 BEATVIC group sessions (n = 53) or befriending group sessions (n = 52). Short term effects on risk factors for victimization (e.g. social cognitive deficits, inadequate interpersonal behavior, low self-esteem, internalized stigma, aggression regulation problems), physical fitness and secondary outcomes were expected. At six-month follow-up, the effect on victimization (either a 50% reduction or an absence of victimization incidents) was examined. RESULTS Intervention-dropout was 28.30% for BEATVIC and 39.62% for befriending. In both conditions the majority of participants (60.5% BEATVIC vs 62.9% befriending) showed a reduction or absence of victimization incidents at six months follow-up, which was not significantly different according to condition. Multilevel analyses revealed no main effect of time and no significant time x group interaction on other outcome measures. Per protocol analyses (participants attending ≥ 75% of the sessions) did not change these results. CONCLUSIONS Although a reduction or absence of victimization was found at short term follow-up for the majority of participants, BEATVIC was not more effective than the active control condition. No short-term additional effects on risk factors of victimization were found. Analysis of the data at 2-year follow-up is warranted to investigate possible effects in the long-term. TRIAL REGISTRATION NUMBER Current Controlled Trials: ISRCTN21423535.
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Ajnakina O, Stubbs B, Francis E, Gaughran F, David AS, Murray RM, Lally J. Employment and relationship outcomes in first-episode psychosis: A systematic review and meta-analysis of longitudinal studies. Schizophr Res 2021; 231:122-133. [PMID: 33839370 DOI: 10.1016/j.schres.2021.03.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/20/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
As employment and relationship status are important long-term outcomes in individuals with a diagnosis of first episode psychosis (FEP) disorders, there is a need to elucidate more accurately the extent of these social deficits in people with FEP. This in turn can aid treatment planning and policy development ultimately ensuring more complete and sustainable recoveries. We carried out a systematic review and meta-analysis of longitudinal studies in FEP reporting on employment and relationship status during the illness course. Random effects meta-analyses and meta-regression analyses were employed. Seventy-four studies were included with a sample totalling 15,272 (range = 20-1724) FEP cases with an average follow-up duration of 8.3 years (SD = 7.2). 32.5% (95%CI = 28.5-36.9) of people with a diagnosis of FEP disorders were employed and 21.3% (95%CI = 16.5-27.1) were in a relationship at the end of follow-up. Studies from high-income countries and Europe had a higher proportion of people in employment at the end of follow-up compared to middle-income nations and non-European countries. The inverse was found for relationship status. The proportion of people with a diagnosis of FEP in employment decreased significantly with longer follow-up. Living with family, being in a relationship at first contact and Black and White ethnicities were identified as significant moderators of these outcomes. These findings highlight marked functional recovery deficits for people with FEP, although cultural factors need to be considered. They support the need for interventions to improve employment opportunities, and social functioning, both in early psychosis and during the longitudinal illness course.
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Affiliation(s)
- Olesya Ajnakina
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, University of London, London, United Kingdom; Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom.
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Emma Francis
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Anthony S David
- Institute of Mental Health, University College London, London, United Kingdom
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychiatry, Experimental Biomedicine and Clinical Neuroscience (BIONEC), University of Palermo, Italy
| | - John Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Psychiatry, St Vincent's Hospital Fairview, Dublin, Ireland
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van der Stouwe ECD, Pijnenborg GHM, Opmeer EM, de Vries B, Marsman JBC, Aleman A, van Busschbach JT. Neural changes following a body-oriented resilience therapy with elements of kickboxing for individuals with a psychotic disorder: a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 2021; 271:355-366. [PMID: 31980899 PMCID: PMC7960594 DOI: 10.1007/s00406-020-01097-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 01/13/2020] [Indexed: 11/27/2022]
Abstract
Individuals with a psychotic disorder are at an increased risk of becoming the victim of a crime. A body-oriented resilience therapy (BEATVIC) aimed at preventing victimization by addressing putatively underlying factors was developed. One of these factors is social cognition, particularly facial affect processing. The current study investigated neural effects of BEATVIC on facial affect processing using two face processing tasks. Participants were randomized to either BEATVIC or a 'Befriending' control group. Twenty-seven patients completed an Emotional Faces task and the Wall of Faces task during fMRI, pre- and post-intervention. General linear model analyses yielded no differences between groups over time. Independent component analyses revealed increased activation of the salience network to angry and fearful faces in BEATVIC compared to Befriending. Increased activation of the salience network may suggest an increased alertness for potentially dangerous faces.
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Affiliation(s)
- Elisabeth C D van der Stouwe
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands.
| | - Gerdina H M Pijnenborg
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
- Department of Psychotic Disorders, GGZ-Drenthe, Dennenweg 9, 9404 LA, Assen, The Netherlands
| | - Esther M Opmeer
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
- Department of Health and Social Work, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA, Zwolle, The Netherlands
| | - Bertine de Vries
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Jan-Bernard C Marsman
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
| | - André Aleman
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Jooske T van Busschbach
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA, Zwolle, The Netherlands
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Baranyi G, Cherrie M, Curtis SE, Dibben C, Pearce J. Changing levels of local crime and mental health: a natural experiment using self-reported and service use data in Scotland. J Epidemiol Community Health 2020; 74:806-814. [PMID: 32503890 PMCID: PMC7577093 DOI: 10.1136/jech-2020-213837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 11/16/2022]
Abstract
Background This study contributes robust evidence on the association between mental health and local crime rates by showing how changing exposure to small area-level crime relates to self-reported and administrative data on mental health. Methods The study sample comprised 112 251 adults aged 16–60 years, drawn from the Scottish Longitudinal Study, a 5.3% representative sample of Scottish population followed across censuses. Outcomes were individual mental health indicators: self-reported mental illness from the 2011 Census and linked administrative data on antidepressants and antipsychotics prescribed through primary care providers in the National Health Service in 2010/2012. Crime rates at data zone level (500–1000 persons) were matched to the participants’ main place of residence, as defined by general practitioner patient registration duration during 2004/2006, 2007/2009 and 2010/12. Average neighbourhood crime exposure and change in area crime were computed. Covariate-adjusted logistic regressions were conducted, stratified by moving status. Results In addition to average crime exposure during follow-up, recent increases in crime (2007/2009–2010/2012) were associated with a higher risk of self-reported mental illness, among ‘stayers’ aged 16–30 years (OR=1.11; 95% CI 1.00 to 1.22), and among ‘movers’ aged 31–45 years (OR=1.07; 95% CI 1.01 to 1.13). Prescribed medications reinforced these findings; worsening crime rates were linked with antidepressant prescriptions among young stayers (OR=1.09; 95% CI 1.04 to 1.14) and with antipsychotic prescriptions among younger middle-aged movers (OR=1.11; 95% CI 1.01 to 1.23). Conclusion Changing neighbourhood crime exposure is related to individual mental health, but associations differ by psychiatric conditions, age and moving status. Crime reduction and prevention, especially in communities with rising crime rates, may benefit public mental health.
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Affiliation(s)
- Gergő Baranyi
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Mark Cherrie
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Sarah E Curtis
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK.,Geography Department, Durham University, Durham, UK
| | - Chris Dibben
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Jamie Pearce
- Center for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
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Ferracuti S, Pucci D, Trobia F, Alessi MC, Rapinesi C, Kotzalidis GD, Del Casale A. Evolution of forensic psychiatry in Italy over the past 40 years (1978-2018). INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 62:45-49. [PMID: 30616853 DOI: 10.1016/j.ijlp.2018.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 10/05/2018] [Accepted: 10/29/2018] [Indexed: 06/09/2023]
Abstract
In Italy, following the closure of psychiatric hospitals in 1978 and the release of psychiatric patients into community care, there was a mismatch between common psychiatric patients and the convicted mentally ill who were sentenced to serve in state forensic psychiatric hospitals. The recent closure of such structures following the Prime Minister's Decree of April 1, 2008, fostered the need to create new structures. These are called "REMS," and they are based in the community and led by psychiatrists and healthcare staff who may rely on the collaboration of public security staff. This act completed a course of progressive deinstitutionalization of all psychiatric patients. However, some problems remain, and persons regarded as "partially mentally disabled" at the time of crime perpetration must serve part of their sentence in prison and the rest in the aforementioned structures or in psychiatric rehabilitation communities, depending on their claimed "social dangerousness." Psychiatric services now face the ambiguity of treating persons who are considered dangerous by court orders, while the civil law criteria for involuntary hospitalization is based only on the need of care. The complete closure of forensic hospitals may be considered a decisive step forward in the humanization of society, but there are still some issues to address to make it work better. The implementation of multidisciplinary teams and effective psychotherapy, psychoeducational, and rehabilitation interventions can help.
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Affiliation(s)
| | - Daniela Pucci
- Local Health Agency ASL Roma, 5, Palombara Sabina, Rome, Italy
| | - Federico Trobia
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University; Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Maria Chiara Alessi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", 66100 Chieti, Italy
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University; Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University; Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Antonio Del Casale
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University; Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
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Ajnakina O, Morgan C, Gayer-Anderson C, Oduola S, Bourque F, Bramley S, Williamson J, MacCabe JH, Dazzan P, Murray RM, David AS. Only a small proportion of patients with first episode psychosis come via prodromal services: a retrospective survey of a large UK mental health programme. BMC Psychiatry 2017; 17:308. [PMID: 28841826 PMCID: PMC5574213 DOI: 10.1186/s12888-017-1468-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/15/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Little is known about patients with a first episode of psychosis (FEP) who had first presented to prodromal services with an "at risk mental state" (ARMS) before making the transition to psychosis. We set out to identify the proportion of patients with a FEP who had first presented to prodromal services in the ARMS state, and to compare these FEP patients with FEP patients who did not have prior contact with prodromal services. METHODS In this study information on 338 patients aged ≤37 years who presented to mental health services between 2010 and 2012 with a FEP was examined. The data on pathways to care, clinical and socio-demographic characteristics were extracted from the Biomedical Research Council Case Register for the South London and Maudsley NHS Trust. RESULTS Over 2 years, 14 (4.1% of n = 338) young adults presented with FEP and had been seen previously by the prodromal services. These ARMS patients were more likely to enter their pathway to psychiatric care via referral from General Practice, be born in the UK and to have had an insidious mode of illness onset than FEP patients without prior contact with the prodromal services. CONCLUSIONS In the current pathways to care configuration, prodromal services are likely to prevent only a few at-risk individuals from transitioning to psychosis even if effective preventative treatments become available.
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Affiliation(s)
- Olesya Ajnakina
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Craig Morgan
- 0000 0001 2322 6764grid.13097.3cSociety and Mental Health Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London, SE5 8AF UK
| | - Charlotte Gayer-Anderson
- 0000 0001 2322 6764grid.13097.3cSociety and Mental Health Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London, SE5 8AF UK
| | - Sherifat Oduola
- 0000 0001 2322 6764grid.13097.3cNIHR Biomedical Research Centre, David Goldberg Building, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF UK
| | - François Bourque
- 0000 0001 2322 6764grid.13097.3cSociety and Mental Health Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London, SE5 8AF UK
| | - Sally Bramley
- 0000 0001 2322 6764grid.13097.3cGuy’s, King’s and St Thomas’ School of Medical Education, King’s College London, London, UK
| | - Jessica Williamson
- 0000 0004 0426 7183grid.450709.fViolence Prevention Research Unit Queen Mary University of London & East London NHS Foundation Trust, Garrod Building, Turner Street, London, E1 2AD UK
| | - James H. MacCabe
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AF UK ,0000 0001 2116 3923grid.451056.3National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | - Paola Dazzan
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AF UK ,0000 0001 2116 3923grid.451056.3National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | - Robin M. Murray
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AF UK
| | - Anthony S. David
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AF UK
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de Waal MM, Kikkert MJ, Blankers M, Dekker JJM, Goudriaan AE. Self-wise, Other-wise, Streetwise (SOS) training: a novel intervention to reduce victimization in dual diagnosis psychiatric patients with substance use disorders: protocol for a randomized controlled trial. BMC Psychiatry 2015; 15:267. [PMID: 26511799 PMCID: PMC4625454 DOI: 10.1186/s12888-015-0652-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/16/2015] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Psychiatric patients are more likely to be victims of crime than others in the community. Dual diagnosis patients with comorbid psychiatric and substance use disorders are especially prone to victimization. Victimization is associated with substance abuse, more severe symptomatology and homelessness. There is a strong need for interventions to reduce victimization in this population. We developed the Self-wise, Other-wise, Streetwise (SOS) training to reduce victimization in patients with dual diagnosis. METHODS/DESIGN This study is a randomized controlled trial using a parallel group design to determine the effectiveness of adding the SOS training to care as usual. Patients with dual diagnosis (N = 250) will be allocated to either care as usual plus SOS training (N = 125) or care as usual only (N = 125) using computer-generated stratified block randomization. To compare effectiveness participants will be interviewed at baseline and 2, 8 and 14 months follow-up. The primary outcome measure is treatment response (yes/no), defined as either no victimization at 14 months follow-up or at least a 50% reduction in incidents of victimization at 14 months follow-up compared to baseline assessment. Victimization is measured with the Safety Monitor, an adequate self-report instrument used by Statistics Netherlands to measure victimization on a large scale in the Netherlands. Outcome assessors are blind to treatment allocation. An economic evaluation will be performed alongside the randomized controlled trial and will take the societal perspective. DISCUSSION This study is the first randomized controlled trial to examine the effectiveness of an intervention that aims to reduce victimization in patients with dual diagnosis. If the intervention is effective it can be implemented in mental health care and contribute to the safety and well-being of patients. TRIAL REGISTRATION Dutch Trial Register (NTR): 4472, date of registration: 24-03-2014.
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Affiliation(s)
- Marleen M de Waal
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
| | - Martijn J Kikkert
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
- Trimbos Institute - Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS, Utrecht, The Netherlands.
| | - Jack J M Dekker
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Anna E Goudriaan
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
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