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Cotrena C, Branco LD, Shansis FM, Fonseca RP. Predictors of quality of life in bipolar disorder: A path analytical study. Psychiatry Res 2020; 285:112846. [PMID: 32066003 DOI: 10.1016/j.psychres.2020.112846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/18/2019] [Accepted: 02/03/2020] [Indexed: 02/07/2023]
Abstract
Quality of life (QoL) is an important outcome in psychiatric illnesses like bipolar disorder (BD). However, little is known about the variables that affect it, and therefore contribute to prognosis and treatment outcomes in these populations. This study aimed to explore QoL in BD and investigate its relationship with modifiable (cognitive reserve, cognitive ability, mood symptoms) and non-modifiable factors (diagnosis, previous suicide attempts, substance misuse, age). The WHOQOL-bref was administered to 121 control participants and 109 patients with BD, who also underwent clinical and neuropsychological assessments. Factor analysis was used to identify latent constructs underlying WHOQOL-bref domains, and structural equation models were used to examine predictors of each latent construct. Two latent constructs were identified in the WHOQOL-bref, and labeled 'Personal' and 'Social' QoL. Both were directly predicted by depression symptoms and a diagnosis of BD, and indirectly predicted by (hypo)manic symptoms. Cognitive reserve was a stronger predictor of social QoL than a diagnosis of BD. Our findings suggest that the management of depression symptoms and fostering of cognitive reserve may improve QoL in BD. A diagnosis of BD and/or substance use disorders were risk factors for poor QoL, and may signal the need for preventive interventions to promote well-being.
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Affiliation(s)
- Charles Cotrena
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, building 11, rm 940, Porto Alegre 90619-900, RS, Brazil.
| | - Laura Damiani Branco
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, building 11, rm 940, Porto Alegre 90619-900, RS, Brazil.
| | - Flávio Milman Shansis
- Medical Sciences Pos Graduate Program, University of Vale do Taquari (Univates), Lajeado, RS, Brazil
| | - Rochele Paz Fonseca
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, building 11, rm 940, Porto Alegre 90619-900, RS, Brazil
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Family-related non-abuse adverse life experiences occurring for adults diagnosed with eating disorders: a systematic review. J Eat Disord 2020; 8:36. [PMID: 32704372 PMCID: PMC7374817 DOI: 10.1186/s40337-020-00311-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/18/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Although previous reviews suggest a strong association between abuse and eating disorders, less is known about non-abuse adverse life experiences, such as parental mental illness or family discord, which occur frequently for this population. The aim of the current study was to identify family-related non-abuse adverse life experiences occurring for adults with eating disorders, and to establish whether they occur for people with anorexia nervosa, bulimia nervosa or binge-eating disorder more than the general population and other psychiatric populations. METHOD A systematic review of studies focusing on family-related non-abuse adverse life experiences and eating disorders was conducted in accordance with PRISMA guidelines. The search string was applied to four electronic databases including Psycinfo, PubMed/Medline, CINAHL Plus and EMBASE. RESULTS Of the 26 studies selected for inclusion, six types of family-related non-abuse adverse life experiences were identified: adverse parenting style; family disharmony; loss of a family member, relative or close person; familial mental health issues; family comments about eating, or shape, weight and appearance; and family disruptions. Findings provided tentative evidence for eating disorder specific (i.e. parental demands and criticism) and non-specific (i.e. familial loss and family disruptions) non-abuse adversities, with findings also suggesting that those with bulimia nervosa and binge-eating disorder were more impacted by loss, family separations and negative parent-child interactions compared to those with anorexia nervosa. CONCLUSIONS This review provides a clear synthesis of previous findings relating to family-related non-abuse adverse life experiences and eating disorders in adults. Implications for trauma-informed care in clinical practice were discussed (e.g. considering the impact of past life events, understanding the function of ED behaviours, reducing the risk of potential re-traumatisation).
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Affiliation(s)
- Timothy Wand
- University of Sydney and Sydney Local Health District, Camperdown, New South Wales, Australia
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Review of Child and Adolescent Mental Health Recovery Literature: Concordance and Contention. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s40737-018-0119-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Doyle L, Ellilä H, Jormfeldt H, Lahti M, Higgins A, Keogh B, Meade O, Sitvast J, Skärsäter I, Stickley T, Kilkku N. Preparing master-level mental health nurses to work within a wellness paradigm: Findings from the eMenthe project. Int J Ment Health Nurs 2018; 27:823-832. [PMID: 28786212 DOI: 10.1111/inm.12370] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 11/27/2022]
Abstract
Mental health promotion remains an important component of mental health nursing practice. Supporting wellness at both the individual and societal levels has been identified as one of the key tenets of mental health promotion. However, the prevailing biomedical paradigm of mental health education and practice has meant that many nurses have not been equipped to incorporate a wellness perspective into their mental health practice. In the present study, we report on an exploratory study which details the knowledge, skills, and attitudes required by master-level mental health nurses to practice within a wellness paradigm from the perspective of three groups of key stakeholders: (i) service users and family members (n = 23); (ii) experienced mental health nurses (n = 49); and (iii) master-level mental health nursing students (n = 37). The findings, which were reported from individual and focus group interviews across five European countries, suggested a need to reorientate mental health nursing education to include a focus on wellness and resilience to equip mental health nurses with the skills to work within a strengths-based, rather than a deficits-based, model of mental health practice. Key challenges to working within a wellness paradigm were identified as the prevailing dominance of the biomedical model of cause and treatment of mental health problems, which focusses on symptoms, rather than the holistic functioning of the individual, and positions the person as passive in the nurse-service user relationship.
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Affiliation(s)
- Louise Doyle
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - Heikki Ellilä
- School of Health and Wellbeing, Turku University of Applied Sciences, Turku, Finland
| | | | - Mari Lahti
- School of Health and Wellbeing, Turku University of Applied Sciences, Turku, Finland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - Brian Keogh
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - Oonagh Meade
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Jan Sitvast
- Master Program in Advanced Nursing Practice, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Ingela Skärsäter
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Theo Stickley
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Nina Kilkku
- School of Healthcare, Tampere University of Applied Sciences, Tampere, Finland
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Murray G, Leitan ND, Thomas N, Michalak EE, Johnson SL, Jones S, Perich T, Berk L, Berk M. Towards recovery-oriented psychosocial interventions for bipolar disorder: Quality of life outcomes, stage-sensitive treatments, and mindfulness mechanisms. Clin Psychol Rev 2017; 52:148-163. [DOI: 10.1016/j.cpr.2017.01.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 01/09/2017] [Accepted: 01/15/2017] [Indexed: 02/08/2023]
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Musolino C, Warin M, Wade T, Gilchrist P. Developing shared understandings of recovery and care: a qualitative study of women with eating disorders who resist therapeutic care. J Eat Disord 2016; 4:36. [PMID: 28018596 PMCID: PMC5159948 DOI: 10.1186/s40337-016-0114-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/04/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This paper explores the differing perspectives of recovery and care of people with disordered eating. We consider the views of those who have not sought help for their disordered eating, or who have been given a diagnosis but have not engaged with health care services. Our aim is to demonstrate the importance of the cultural context of care and how this might shape people's perspectives of recovery and openness to receiving professional care. METHOD This study utilised a mixed methods approach of ethnographic fieldwork and psychological evaluation with 28 women from Adelaide, South Australia. Semi-structured interviews, observations, field notes and the Eating Disorder Examination were the primary forms of data collection. Data was analysed using thematic analysis. RESULTS & DISCUSSION Participants in our study described how their disordered eating afforded them safety and were consistent with cultural values concerning healthy eating and gendered bodies. Disordered eating was viewed as a form of self-care, in which people protect and 'take care' of themselves. These subjectively experienced understandings of care underlie eating disorder behaviours and provide an obstacle in seeking any form of treatment that might lead to recovery. CONCLUSION A shared understanding between patients and health professionals about the function of the eating disorder may avoid conflict and provide a pathway to treatment. These results suggest the construction of care by patients should not be taken for granted in therapeutic guidelines. A discussion considering how disordered eating practices are embedded in a matrix of care, health, eating and body practices may enhance the therapeutic relationship.
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Affiliation(s)
- Connie Musolino
- Gender Studies & Social Analysis, School of Social Sciences, Faculty of Arts, University of Adelaide, Napier Building, Adelaide, South Australia 5005 Australia
| | - Megan Warin
- Gender Studies & Social Analysis, School of Social Sciences, Faculty of Arts, University of Adelaide, Napier Building, Adelaide, South Australia 5005 Australia
| | - Tracey Wade
- School of Psychology, Flinders University, Adelaide, South Australia Australia
| | - Peter Gilchrist
- Psychiatrist in private practice, Adelaide, South Australia Australia
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Bosanac P, Hopwood M, Keks N, Newton R, Tiller JW, Coplov Ao D, Paoletti N, Castle DJ. Recovery is a core goal of psychiatrists. Aust N Z J Psychiatry 2016; 50:935-6. [PMID: 27531936 DOI: 10.1177/0004867416662918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Peter Bosanac
- St Vincent's Hospital Melbourne, The University of Melbourne, Fitzroy, VIC, Australia
| | - Malcolm Hopwood
- Albert Road Clinic and Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Nicholas Keks
- Delmont Private Hospital and Monash University, Glen Iris, VIC, Australia
| | - Richard Newton
- MHCSU, Austin Health, The University of Melbourne, Heidelberg, VIC, Australia
| | - John Wg Tiller
- Albert Road Clinic, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Nick Paoletti
- Austin Hospital, The University of Melbourne, Heidelberg, VIC, Australia
| | - David J Castle
- St Vincent's Hospital Melbourne, The University of Melbourne, Fitzroy, VIC, Australia
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Affiliation(s)
- Shuichi Suetani
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
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