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Zamora-Moncayo EC, Herrera B, Larrieta J, DuBois A, Miguel Esponda G. A Participatory Evaluation of an Urban Garden Project in Ecuador: Exploring Factors That Impact the Recovery of People With Severe Mental Health Problems. QUALITATIVE HEALTH RESEARCH 2024:10497323241245867. [PMID: 39030699 DOI: 10.1177/10497323241245867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
For the past years, Ecuador has been transitioning away from a hospital-based model of mental healthcare to one that is community-centred. However, challenges associated with hospital-based models endure, notably financial burden faced by those with severe mental health problems (SMHPs) due to labour market discrimination. Employment access for this group is often disregarded in policy planning, despite evidence of its benefits on mental health. Huertomanías, an urban garden initiative in Ecuador founded in 2015, works with individuals with SMHPs, providing work, income, and social inclusion. A case study using a participatory approach was carried out to explore factors that impact the recovery of people with SMHPs. Twelve participants engaged in diverse stages of the research, where several participatory activities were conducted including cognitive mapping, a photovoice project, and interviews. The analysis employed a thematic approach leading to four categories of impact within the urban garden: autonomy (financial and personal), interpersonal relations and relation with the environment, mental health, and family dynamics. A final category of impact was established encompassing external factors (family support and public policy and healthcare services) that influence recovery. Findings suggest that the urban garden promotes autonomy and active participation within society, improves mental health, and transforms family dynamics. Further, this study highlights the importance of community-based mental healthcare (CBMHC), emphasising the need of public policies and healthcare in promoting autonomy through employment and community-centred services. Lastly, the study contributes insights into recovery experiences and CBMHC benefits, informing programme development and similar initiatives in Latin America.
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Affiliation(s)
| | | | | | | | - Georgina Miguel Esponda
- SHM Foundation, London, UK
- Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
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Ali Y, Rennick-Egglestone S, Llewellyn-Beardsley J, Ng F, Yeo C, Franklin D, Perez Vallejos E, Ben-Zeev D, Kotera Y, Slade M. Perception and appropriation of a web-based recovery narratives intervention: qualitative interview study. Front Digit Health 2024; 6:1297935. [PMID: 38419807 PMCID: PMC10899698 DOI: 10.3389/fdgth.2024.1297935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Mental health recovery narratives are widely available to the public, and can benefit people affected by mental health problems. The NEON Intervention is a novel web-based digital health intervention providing access to the NEON Collection of recovery narratives. The NEON Intervention was found to be effective and cost-effective in the NEON-O Trial for people with nonpsychosis mental health problems (ISRCTN63197153), and has also been evaluated in the NEON Trial for people with psychosis experience (ISRCTN11152837). We aimed to document NEON Intervention experiences, through an integrated process evaluation. Methods Analysis of interviews with a purposive sample of intervention arm participants who had completed trial participation. Results We interviewed 34 NEON Trial and 20 NEON-O Trial participants (mean age 40.4 years). Some users accessed narratives through the NEON Intervention almost daily, whilst others used it infrequently or not at all. Motivations for trial participation included: exploring the NEON Intervention as an alternative or addition to existing mental health provision; searching for answers about mental health experiences; developing their practice as a mental health professional (for a subset who were mental health professionals); claiming payment vouchers. High users (10 + narrative accesses) described three forms of appropriation: distracting from difficult mental health experiences; providing an emotional boost; sustaining a sense of having a social support network. Most participants valued the scale of the NEON Collection (n = 659 narratives), but some found it overwhelming. Many felt they could describe the characteristics of a desired narrative that would benefit their mental health. Finding a narrative meeting their desires enhanced engagement, but not finding one reduced engagement. Narratives in the NEON Collection were perceived as authentic if they acknowledged the difficult reality of mental health experiences, appeared to describe real world experiences, and described mental health experiences similar to those of the participant. Discussion We present recommendations for digital health interventions incorporating collections of digital narratives: (1) make the scale and diversity of the collection visible; (2) provide delivery mechanisms that afford appropriation; (3) enable contributors to produce authentic narratives; (4) enable learning by healthcare professionals; (5) consider use to address loneliness.
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Affiliation(s)
- Yasmin Ali
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Joy Llewellyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Caroline Yeo
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Department of Architecture and Built Environment, Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | - Donna Franklin
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Elvira Perez Vallejos
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Dror Ben-Zeev
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Yasuhiro Kotera
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Center for Infectious Disease Education and Research, Osaka University, Osaka, Japan
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Faculty of Nursing and Health Sciences, Health, and Community Participation Division, Nord University, Namsos, Norway
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Sands G, Blake H, Carter T, Spiby H. Nature-based interventions to support mental health and well-being of young women in pregnancy: exploratory work for future feasibility RCT. PUBLIC HEALTH RESEARCH 2023:1-23. [PMID: 38140912 DOI: 10.3310/npgr3411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
Background The prevalence of mental health and well-being issues among young women is increasing. Pregnancy is a time when new mental health challenges may arise, or existing conditions can be exacerbated. This project presents preparatory work on how nature-based interventions may help to support the mental health and well-being of young pregnant women (aged 16-24 years) in a future study. Methods This project was formed of three main phases conducted from March to August 2022: (1) mapping nature activities available across the East Midlands region and two focus groups with providers of nature activities (n = 6); (2) public participation and involvement work to inform future research. This included four focus groups with young women (n = 11), leading to the formation of a new young women's panel (Research Influencers Group). Networking and stakeholder engagement to support future research. Results The mapping survey identified 68 nature-based organisations/projects operating in the region, many of whom expressed interest in being involved in future research. The young women's focus groups confirmed the importance of the topic and generated a wealth of information to support the intervention design. A Research Influencer Group of five young women was established from the focus group participants. The Research Influencer Group chose the nature-based intervention and had input into all aspects of the study design. This group will continue into future projects. Focus groups with providers of nature activities have further advanced the study design. The project team have developed relationships with relevant stakeholders and networks that will inform the future trial. Conclusion This preparatory co-design work suggested that a nature-based intervention may be acceptable to young women, and providers of such interventions felt it was feasible to offer these activities to young pregnant women. This preparatory work has led to an outline research plan which has been co-produced with public contributors and stakeholders throughout. Limitations This preparatory work is limited by small focus group samples, and the possibility that not all providers were reached through the snowballing approach to the mapping survey. Future work Future research is needed to test the nature-based intervention; this would be in the form of a feasibility randomised controlled trial of nature-based interventions to promote the mental health and well-being of young pregnant women. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135167.
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Affiliation(s)
- Gina Sands
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Tim Carter
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham, UK
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Caple V, Maude P, Walter R, Ross A. An exploration of loneliness experienced by people living with mental illness and the impact on their recovery journey: An integrative review. J Psychiatr Ment Health Nurs 2023; 30:1170-1191. [PMID: 37382063 DOI: 10.1111/jpm.12945] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/15/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: There is evidence that social isolation and loneliness is more prevalent in people living with mental illness than in the general population. People living with mental illness frequently experience stigma, discrimination, rejection, repeated psychiatric admissions, low self-esteem, low self-efficacy, and increased symptoms of paranoia, depression, and anxiety. There is evidence of common interventions that can be used to improve loneliness and social isolation such as psychosocial skills training and cognitive group therapy. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper offers a comprehensive assessment of the evidence between mental illness, loneliness, and recovery. The results suggest that people living with mental illness experience elevated levels of social isolation and loneliness leading to poor recovery and quality of life. Social deprivation, social integration and romantic loneliness are related to loneliness, poor recovery, and reduced quality of life. A sense of belonging, ability to trust and hope are important aspects of improved loneliness, quality of life and recovery. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The existing culture in mental health nursing practice needs to be examined to address loneliness in people living with mental illness and its impact on recovery. Existing tools to research loneliness do not consider dimensions in loneliness experience as reflected in the literature. Practice needs to demonstrate an integrated approach to recovery, optimal service delivery and augmentation of evidence-based clinical practice to improve individual's loneliness, social circumstances, and relationships. Practice needs to demonstrate nursing knowledge in caring for people living with mental illness experiencing loneliness. Further longitudinal research is required to clearly understand the relationship between loneliness, mental illness, and recovery. ABSTRACT INTRODUCTION: To our knowledge, there are no previous reviews on the impact of loneliness experienced by people aged 18-65, who are living with mental illness and their recovery experience. AIM/QUESTION To explore the experience and impact of loneliness in people living with mental illness during recovery. METHOD An integrative review. RESULTS A total of 17 papers met the inclusion criteria. The search was conducted using four electronic databases: MEDLINE, CINAHL, Scopus and PsycINFO. Across these 17 papers, participants were most commonly, diagnosed with schizophrenia or psychotic disorders and recruited from community mental health services. DISCUSSION The review revealed loneliness to be substantial in people living with mental illness and that loneliness affected their recovery, and their quality of life. The review identified many factors that contribute to loneliness including unemployment, financial strain, social deprivation, group housing, internalized stigma and mental illness symptoms. Individual factors such as social/community integration and social network size as well as an inability to trust, a sense of not belonging, hopelessness and lack of romance were also evident. Interventions targeting social functioning skills and social connectedness were found to improve social isolation and loneliness. IMPLICATIONS FOR PRACTICE It is vital for mental health nursing practice to employ an approach integrating physical health as well as social recovery needs, optimal service delivery and augmentation of evidence-based clinical practice to improve loneliness, recovery, and quality of life.
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Affiliation(s)
- Vanessa Caple
- School of Nursing and Midwifery, La Trobe. University, Bundoora, Victoria, Australia
| | - Phil Maude
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, Latrobe University, Bendigo, Victoria, Australia
| | - Ruby Walter
- School of Health and Biomedical Sciences Nursing, RMIT University, Bundoora, Victoria, Australia
| | - Alistair Ross
- La Trobe Rural Health School, Latrobe University, Bendigo, Victoria, Australia
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Sands G, Blake H, Carter T, Spiby H. Nature-Based Interventions in the UK: A Mixed Methods Study Exploring Green Prescribing for Promoting the Mental Wellbeing of Young Pregnant Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6921. [PMID: 37887659 PMCID: PMC10606054 DOI: 10.3390/ijerph20206921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/29/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Green prescribing is gaining in popularity internationally for the promotion of mental wellbeing. However, the evidence base is limited, particularly in young pregnant women, a population with known risk factors for anxiety and depression. The aim of this mixed-methods study was to provide insights into the availability, processes, and suitability of nature-based interventions for young pregnant women. First, an online mapping survey of nature-based activities in the East Midlands region of the United Kingdom (UK) was undertaken. Second, focus groups (n = 6) were conducted with nature activity providers and young mothers (n = 11). This study found there were many diverse nature-based activities available to promote mental wellbeing. The organisational challenges highlighted include a lack of sufficient funding for service provision and disappointing experiences with some green prescribing programmes. The young women felt that nature-based activities helped to promote their mental wellbeing, and also offered an opportunity for social support. The facilitators, such as having detailed information and being accompanied to initial sessions to ease anxieties, were found to maximise the women's engagement with nature-based interventions. This study provides new perspectives on nature-based interventions from service providers and young women. Findings on the organisational barriers and facilitators to delivering interventions will inform the design of much needed future experimental research.
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Affiliation(s)
- Gina Sands
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.B.); (T.C.); (H.S.)
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.B.); (T.C.); (H.S.)
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
| | - Tim Carter
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.B.); (T.C.); (H.S.)
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.B.); (T.C.); (H.S.)
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Swinkels LTA, Hoeve M, Ter Harmsel JF, Schoonmade LJ, Dekker JJM, Popma A, van der Pol TM. The effectiveness of social network interventions for psychiatric patients: A systematic review and meta-analysis. Clin Psychol Rev 2023; 104:102321. [PMID: 37499318 DOI: 10.1016/j.cpr.2023.102321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
Strengthening social networks is an important goal in mental health treatment. This study aimed to determine the effectiveness of social network interventions for psychiatric patients. A systematic review and meta-analysis was conducted comparing these interventions with control groups on social and mental health-related outcomes in psychiatric patients. PubMed, EMBASE.com, PsycInfo, Scopus, and IBSS were searched for studies until December 21, 2022. Three-level random effects models were used to obtain Cohen's d mean estimates on composite outcomes of social network and secondary mental health outcomes. Heterogeneity was examined with potential moderators. Thirty-three studies were included. Small-to-moderate effects of social network interventions were detected on positive social network (d = 0.115, p = 0.022) and support (d = 0.159; p = 0.007), general functioning (d = 0.127, p = 0.046), mental health treatment adherence (d = 0.332, p = 0.003), days substance use (d = 0.097, p = 0.004), and abstinence (d = 0.254, p = 0.004). Estimates of psychiatric functioning were higher in samples with more females. The quality of evidence was moderate-to-low. This evidence suggests that social network interventions can improve positive social networks, general functioning, mental health treatment adherence, and substance use in psychiatric patients receiving usual care. PROSPERO ID: CRD42019131959.
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Affiliation(s)
- L T A Swinkels
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - M Hoeve
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, Netherlands
| | - J F Ter Harmsel
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - L J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - J J M Dekker
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV, Amsterdam, Netherlands; Department of Research and Quality of Care, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - T M van der Pol
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands; Department of Research and Quality of Care, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, Netherlands
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Brooks H, Devereux-Fitzgerald A, Richmond L, Caton N, Cherry MG, Bee P, Lovell K, Downs J, Edwards BM, Vassilev I, Bush L, Rogers A. Exploring the use of social network interventions for adults with mental health difficulties: a systematic review and narrative synthesis. BMC Psychiatry 2023; 23:486. [PMID: 37420228 PMCID: PMC10329398 DOI: 10.1186/s12888-023-04881-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/17/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND People with mental health difficulties often experience social isolation. The importance of interventions to enhance social networks and reduce this isolation is increasingly being recognised. However, the literature has not yet been systematically reviewed with regards to how these are best used. This narrative synthesis aimed to investigate the role of social network interventions for people with mental health difficulties and identify barriers and facilitators to effective delivery. This was undertaken with a view to understanding how social network interventions might work best in the mental health field. METHODS Systematic searches using combinations of synonyms for mental health difficulties and social network interventions were undertaken across 7 databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science) and 2 grey literature databases (EThoS and OpenGrey) from their inception to October 2021. We included studies reporting primary qualitative and quantitative data from all study types relating to the use of social network interventions for people with mental health difficulties. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Data were extracted and synthesised narratively. RESULTS The review included 54 studies, reporting data from 6,249 participants. Social network interventions were generally beneficial for people with mental health difficulties but heterogeneity in intervention type, implementation and evaluation made it difficult to draw definitive conclusions. Interventions worked best when they (1) were personalised to individual needs, interests and health, (2) were delivered outside formal health services and (3) provided the opportunity to engage in authentic valued activities. Several barriers to access were identified which, without careful consideration could exacerbate existing health inequalities. Further research is required to fully understand condition-specific barriers which may limit access to, and efficacy of, interventions. CONCLUSIONS Strategies for improving social networks for people with mental health difficulties should focus on supporting engagement with personalised and supported social activities outside of formal mental health services. To optimise access and uptake, accessibility barriers should be carefully considered within implementation contexts and equality, diversity and inclusion should be prioritised in intervention design, delivery and evaluation and in future research.
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Affiliation(s)
- Helen Brooks
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
| | - Angela Devereux-Fitzgerald
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
| | - Laura Richmond
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- Department of Clinical, Education & Health Psychology, University College London, London, UK
| | - Neil Caton
- Patient and Public Involvement Contributor, University of Manchester, Manchester, UK
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
- Linda McCartney Centre, Liverpool University Hospitals NHS Trust, Prescot St, Liverpool, UK
| | - Penny Bee
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
| | - Karina Lovell
- Mental Health Research Group, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - James Downs
- Patient and Public Involvement Contributor, Cambridge, UK
| | | | - Ivaylo Vassilev
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | - Anne Rogers
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
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Ngamaba KH, Webber M, Xanthopoulou P, Chevalier A, Giacco D. Participation in leisure activities and quality of life of people with psychosis in England: a multi-site cross-sectional study. Ann Gen Psychiatry 2023; 22:8. [PMID: 36915120 PMCID: PMC10009983 DOI: 10.1186/s12991-023-00438-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/15/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Leisure activities can improve quality of life in the general population. For people with psychosis, negative symptoms (e.g. being unmotivated, difficulty in sticking with activities) are often a barrier to engaging in social leisure activities. However, we do not know if participation in leisure activities is associated with quality of life in this group and, whether psychosocial interventions should aim to increase leisure activities. AIM This study investigates participation in social leisure activities of people with psychosis and whether their participation is associated with better quality of life. METHODS A cross-sectional survey was conducted in 6 NHS mental health trusts. Adults aged 18-65 (N = 533) with a diagnosis of a psychosis-related condition (ICD-10 F20-29) were recruited from outpatient secondary mental health services. Several measures were used including an adapted version of the Time Use Survey (TUS), the Social contacts assessment (SCA) and Manchester Short Assessment of Quality of Life (MANSA). A Structural Equation Model (SEM) was used to explore the relationships between participation in leisure activities and quality of life, and whether social contacts mediated the link. RESULTS Participants attended an average of 2.42 (SD = 1.47) leisure activities in the last 7 days. Their quality of life increased with the number of leisure activities they attended. Participation in leisure activities was positively associated with quality of life in people with psychosis (B = 0.104, SE = 0.051, p = 0.042, 95% CI [0.003 to 0.204]). Leisure activities predicted social contacts, but the link between social contacts and the quality of life was not significant. After controlling for sociodemographic factors, being female and unemployed were negatively linked with quality of life (B = - 0.101, SE = 0.048, p = 0.036, 95% CI [- 0.196 to - 0.006; B = - 0.207, SE = 0.050, p = 0.001, 95% CI [- 0.305 to - 0.108, respectively]. CONCLUSION People with psychosis who attend more leisure activities have a higher quality of life. Quality of life was lower amongst female and unemployed participants who attended leisure activities. Intervention which helps improve participation in leisure activities may be beneficial for people with psychosis. Trial registration number ISRCTN15815862.
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Affiliation(s)
- Kayonda Hubert Ngamaba
- International Centre for Mental Health Social Research (ICMHSR), School for Business and Society, University of York, Heslington, York, YO10 5DD, UK.
| | - Martin Webber
- International Centre for Mental Health Social Research (ICMHSR), School for Business and Society, University of York, Heslington, York, YO10 5DD, UK
| | - Penny Xanthopoulou
- Mental Health Research Group, College of Medicine and Health, University of Exeter, College House (1.05), St. Luke's Campus, Exeter, EX1 2LU, Devon, UK
| | - Agnes Chevalier
- Unit for Social and Community Psychiatry, (WHO Collaborating Centre for Mental Health Service Development), Barts and the London School of Medicine, Newham Centre for Mental Health, Queen Mary University of London, London, E13 8SP, UK
| | - Domenico Giacco
- Unit for Social and Community Psychiatry, (WHO Collaborating Centre for Mental Health Service Development), Barts and the London School of Medicine, Newham Centre for Mental Health, Queen Mary University of London, London, E13 8SP, UK.,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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Abstract
PURPOSE OF REVIEW People with persistent depressive disorders and with bipolar disorder are more likely to feel lonely than people in the general population. This evidence update focused on studies in the last 2 years, characterized by the COVID-19 pandemic and consequent social distancing directives. RECENT FINDINGS Longitudinal studies identified that people who feel lonely are more likely to become depressed or to experience relapse of mood disorders. There is emerging evidence that feelings of loneliness or mandatory social isolation can precede manic episodes. Hence the relationship between loneliness and mood disorders is complex and bidirectional. Interventions were developed to reduce loneliness in people with mental health problems, including depressive disorders, through cognitive modification and/or supported socialisation. No loneliness-focused interventions have been specifically tailored to people with bipolar disorder. SUMMARY Studies carried out before and during the COVID-19 pandemic found that feelings of loneliness can be both consequences and precursors of persistent depression and bipolar disorder. Mood symptoms and loneliness have a cumulative negative effect on physical and mental health outcomes. Conceptual overlaps and relations between loneliness and mood symptoms should be clarified in qualitative studies. Theory-driven intervention models should be developed and tested in methodologically robust studies.
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Cohen CI. Social Networks and Residential Status in Community-Dwelling Older Adults With Schizophrenia: Compensation by Reconfiguration? Am J Geriatr Psychiatry 2022; 30:1159-1167. [PMID: 35654726 DOI: 10.1016/j.jagp.2022.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To address the paucity of data on the structure and content of social networks of older adults with schizophrenia (OAS). METHODS The OAS group comprised 249 persons aged 55 and older with early-onset schizophrenia living in supportive housing (SS; n = 151), independently (SI; n = 70), or with family (SF; n = 28). The community comparison (CC) group comprised 113 individuals. Social network analysis was used. Multinomial logistic regression with p ≤0.001 and p ≤0.05 was used for overall and pairwise comparisons, respectively. RESULTS Each OAS subgroup had more total, nonkin, and formal linkages than the CC group. The SS and SI subgroups had fewer kin linkages than the CC group. The CC group had more confidants than the SS subgroup, more reliable linkages than the SS and SI subgroups, and more sustenance linkages than each of the OAS subgroups. Nearly everyone in the CC, SI, and SF subgroups had a confidant, a reliable contact, and a sustenance linkage; 33% of the SS subgroup had no confidants. The SS subgroup displayed more psychiatric symptoms than the SI and SF subgroups. There were no differences in loneliness or relationship satisfaction between the CC and the schizophrenia subgroups. CONCLUSION Networks were expressed differentially across residential arrangements and differences may reflect dissimilarities in psychiatric functioning. OAS generally had ample levels of companionship and emotional and instrumental support, often comparable to their age peers. Whereas social networks typically decline at illness onset and may be predominantly family-focused, later life may be a time of network reconfiguration and reconstitution.
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Affiliation(s)
- Carl I Cohen
- Division of Geriatric Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY.
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Ngamaba KH, Lombo LS, Makopa IK, Panzaekofo J. Are COVID-19's restrictive measures associated with people's quality of life and the prevalence of anxiety and depression in Kinshasa in the Democratic Republic of Congo? J Public Health Afr 2022; 13:1728. [PMID: 36405521 PMCID: PMC9667577 DOI: 10.4081/jphia.2022.1728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 05/28/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The spread of COVID-19 and the economic repercussions of several restrictive measures have worsened the lives of the Congolese and caused panic, fear, and anxiety. No study has yet examined the effect COVID-19's restrictive measures had on the quality of life in the Congo. AIMS The purpose of this study is to determine if the restrictive measures of COVID-19 are associated with the quality of life and the prevalence of anxiety and depression in Kinshasa. METHODS A cross-sectional survey was conducted in seventeen Kinshasa municipalities. N=100 adults over the age of 18 were recruited (41 females, 58 males and 1 prefer not). Social Contacts Assessment (SCA), Time Use Survey (TUS), Manchester Short Assessment of quality of life (MANSA), Health status EQ-5D-3L, UCLA Loneliness Scale; Patient Health Questionnaire (PHQ-9); General Anxiety Disorder (GAD-7) and COVID-19 related questions were utilized. We conducted descriptive statistics and multiple regression analyses. RESULTS suggest that depression and anxiety are more prevalent (PHQ-9 and GAD-7 scores were 9.1 (SD=6.8) and 8.5 (SD=6.1) respectively). Negative associations were found between the quality of life and living alone (B=-0.35, p=0.05) and mental health decline due to COVID- 19 (B=-0.30, p=0.04). Those who described themselves as less lonely reported a higher quality of life (B=0.34, p=0.03). CONCLUSIONS Living alone is associated with a lower quality of life. This study fills a gap in the literature on public health in the DRC and low- and middle-income countries.
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Affiliation(s)
- Kayonda Hubert Ngamaba
- International Centre for Mental Health Social Research, University of York, York, UK,University of York, York, UK.
| | - Laddy Sedzo Lombo
- Centre Spécialisé dans la Prise en charge Psychosociale en Santé Mentale (CSPEMRDC), Université Chrétienne de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Israel Kenda Makopa
- Centre Spécialisé dans la Prise en charge Psychosociale en Santé Mentale (CSPEMRDC), Université Chrétienne de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Joyce Panzaekofo
- Social Work and International Studies, University of North Carolina at Charlotte, Charlotte, USA
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Murray AL, Nagin D, Obsuth I, Ribeaud D, Eisner M. Young Adulthood Outcomes of Joint Mental Health Trajectories: A Group-Based Trajectory Model Analysis of a 13-Year Longitudinal Cohort Study. Child Psychiatry Hum Dev 2022; 53:1083-1096. [PMID: 34059956 PMCID: PMC9470602 DOI: 10.1007/s10578-021-01193-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 11/21/2022]
Abstract
Developmental trajectories of common mental health issues such as ADHD symptoms, internalising problems, and externalising problems can often be usefully summarised in terms of a small number of 'developmental subtypes' (e.g., 'childhood onset', 'adolescent onset') that may differ in their profiles or levels of clinically meaningful variables such as etiological risk factors. However, given the strong tendency for symptoms in these domains to co-occur, it is important to consider not only developmental subtypes in each domain individually, but also the joint developmental subtypes defined by symptoms trajectories in all three domains together (e.g., 'late onset multimorbid', 'pure internalising', 'early onset multimorbid'). Previous research has illuminated the joint developmental subtypes of ADHD symptoms, internalising problems, and externalising problems that emerge from normative longitudinal data using methods such as group-based trajectory modelling, as well as predictors of membership in these developmental subtypes. However, information on the long-term outcomes of developmental subtype membership is critical to illuminate the likely nature and intensity of support needs required for individuals whose trajectories fit different developmental subtypes. We, therefore, evaluated the relations between developmental subtypes previously derived using group-based trajectory modelling in the z-proso study (n = 1620 with trajectory data at ages 7, 8, 9, 10, 11, 12, 13, 15) and early adulthood outcomes. Individuals with multimorbid trajectories but not 'pure' internalising problem elevations showed higher levels of social exclusion and delinquency at age 20. These associations held irrespective of the specific developmental course of symptoms (e.g., early versus late onset versus remitting). There was also some evidence that intimate partner violence acts as a form of heterotypic continuity for earlier externalising problems. Results underline the need for early intervention to address the pathways that lead to social exclusion and delinquency among young people with multiple co-occurring mental health issues.
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Affiliation(s)
| | | | - Ingrid Obsuth
- Clinical Psychology Department, University of Edinburgh, Edinburgh, UK
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
- Institute of Criminology, University of Cambridge, Cambridge, UK
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Renwick L, McWilliams C, Schaff O, Russell L, Ramsdale S, Morris RL. Stakeholder identified research priorities for early intervention in psychosis. Health Expect 2022; 25:2960-2970. [PMID: 36129063 DOI: 10.1111/hex.13604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Public resources to answer pertinent research questions about the impact of illness and treatment on people with mental health problems are limited. To target funds effectively and efficiently and maximize the health benefits to populations, prioritizing research areas is needed. Research agendas are generally driven by researcher and funder priorities, however, there is growing recognition of the need to include user-defined research priorities to make research more relevant, needs-based and efficient. OBJECTIVE To gain consensus on top priorities for research into early intervention in psychosis through a robust, democratic process for prioritization enlisting the views of key stakeholders including users, carers and healthcare professionals. We also sought to determine which user-prioritized questions were supported by scientific evidence. DESIGN AND METHODS We used a modified nominal group technique to gain consensus on unanswered questions that were obtained by survey and ranked at successive stages by a steering group comprising users, carer representatives and clinicians from relevant disciplines and stakeholder bodies. We checked each question posed in the survey was unanswered in research by reviewing evidence in five databases (Medline, Cinahl, PsychInfo, EMBASE and Cochrane Database). RESULTS Two hundred and eighty-three questions were submitted by 207 people. After checking for relevance, reframing and examining for duplicates, 258 questions remained. We gained consensus on 10 priority questions; these largely represented themes around access and engagement, information needs before and after treatment acceptance, and the influence of service-user (SU) priorities and beliefs on treatment choices and effectiveness. A recovery SUtheme identified specific self-management questions and more globally, a need to fully identify factors that impact recovery. DISCUSSION AND CONCLUSIONS Published research findings indicated that the priorities of service users, carers and healthcare professionals were aligned with researchers' and funders' priorities in some areas and misaligned in others providing vital opportunities to develop research agendas that more closely reflect users' needs. PATIENT AND PUBLIC CONTRIBUTION Initial results were presented at stakeholder workshops which included service-users, carers, health professionals and researchers during a consensus workshop to prioritize research questions and allow the opportunity for feedback. Patient and public representatives formed part of the steering group and were consulted regularly during the research process.
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Affiliation(s)
- Laoise Renwick
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Caitlin McWilliams
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Olivia Schaff
- The Education Campus - Oxford Road, Central Manchester Foundation NHS Trust Library Services, Manchester, UK
| | - Laura Russell
- The Education and Research Centre - Wythenshawe Hospital, Central Manchester Foundation NHS Trust, Manchester, UK
| | - Susan Ramsdale
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Rebecca Lauren Morris
- NIHR Greater Manchester Patient Safety Translation Research Centre,Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Manchester, UK
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Brooks H, Devereux-Fitzgerald A, Richmond L, Caton N, Newton A, Downs J, Lovell K, Bee P, Cherry MG, Young B, Vassilev I, Rotheram C, Rogers A. Adapting a social network intervention for use in secondary mental health services using a collaborative approach with service users, carers/supporters and health professionals in the United Kingdom. BMC Health Serv Res 2022; 22:1140. [PMID: 36085063 PMCID: PMC9461266 DOI: 10.1186/s12913-022-08521-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Background Social integration, shared decision-making and personalised care are key elements of mental health and social care policy. Although these elements have been shown to improve service user and service-level outcomes, their translation into practice has been inconsistent and social isolation amongst service users persists. Aim To co-adapt, with service users, carers/supporters and health professionals, a web-based social network intervention, GENIE™, for use in secondary mental health services. The intervention is designed to support social activity and preference discussions between mental healthcare professionals and service users as a means of connecting individuals to local resources. Methods In Phase 1 (LEARN), we completed two systematic reviews to synthesise the existing evidence relating to the i) effectiveness and ii) the implementation of social network interventions for people with mental health difficulties. We undertook semi-structured interviews with a convenience sample of 15 stakeholders previously involved in the implementation of the intervention in physical healthcare settings. Interviews were also conducted with 5 national key stakeholders in mental health (e.g., policy makers, commissioners, third sector leads) to explore wider implementation issues. In Phase 2 (ADAPT), we worked iteratively with eight service users, nine carers, six professionals/volunteers and our patient and public advisory group. We drew on a framework for experience-based co-design, consisting of a series of stakeholder consultation events, to discuss the use of the social network intervention, in mental health services. Participants also considered factors that could serve as enablers, barriers, and challenges to local implementation. Results Across the stakeholder groups there was broad agreement that the social network intervention had potential to be useful within mental health services. In terms of appropriate and effective implementation, such an intervention was predicted to work best within the care planning process, on discharge from hospital and within early intervention services. There were indications that the social connection mapping and needs assessment components were of most value and feasible to implement which points to the potential utility of a simplified version compared to the one used in this study. The training provided to facilitators was considered to be more important than their profession and there were indications that service users should be offered the opportunity to invite a carer, friend, or family member to join them in the intervention. Conclusion The GENIE™ intervention has been co-adapted for use in mental health services and a plan for optimal implementation has been co-produced. The next phase of the programme of work is to design and implement a randomised controlled trial to evaluate clinical and cost effectiveness of a simplified version of the intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08521-1.
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15
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Giacco D. Tackling social isolation in people with psychosis: promising developments but need for conceptual clarity. J Ment Health 2022; 31:297-301. [PMID: 35599584 DOI: 10.1080/09638237.2022.2069725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Domenico Giacco
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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16
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Hailemariam M, Zlotnick C, Taft A, Johnson JE. MOSAIC (MOthers’ AdvocateS In the Community) for pregnant women and mothers of children under 5 with experience of intimate partner violence: A pilot randomized trial study protocol. PLoS One 2022; 17:e0267679. [PMID: 35584181 PMCID: PMC9116623 DOI: 10.1371/journal.pone.0267679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/22/2022] [Indexed: 11/19/2022] Open
Abstract
Background Pregnancy and motherhood increase the risk for long-term exposure to physical, psychological and sexual intimate partner violence (IPV; sexual or physical violence by current or former partners). Pregnant women and mothers with children under 5 who have experienced IPV exhibit poor physical and mental health and obstetric outcomes. Depression and posttraumatic stress disorder (PTSD) are the two most common mental health consequences of IPV. There is good evidence that women with good social support have better mental health and IPV outcomes. Methods This study will develop MOthers’ AdvocateS In the Community (MOSAIC) Plus intervention for pregnant women and mothers with children under the age of 5. MOSAIC uses trained mentor mothers and has been found to reduce subsequent IPV. This study will blend the original MOSAIC intervention with principles of interpersonal psychotherapy (IPT) to address symptoms of depression, PTSD, and prevent subsequent risk of IPV. We will conduct a pilot randomized trial of the MOSAIC Plus intervention compared to the traditional MOSAIC intervention to determine its feasibility and acceptability. Study samples include focus groups (n = 36), open trial (n = 15), and a randomized pilot trial including 40 pregnant women and mothers with children under 5 who report current/recent of IPV and elevated symptoms of maternal depression and/or PTSD. The study’s primary outcome will be changes in maternal depressive and PTSD symptoms. Secondary outcomes will include reduction in subsequent IPV, improvement in functioning, changes in social support and effectiveness in obtaining resources. Discussion This is a formative study evaluating the feasibility and acceptability of a mentor mother intervention for pregnant women and mothers with children under 5. Promising results of this study will be used for a larger, fully-powered randomized trial evaluating the effectiveness of a mentor mother intervention in preventing subsequent IPV and reducing depressive and PTSD symptoms in this population.
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Affiliation(s)
- Maji Hailemariam
- Department of Obstetrics, Gynaecology and Reproductive Biology, Michigan State University, College of Human Medicine, East Lansing, MI, United States of America
- * E-mail:
| | - Caron Zlotnick
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, United States of America
- Department of Medicine at Women and Infants Hospital, Providence, RI, United States of America
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Angela Taft
- Judith Lumley Centre for Mother, Infant and Family Health Research, Latrobe University, Bundoora, Australia
| | - Jennifer E. Johnson
- Department of Obstetrics, Gynaecology and Reproductive Biology, Michigan State University, College of Human Medicine, East Lansing, MI, United States of America
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI, United States of America
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17
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Mikhaylova O, Dokuka S. Anorexia and Young Womens' Personal Networks: Size, Structure, and Kinship. Front Psychol 2022; 13:848774. [PMID: 35519652 PMCID: PMC9063839 DOI: 10.3389/fpsyg.2022.848774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Anorexia is a serious threat to young women's wellbeing worldwide. The effectiveness of mental health intervention and treatment is often evaluated on the basis of changes in the personal networks; however, the development of such measures for young women with anorexia is constrained due to the lack of quantitative descriptions of their social networks. We aim to fill this substantial gap. In this paper, we identify the basic properties of these women's personal networks such as size, structure, and proportion of kin connections. The empirical analysis, using a concentric circles methodology, is based on 50 ego networks constructed on data drawn from interviews with Russian-speaking bloggers who have been diagnosed with anorexia and write about this condition. We conclude that young women with anorexia tend to support a limited number of social ties; they are prone to select women as alters, but do not have a preference to connect to their relatives. Further research is needed to elucidate whether these personal network characteristics are similar among women with anorexia who belong to different age, ethnic, cultural, and income groups.
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Affiliation(s)
| | - Sofia Dokuka
- Institute of Education, HSE University, Moscow, Russia
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18
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A Bridging-Community (ABC) Project: A Community Building Social Participation Intervention Among Resettled Refugees in Boston. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2022. [DOI: 10.1007/s12134-021-00908-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractGiven the complexities of displacement and resettlement in the United States (US), few resources have been invested in facilitating social relationships, social integration, and social support for recently resettled refugees. Studies indicate low levels of socialization and thus extreme isolation among refugees, suggesting the need to create additional safety nets that encourage social connectivity (Strang & Quinn, 2019). In partnership with a resettlement agency, university researchers developed a pilot study exploring the feasibility and impact of a social participation intervention for a target group of recently resettled refugees. Research facilitators from the A Bridging-Community (or ABC) Project hosted weekly social events for resettled refugees (N=12). Participants were split into three groups and attended social events either two, four, or six times over a four month period. To assess the experiences of participants in the program, survey data were collected at the beginning and end of the program, and semi-structured qualitative interviews were conducted upon entry into the program and at the conclusion of the study. Findings suggest that the ABC Project helped cultivate new relationships and a sense of belonging among participants, with stronger results observed among participants who met four or six times. The overall effectiveness of the program was rated highly by all participants, indicating a need for additional research about targeted social interventions among groups at risk for social isolation.
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19
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Baker AL, Forbes E, Pohlman S, McCarter K. Behavioral Interventions to Reduce Cardiovascular Risk Among People with Severe Mental Disorder. Annu Rev Clin Psychol 2022; 18:99-124. [PMID: 35175861 DOI: 10.1146/annurev-clinpsy-072720-012042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death among people with severe mental disorder (SMD). CVD risk factors occur at the individual, health system, and socio-environmental levels and contribute not only to high rates of CVD but also to worsening mental health. While acknowledging this wider context, this review focuses on behavioral interventions for seven CVD risk behaviors-smoking, physical inactivity, excessive alcohol consumption, low fruit and vegetable intake, inadequate sleep, poor social participation, and poor medication adherence-that are common among people with SMD. We survey recent meta-reviews of the literature and then review additional key studies to provide clinical recommendations for behavioral interventions to reduce CVD risk among people with SMD. A transdiagnostic psychological approach from the start of mental health treatment, drawing upon multidisciplinary expertise to address multiple risk behaviors, is recommended. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia;
| | - Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia;
| | - Sonja Pohlman
- School of Psychology, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kristen McCarter
- School of Psychology, College of Engineering, Science and Environment, University of Newcastle, Callaghan, New South Wales, Australia
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20
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Beckers T, Maassen N, Koekkoek B, Tiemens B, Hutschemaekers G. Can social support be improved in people with a severe mental illness? A systematic review and meta-analysis. CURRENT PSYCHOLOGY 2022; 42:1-11. [PMID: 35125852 PMCID: PMC8802266 DOI: 10.1007/s12144-021-02694-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 11/26/2022]
Abstract
People with a severe mental illness often have less social support than other people, yet these people need social support to face the challenges in their lives. Increasing social support could benefit the person's recovery, but it is not clear whether interventions that aim to improve social support in people with a severe mental illness are effective. A systematic literature search and review in MEDLINE (PubMed), PsycINFO, CINAHL, Cochrane, JSTOR, IBSS, and Embase was performed. Studies were included if they had a control group and they were aimed at improving social support in people with a severe mental illness who were receiving outpatient treatment. Summary data were extracted from the research papers and compared in a meta-analysis by converting outcomes to effect sizes (Hedges's g). Eight studies (total n = 1538) that evaluated ten different interventions met the inclusion criteria. All but one of these studies was of sufficient quality to be included in the review. The studies that were included in the meta-analysis had a combined effect size of 0.17 (confidence interval: 0.02 to 0.32), indicating a small or no effect for the interventions that were evaluated. A subgroup analysis of more personalized studies showed a combined effect size of 0.35 (CI = 0.27 to 0.44), indicating a noteworthy effect for these more personalized studies. This evaluation of interventions aimed at improving social support in people with a severe mental illness suggests that these interventions in general have little or no clinical benefit. However, in a subgroup analysis the more personalized interventions have a larger effect on improving social support and merit further research.
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Affiliation(s)
- Thijs Beckers
- MET Ggz, Primary Healthcare Department, Minister Beverstraat 3, 6042 BL Roermond, the Netherlands
- Research Group Social Psychiatry and Mental Health Nursing, HAN University of Applied Science, Nijmegen, the Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Niek Maassen
- Research Group Social Psychiatry and Mental Health Nursing, HAN University of Applied Science, Nijmegen, the Netherlands
| | - Bauke Koekkoek
- Research Group Social Psychiatry and Mental Health Nursing, HAN University of Applied Science, Nijmegen, the Netherlands
- Pro Persona Research, Renkum, the Netherlands
| | - Bea Tiemens
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
- Pro Persona Research, Renkum, the Netherlands
- Indigo, Utrecht, the Netherlands
| | - Giel Hutschemaekers
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
- Pro Persona Research, Renkum, the Netherlands
- Indigo, Utrecht, the Netherlands
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21
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Chmielowska M, Zisman-Ilani Y, Saunders R, Pilling S. Social network interventions in mental healthcare: a protocol for an umbrella review. BMJ Open 2021; 11:e052831. [PMID: 34921079 PMCID: PMC8685933 DOI: 10.1136/bmjopen-2021-052831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Social networks (SNs) can play a crucial role in the process of recovery from mental illness. Yet there is no standard best practice for involving SNs to optimise patient recovery. It is therefore critical to explore the diversity of SN approaches in mental health, highlight gaps in the evidence and suggest future directions for research and practice. This protocol describes the methods for an umbrella review of SN interventions for the care and/or treatment of mental illness. METHODS AND ANALYSIS Nine electronic databases will be searched for the relevant journal articles: CINAHL, PubMed, Scopus, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Library, Web of Science, Scopus and Ovid PsycINFO. We will include reviews which extracted information about the quantity, structure and quality of patient's SNs as well as frequency of contact. The range of publication dates of the included articles will be from 2010 and 2021, as recommended by Joanna Briggs Institute guidelines. The Assessment of Multiple Systematic Reviews 2 tool and ratings of the quality of evidence will be used to assess the quality of the included reviews. The results will be presented in accordance with guidelines in the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Findings will inform the development of an SN framework to guide the design and evaluation of psychosocial interventions. ETHICS AND DISSEMINATION This umbrella review will involve secondary data analysis and ethical approval is not required. The target audience includes clinicians, researchers and service users, who will be reached with tailored materials through journal publications, conference presentations and social media. The presentation of the results will provide a more complete picture of relevant evidence and explicit basis from which to improve psychosocial well-being for people diagnosed with a mental illness. PROSPERO REGISTRATION NUMBER This protocol was registered with the International Prospective Register of Systematic Reviews (http:/ /www.crd.york.ac.uk/PROSPERO), registration number CRD42020192873.
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Affiliation(s)
- Marta Chmielowska
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Yaara Zisman-Ilani
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Social and Behavioural Sciences, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Rob Saunders
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephen Pilling
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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22
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Giacco D, Chevalier A, Patterson M, Hamborg T, Mortimer R, Feng Y, Webber M, Xanthopoulou P, Priebe S. Effectiveness and cost-effectiveness of a structured social coaching intervention for people with psychosis (SCENE): protocol for a randomised controlled trial. BMJ Open 2021; 11:e050627. [PMID: 34903539 PMCID: PMC8671980 DOI: 10.1136/bmjopen-2021-050627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION People with psychosis tend to have smaller social networks than both people in the general population and other people with long-term health conditions. Small social networks are associated with poor quality of life. Preliminary evidence suggests that coaching patients to increase their social contacts may be effective. In this study, we assessed whether structured social coaching improves the quality of life of patients with psychosis (primary outcome) compared with an active control group, receiving information on local social activities. METHODS AND ANALYSIS A structured social coaching intervention was developed based on the literature and refined through stakeholder involvement. It draws on principles from motivational interviewing, solution focused therapy and structured information giving. It is provided over a 6-month period and can be delivered by a range of different mental health professionals. Its effectiveness and cost-effectiveness are assessed in a randomised controlled trial, compared with an active control group, in which participants are given an information booklet on local social activities. Participants are aged 18 or over, have a primary diagnosis of a psychotic disorder (International Classification of Disease: F20-29) and capacity to provide informed consent. Participants are assessed at baseline and at 6, 12 and 18 months after individual randomisation. The primary outcome is quality of life at 6 months (Manchester Short Assessment of Quality of Life). We hypothesise that the effects on quality of life are mediated by an increase in social contacts. Secondary outcomes are symptoms, social situation and time spent in social activities. Costs and cost-effectiveness analyses will consider service use and health-related quality of life. ETHICS AND DISSEMINATION National Health Service REC London Hampstead (19/LO/0088) provided a favourable opinion. Findings will be disseminated through a website, social media, scientific papers and user-friendly reports, in collaboration with a lived experience advisory panel. TRIAL REGISTRATION NUMBER ISRCTN15815862.
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Affiliation(s)
- Domenico Giacco
- Warwick Medical School, University of Warwick, Coventry, UK
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Agnes Chevalier
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Megan Patterson
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Thomas Hamborg
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Rianna Mortimer
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Yan Feng
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Martin Webber
- Department of Social Policy and Social Work, University of York, York, UK
| | | | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
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Schenk L, Sentse M, Marhe R, van Duin L, Engbersen G, Popma A, Severiens S. The Longitudinal Interplay Between Social Network and Psychopathology in Multi-Problem Young Adult Men; Separating Within-and Between-Person Effects. Front Psychol 2021; 12:727432. [PMID: 34955956 PMCID: PMC8695720 DOI: 10.3389/fpsyg.2021.727432] [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: 06/18/2021] [Accepted: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
Young adulthood is characterized by many life changes. Especially for young men with problems across different life domains (i.e., multi-problem), these changes may entail obstacles. Incidences of psychopathology increase during young adulthood and at the same time important shifts in social networks - such as changing relations with peers and parents, isolation, or deviant peer affiliation - take place. The present study examined the longitudinal interplay between psychopathology and social network characteristics over the course of 1 year in multi-problem young adults, at both between-person and within-person level. A sample of 696 multi-problem young adult men (age 18-27) participated in this three wave study. We used traditional cross-lagged panel models (CLPM) to examine how social network characteristics and psychopathology are related at the between-person level, and random intercept cross-lagged panel models (RI-CLPM) to examine within-person links. Between-person associations between internalizing problems and social networks were bidirectional, and externalizing problems were related to problematic social network characteristics, but not vice versa. At the within-person level, no such cross-lagged paths were found. Overall, results indicated that in multi-problem young adults, social network characteristics and psychopathology are related. However, looking at within-person processes this relation is not reciprocal.
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Affiliation(s)
- Loïs Schenk
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Miranda Sentse
- Institute of Criminal Law and Criminology, Leiden University, Leiden, Netherlands
| | - Reshmi Marhe
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
- Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Laura van Duin
- Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Godfried Engbersen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Arne Popma
- Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Sabine Severiens
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
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24
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Vogel JS, Bruins J, de Jong S, Knegtering H, Bartels-Velthuis AA, Bruggeman R, Jörg F, Pijnenborg MGHM, Veling W, Visser E, van der Gaag M, Castelein S. Satisfaction with social connectedness as a predictor for positive and negative symptoms of psychosis: A PHAMOUS study. Schizophr Res 2021; 238:121-127. [PMID: 34653741 DOI: 10.1016/j.schres.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 10/02/2021] [Accepted: 10/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study examines satisfaction with social connectedness (SSC) as predictor of positive and negative symptoms in people with a psychotic disorder. METHODS Data from the Pharmacotherapy Monitoring and Outcome Survey (PHAMOUS) was used from patients assessed between 2014 and 2019, diagnosed with a psychotic disorder (N = 2109). Items about social connectedness of the Manchester short assessment of Quality of Life (ManSA) were used to measure SSC. Linear mixed models were used to estimate the association of SSC with the Positive and Negative Syndrome Scale (PANSS) after one and two years against α = 0.01. Analyses were adjusted for symptoms, time since onset, gender and age. Additionally, fluctuation of positive and negative symptom scores over time was estimated. RESULTS The mean duration of illness of the sample was 18.8 years (SD 10.7) with >65% showing only small variation in positive and negative symptoms over a two to five-year time period. After adjustment for covariates, SSC showed to be negatively associated with positive symptoms after one year (β = -0.47, p < 0.001, 95% CI = -0.70, -025) and two years (β = -0.59, p < 0.001, 95% CI = -0.88, -0.30), and for negative symptoms after one year (β = -0.52, p < 0.001, 95% CI = -0.77, -0.27). The prediction of negative symptoms was not significant at two years. CONCLUSION This research indicates that interventions on SSC might positively impact mental health for people with psychosis. SSC is a small and robust predictor of future levels of positive symptoms. Negative symptoms could be predicted by SSC at one year.
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Affiliation(s)
- Jelle Sjoerd Vogel
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands; GGZ Drenthe Mental Health Institute, Department of Psychotic Disorders, Dennenweg 9, 9404 LA Assen, the Netherlands.
| | - Jojanneke Bruins
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Steven de Jong
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Henderikus Knegtering
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Agna A Bartels-Velthuis
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | | | - Richard Bruggeman
- University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Frederike Jörg
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands; GGZ Friesland Mental Health Institute, Department of Research and Education, Sixmastraat 2, 8932 PA Leeuwarden, the Netherlands.
| | - Marieke G H M Pijnenborg
- University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; GGZ Drenthe Mental Health Institute, Department of Psychotic Disorders, Dennenweg 9, 9404 LA Assen, the Netherlands.
| | - Wim Veling
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Psychosis Department, Hanzeplein 1 (CC60), 9713 GZ, Groningen, the Netherlands.
| | - Ellen Visser
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Mark van der Gaag
- VU University Amsterdam, Department of Clinical Psychology, Van der Boechorststraat 1, 1081 BR Amsterdam, the Netherlands; Amsterdam Public Mental Health Research Institute, Van der Boechorststraat 1, 1081 BR Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Department of Psychosis Research, Zoutkeetsingel 40, 2512 HN The Hague, the Netherlands
| | - Stynke Castelein
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
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25
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Tjaden C, Mulder CL, den Hollander W, Castelein S, Delespaul P, Keet R, van Weeghel J, Kroon H. Effectiveness of Resource Groups for Improving Empowerment, Quality of Life, and Functioning of People With Severe Mental Illness: A Randomized Clinical Trial. JAMA Psychiatry 2021; 78:1309-1318. [PMID: 34643679 PMCID: PMC8515257 DOI: 10.1001/jamapsychiatry.2021.2880] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022]
Abstract
Importance Although the importance of recovery-oriented care for people with severe mental illness (SMI) is widely acknowledged, essential elements such as personalization and involvement of significant others are not adequately implemented in practice. Objective To determine whether using resource groups (RGs) within flexible assertive community treatment (FACT) has favorable effects on empowerment and recovery-related outcomes in people with SMI. Design, Setting, and Participants This assessor-blind, multisite randomized clinical trial was conducted from September 1, 2017, to September 30, 2020, with follow-up at 9 and 18 months. A total of 158 participants aged 18 to 65 years meeting the criteria for SMI were randomly allocated to FACT plus RG vs FACT as usual (1:1) in 20 FACT teams throughout the Netherlands. Data were analyzed from September 1, 2020, to January 31, 2021. The study was prespecified in the trial protocol and data from the intent-to-treat population were analyzed. Interventions In the FACT plus RG condition, patients chose members from their informal and formal networks to form an RG that meets quarterly to discuss self-formulated recovery goals. The RG was integrated into the multidisciplinary support provided by the FACT team. In the FACT as-usual condition, empowerment (defined as overcoming powerlessness and gaining control of one's life) and involvement of significant others was also part of the provided care, but without the structure of the RG. Main Outcomes and Measures The primary outcome was self-reported empowerment, measured with the Netherlands Empowerment List. Results A total of 158 participants with SMI (median age, 38 [median absolute deviation, 13] years; 93 men [58.9%]) were randomized to FACT plus RG (n = 80) or FACT as usual (n = 78) care. Intention-to-treat analyses showed that randomization to the RG condition was associated with a clinically significant increase in empowerment (Cohen d, 0.54; 95% CI, 0.21-0.86) and improved outcomes with small to medium effect sizes in terms of quality of life (Cohen d, 0.25; 95% CI, -0.07 to 0.56), personal recovery (Cohen d, 0.38; 95% CI, 0.06-0.69), quality of social contact (Cohen d, 0.24; 95% CI, -0.07 to 0.56), disability (Cohen d, 0.29; 95% CI, -0.03 to 0.60), general functioning (Cohen d, 0.30; 95% CI, -0.01 to 0.62), and social functioning (Cohen d, 0.28; 95% CI, -0.04 to 0.59). No differences between conditions were found regarding psychopathological symptoms, attachment, frequency of social contact, and employment. Compared with FACT as usual, participants who stayed with the assigned treatment in the RG condition were more satisfied with treatment at 9 (Cohen d = 0.45; t135 = -2.62; P = .009) and 18 (Cohen d = 0.41; t116 = -2.22; P = .02) months. Conclusions and Relevance These findings show that working with RGs improves empowerment and other mental health outcomes in people with SMI who receive community-based mental health services. This method of network-oriented care empowers people with SMI within their own environment. Trial Registration Netherlands Trial Register Identifier: NL6548.
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Affiliation(s)
- Cathelijn Tjaden
- Department of Reintegration and Community Care, Trimbos Institute, Utrecht, the Netherlands
- Tranzo Scientific Center for Care and Welfare, Department of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Cornelis L. Mulder
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
- Parnassia Psychiatric Institute, Rotterdam, the Netherlands
| | - Wouter den Hollander
- Department of Reintegration and Community Care, Trimbos Institute, Utrecht, the Netherlands
| | - Stynke Castelein
- Lentis Research, Lentis Psychiatric Institute, Groningen, the Netherlands
- Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Philippe Delespaul
- School of Mental Health and NeuroSciences, Maastricht University, Maastricht, the Netherlands
- Mondriaan Mental Health Trust, Maastricht/Heerlen, the Netherlands
| | - Rene Keet
- Department of Community Mental Health, GGZ Noord-Holland-Noord, Heiloo, the Netherlands
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Welfare, Department of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
- Phrenos Centre of Expertise, Utrecht, the Netherlands
| | - Hans Kroon
- Department of Reintegration and Community Care, Trimbos Institute, Utrecht, the Netherlands
- Tranzo Scientific Center for Care and Welfare, Department of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
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Gillard S, Dare C, Hardy J, Nyikavaranda P, Rowan Olive R, Shah P, Birken M, Foye U, Ocloo J, Pearce E, Stefanidou T, Pitman A, Simpson A, Johnson S, Lloyd-Evans B. Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1447-1457. [PMID: 33665680 PMCID: PMC7931976 DOI: 10.1007/s00127-021-02051-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Research is beginning to quantify the impact of COVID-19 on people with pre-existing mental health conditions. Our paper addresses a lack of in-depth qualitative research exploring their experiences and perceptions of how life has changed at this time. METHODS We used qualitative interviews (N = 49) to explore experiences of the pandemic for people with pre-existing mental health conditions. In a participatory, coproduced approach, researchers with lived experiences of mental health conditions conducted interviews and analysed data as part of a multi-disciplinary research team. RESULTS Existing mental health difficulties were exacerbated for many people. People experienced specific psychological impacts of the pandemic, struggles with social connectedness, and inadequate access to mental health services, while some found new ways to cope and connect to the community. New remote ways to access mental health care, including digital solutions, provided continuity of care for some but presented substantial barriers for others. People from black and ethnic minority (BAME) communities experienced heightened anxiety, stigma and racism associated with the pandemic, further impacting their mental health. CONCLUSION There is a need for evidence-based solutions to achieve accessible and effective mental health care in response to the pandemic, especially remote approaches to care. Further research should explore the long-term impacts of COVID-19 on people with pre-existing mental health conditions. Particular attention should be paid to understanding inequalities of impact on mental health, especially for people from BAME communities.
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Affiliation(s)
- Steven Gillard
- Centre for Mental Health Research, City, University of London, 1 Myddelton Street, London, EC1R 1UW, UK
| | - Ceri Dare
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Jackie Hardy
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Patrick Nyikavaranda
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Rachel Rowan Olive
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Prisha Shah
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Mary Birken
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Una Foye
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, 18 DeCrespigny Park, London, SE5 8AF, UK
| | - Josephine Ocloo
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, 18 DeCrespigny Park, London, SE5 8AF, UK
| | - Ellie Pearce
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Theodora Stefanidou
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Alan Simpson
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, 18 DeCrespigny Park, London, SE5 8AF, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Brynmor Lloyd-Evans
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
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Yousefi Nooraie R, Warren K, Juckett LA, Cao QA, Bunger AC, Patak-Pietrafesa MA. Individual- and group-level network-building interventions to address social isolation and loneliness: A scoping review with implications for COVID19. PLoS One 2021; 16:e0253734. [PMID: 34170980 PMCID: PMC8232435 DOI: 10.1371/journal.pone.0253734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 06/11/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Worldwide mandates for social distancing and home-quarantine have contributed to loneliness and social isolation. We conducted a systematic scoping review to identify network-building interventions that address loneliness and isolation, describe their components and impact on network structure, and consider their application in the wake of COVID19. METHODS We performed forward and backward citation tracking of three seminal publications on network interventions and Bibliographic search of Web of Science and SCOPUS. We developed data charting tables and extracted and synthesized the characteristics of included studies, using an iteratively updating form. FINDINGS From 3390 retrieved titles and abstracts, we included 8 studies. These interventions focused on building networks at either individual- or group-levels. Key elements that were incorporated in the interventions at varying degrees included (a) creating opportunities to build networks; (b) improving social skills; (c) assessing network diagnostics (i.e. using network data or information to inform network strategies); (d) promoting engagement with influential actors; and (e) a process for goal-setting and feedback. The effect of interventions on network structures, or the moderating effect of structure on the intervention effectiveness was rarely assessed. CONCLUSIONS As many natural face-to-face opportunities for social connection are limited due to COVID19, groups already at risk for social isolation and loneliness are disproportionately impacted. Network-building interventions include multiple components that address both the structure of individuals' networks, and their skills and motivation for activating them. These intervention elements could be adapted for delivery via online platforms, and implemented by trained facilitators or novice volunteers, although more rigorous testing is needed.
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Affiliation(s)
- Reza Yousefi Nooraie
- Department of Public Health Sciences, University of Rochester, Rochester, New York, United States of America
- * E-mail:
| | - Keith Warren
- College of Social Work, The Ohio State University, Columbus, Ohio, United States of America
| | - Lisa A. Juckett
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, United States of America
| | - Qiuchang A. Cao
- College of Social Work, The Ohio State University, Columbus, Ohio, United States of America
| | - Alicia C. Bunger
- College of Social Work, The Ohio State University, Columbus, Ohio, United States of America
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Buhagiar K, Priebe S, Klingemann J, Lasalvia A, Nicaise P, Soltmann B, Giacco D. Social contacts, friends and satisfaction with friendships in patients with psychotic, mood and neurotic disorders 1 year after hospitalisation: data from five European countries. Soc Psychiatry Psychiatr Epidemiol 2021; 56:363-373. [PMID: 32627062 DOI: 10.1007/s00127-020-01915-8] [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: 10/09/2019] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND People with severe mental illness often struggle with social relationships, but differences among diagnostic groups are unclear. We assessed and compared objective and subjective social relationship indicators among patients with psychotic, mood and neurotic disorders one year after hospitalisation in five European countries (Belgium, Germany, Italy, Poland and United Kingdom). METHODS The number of social contacts, including family members and friends during the previous week (Social Network Schedule), and satisfaction with the number and quality of friendships (Manchester Short Assessment of Quality of Life Quality) were assessed by face-to-face interview. Linear regression models were used to analyse associations with diagnostic groups. RESULTS Participants (n = 2155) reported on average 2.79 ± 2.37 social contacts overall in the previous week, among whom, a mean of 1.65 ± 1.83 (59.2 ± 38.7%) were friends. Satisfaction with friendships was moderate (mean 4.62, SD 1.77). In the univariable model, patients with psychotic disorders reported having less social contact with friends than those with either mood (p < 0.05) or neurotic disorders (p < 0.001), but this difference disappeared when adjusting for socioeconomic and clinical variables (β = - 0.106, 95% CI - 0.273 to 0.061, p = 0.215). Satisfaction with friendships was similar across diagnostic groups in both univariable (β = - 0.066, 95% CI - 0.222 to 0.090, p = 0.408) and multivariable models (β = 0.067, 95% CI - 0.096 to 0.229, p = 0.421). The two indicators showed a weak correlation in the total sample (total social contacts, rs = 0.266; p < 0.001; friends, rs = 0.326, p < 0.001). CONCLUSION While objective and subjective social relationship indicators appear to be weakly correlated concepts, there is no variation in either indicator across diagnostic groups when confounders are taken into account among patients with severe mental illness. Interventions specifically targeting social relationships are needed, but they do not necessitate diagnosis-specific adaptations.
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Affiliation(s)
- Kurt Buhagiar
- Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK. .,Department of Research, Innovation and Medical Education, East London NHS Foundation Trust, London, UK.
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
| | - Justyna Klingemann
- Department of Studies on Alcohol and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Pablo Nicaise
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Bettina Soltmann
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Domenico Giacco
- Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK.,Department of Research, Innovation and Medical Education, East London NHS Foundation Trust, London, UK.,Warwick Medical School - Mental Health and Wellbeing, University of Warwick, Coventry, UK
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29
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Pennanen-Iire C, Prereira-Lourenço M, Padoa A, Ribeirinho A, Samico A, Gressler M, Jatoi NA, Mehrad M, Girard A. Sexual Health Implications of COVID-19 Pandemic. Sex Med Rev 2021; 9:3-14. [PMID: 33309005 PMCID: PMC7643626 DOI: 10.1016/j.sxmr.2020.10.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/15/2020] [Accepted: 10/25/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION A novel coronavirus (COVID-19) reached pandemic levels by March 11th, 2020, with a destructive impact across socioeconomic domains and all facets of global health, but little is known of its impact on sexual health. OBJECTIVE To review current knowledge on sexual health-related containment measures during pandemics, specifically COVID-19, and focus on 2 main areas: intimacy and relational dynamics and clinical effects on sexual health. METHODS We carried out a literature search encompassing sexual health and pandemic issues using Entrez-PubMed and Google Scholar. We reviewed the implications of the COVID-19 pandemic on sexual health regarding transmission and safe sex practices, pregnancy, dating and intimacy amid the pandemic, benefits of sex, and impact on sexual dysfunctions. RESULTS Coronavirus transmission occurs via inhalation and touching infected surfaces. Currently, there is no evidence it is sexually transmitted, but there are sexual behaviors that pose a higher risk of infectivity due to asymptomatic carriers. Nonmonogamy plays a key role in transmission hubs. New dating possibilities and intimacy issues are highlighted. Sexual activity has a positive impact on the immune response, psychological health, and cognitive function and could mitigate psychosocial stressors. COVID-19 pandemic affects indirectly the sexual function with implications on overall health. CONCLUSION Increased awareness of health-care providers on sexual health implications related to the COVID-19 pandemic is needed. Telemedicine has an imperative role in allowing continued support at times of lockdown and preventing worsening of the sexual, mental, and physical health after the pandemic. This is a broad overview addressing sexual issues related to the COVID-19 pandemic. As this is an unprecedented global situation, little is known on sexuality related to pandemics. Original research is needed on the topic to increase the understanding of the impact the current pandemic may have on sexual health and function. Pennanen-Iire C, Prereira-Lourenço M, Padoa A, et al. Sexual Health Implications of COVID-19 Pandemic. Sex Med Rev 2021;9:3-14.
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Affiliation(s)
- Corina Pennanen-Iire
- Gynecology and Sexology, Tmi Corina Pennanen, Kuopio, Finland; Gynecology and Sexology, Terveystalo Oy, Varkaus, Finland.
| | | | - Anna Padoa
- Department of Obstetrics and Gynecology, Shamir-Assaf Harofe Medical Center, Tsrifin, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - André Ribeirinho
- Psychiatry Department, Hospital Distrital de Santarém, Santarém, Portugal
| | - Ana Samico
- Psychiatry Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marina Gressler
- Department of Urology, Santa Casa da Misericórdia, Porto Alegre, Brazil
| | - Noor-Ahmed Jatoi
- Department of Internal Medicine, King Fahd University Hospital, Al-Khobar, Saudi Arabia; Vascular Medicine Research Unit (Internal Medicine), College of Medicine, Imam AbdulRahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mehri Mehrad
- Voiding Dysfunction and Neuro-Urology Clinic, Pars Hospital, Tehran, Iran; Department of Neuro-Urology, MehriMah Multidiciplinary Neuro-Urology Clinic, Tehran, Iran
| | - Abby Girard
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
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30
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Strauss GP. A Bioecosystem Theory of Negative Symptoms in Schizophrenia. Front Psychiatry 2021; 12:655471. [PMID: 33841217 PMCID: PMC8026872 DOI: 10.3389/fpsyt.2021.655471] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/04/2021] [Indexed: 12/17/2022] Open
Abstract
Objective: Negative symptoms are a core feature of schizophrenia that has been linked to numerous poor clinical outcomes. Although person-level mechanisms have been identified for negative symptoms, psychosocial and pharmacological treatments targeting these mechanisms have been ineffective. The current theoretical paper proposes that limited treatment progress may result in part from a failure to identify and target environmental processes that cause and maintain negative symptoms. Methods: A novel theoretical model is outlined, called the bioecosystem theory of negative symptoms, that offers a conceptual framework for studying interactions among environmental systems and person-related biological and psychosocial factors. Results: Relying on Bronfenbrenner's developmental theory as an organizing framework, four interactive environmental systems are proposed to be critical for the genesis and maintenance of negative symptoms: (1) Microsystem: the immediate environment; (2) Mesosystem: the interactions among microsystems; (3) Exosystem: indirect environments that influence the individual through the microsystems; (4) Macrosystem: socio-cultural factors. The environmental factors within these systems are proposed to function as a network and have dynamic within-system interactions, as well as cross-system interactions that change over time and across phases of illness. Conclusions: Environmental contributions to negative symptoms have received minimal empirical attention, despite their potential to explain variance in negative symptom severity. The bioecosystem model of negative symptoms introduced here offers a novel conceptual framework for exploring environmental contributions to negative symptoms and their interaction with person-level biological and psychological factors. This theory may facilitate new avenues for identifying environmental treatment targets and novel systems-level interventions.
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Affiliation(s)
- Gregory P Strauss
- Department of Psychology, University of Georgia, Athens, GA, United States
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Nevard I, Green C, Bell V, Gellatly J, Brooks H, Bee P. Conceptualising the social networks of vulnerable children and young people: a systematic review and narrative synthesis. Soc Psychiatry Psychiatr Epidemiol 2021; 56:169-182. [PMID: 33140120 PMCID: PMC7870613 DOI: 10.1007/s00127-020-01968-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The relationship between social networks and health and wellbeing is increasingly demonstrated in vulnerable adult populations. This relationship for vulnerable children and young people has not hitherto been systematically reviewed. This narrative synthesis aims to consolidate research to provide a foundational basis for future health-related social network research and interventions for children and young people. METHODS This mixed methods systematic review synthesises research investigating whole, egocentric social networks of 32 vulnerable child groups with a mean age below 18. There were no setting, language or date restrictions. The quality was assessed using the Mixed Methods Appraisal Tool. Of 6360 search results, 49 were included for narrative synthesis. RESULTS The majority of pertinent research originates from the USA; the most frequently investigated vulnerabilities were minority ethnic status, homelessness and the presence of special educational needs. Research aims and methodologies varied significantly between studies. Key findings included (i) vulnerable (excluding minority ethnic) children and young people have impoverished networks (ii) access to networks is a protective factor against negative outcomes (iii) social ties, primarily immediate family, provide access to personal resources and (iv) network ties are to a degree substitutable. CONCLUSIONS Networks are associated with wellbeing and vulnerable children and young people commonly have impoverished networks, excluding cases where vulnerability classification relates to minority ethnic status. Network embeddedness is associated with positive outcomes, particularly for homeless children. Family are typically primary providers of support, but ties are substitutable when networks are restricted. Egocentric social network research is currently limited for vulnerable child populations. Further research could inform interventions that harness networks to improve health, wellbeing and functional outcomes for these child groups.
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Affiliation(s)
- Imogen Nevard
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK.
| | - Chloe Green
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Vicky Bell
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Judith Gellatly
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
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Social networks of older patients with advanced cancer: Potential contributions of an integrated mixed methods network analysis. J Geriatr Oncol 2020; 12:855-859. [PMID: 33342721 DOI: 10.1016/j.jgo.2020.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/03/2020] [Indexed: 12/28/2022]
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Delcea C. Construction, Validation, and Standardization of the Sexual‐DSMapp Application. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2020; 2:70-75. [PMID: 36101868 PMCID: PMC9175885 DOI: 10.1176/appi.prcp.20190047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/05/2020] [Accepted: 04/17/2020] [Indexed: 12/01/2022] Open
Abstract
Objective The aim of this research was to construct, validate, and standardize a new tool for assessing sexual dysfunction. The Sexual‐DSMapp is an application that can be used on a computer, tablet, or mobile phone. Methods Of the participants (N=800), 400 met DSM‐5 criteria for clinical dysfunction (the clinical group), and 400 had no dysfunction (the healthy control group). Both groups were 50% male and 50% female. Patients in the clinical group had sexual disorders such as premature ejaculation, erectile dysfunction, diminished sexual desire, orgasm issues, arousal issues, and dyspareunia but no mental, personality, medical, and/or substance use disorders. Average age for both groups was 34, and the average education level was 11.5 years. Participants were from various localities in Romania and were of differing racial‐ethnic groups. Results Fidelity of the app's nine scales on Cronbach's alpha (0.975), Spearman's rank‐order correlation coefficient (0.986), and the Guttman scale (0.969) reached maximum threshold, was significant on test‐retest reliability, and reached a Cronbach's alpha average of 0.89 for the whole questionnaire. For the test scales, results from 0.76 to 0.98 were obtained, and significant correlation was shown with other questionnaires. The result of the Kaiser‐Meyer‐ Olkin test for adequate participant sampling was 0.939. Analysis of variance indicated significance (p<0.001). Correlation with similar questionnaires showed significant validity. Conclusions The results of this research suggest that the Sexual‐DSMapp can discriminate between clinical and nonclinical sexual dysfunction and can be used to test and evaluate sexual dysfunctions. The Sexual‐DSMapp is a new tool for assessing sexual dysfunction that can be used on a computer, tablet, or mobile phone. The app can discriminate between clinical and nonclinical sexual dysfunction and can test and evaluate sexual dysfunctions. A standardized tool to assess and test for sexual dysfunction will aid advanced technology users, such as specialists in the field of sexology, or patients with sexual dysfunctions.
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Affiliation(s)
- Cristian Delcea
- Department of Medicine Iuliu Hat¸ieganu University of Medicine and Pharmacy Department of Advanced Studies in Sexology Sexology Institute of Romania Cluj‐Napoca Romania
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Beckers T, Koekkoek B, Tiemens B, Hutschemaekers G. Measuring Social Support in People with Mental Illness: A Quantitative Analysis of the Social Network Map. Issues Ment Health Nurs 2020; 41:916-924. [PMID: 32584625 DOI: 10.1080/01612840.2020.1744205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
An instrument is needed for quantitatively evaluating changes in social support in people with mental illness, but no gold standard is available. The Social Network Map is a structured interview for assessing social support that is used in individual care settings, yet provides overwhelming output (16-128 data points per assessment). A method comprising two factors (quality and quantity of the social network) was developed. The psychometric properties were judged to be sufficient. This study shows that data from the Social Network Map can be analysed at the group level, yet further research on the psychometric properties is needed.
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Affiliation(s)
- Thijs Beckers
- Research Group Social Psychiatry and Mental Health Nursing, Hogeschool van Arnhem en Nijmegen (University of Applied Sciences), Nijmegen, Netherlands.,MET ggz, Primary Mental Healthcare, Roermond, Netherlands.,Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Bauke Koekkoek
- Research Group Social Psychiatry and Mental Health Nursing, Hogeschool van Arnhem en Nijmegen (University of Applied Sciences), Nijmegen, Netherlands.,Pro Persona Research, Wolfheze, Netherlands
| | - Bea Tiemens
- Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Pro Persona Research, Wolfheze, Netherlands.,Indigo Service Organization, Utrecht, Netherlands
| | - Giel Hutschemaekers
- Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Pro Persona Research, Wolfheze, Netherlands.,Indigo Service Organization, Utrecht, Netherlands
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Ma R, Mann F, Wang J, Lloyd-Evans B, Terhune J, Al-Shihabi A, Johnson S. The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2020; 55:839-876. [PMID: 31741017 PMCID: PMC7303071 DOI: 10.1007/s00127-019-01800-z] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 10/17/2019] [Indexed: 01/12/2023]
Abstract
PURPOSE Subjective and objective social isolation are important factors contributing to both physical and mental health problems, including premature mortality and depression. This systematic review evaluated the current evidence for the effectiveness of interventions to improve subjective and/or objective social isolation for people with mental health problems. Primary outcomes of interest included loneliness, perceived social support, and objective social isolation. METHODS Three databases were searched for relevant randomised controlled trials (RCTs). Studies were included if they evaluated interventions for people with mental health problems and had objective and/or subjective social isolation (including loneliness) as their primary outcome, or as one of a number of outcomes with none identified as primary. RESULTS In total, 30 RCTs met the review's inclusion criteria: 15 included subjective social isolation as an outcome and 11 included objective social isolation. The remaining four evaluated both outcomes. There was considerable variability between trials in types of intervention and participants' characteristics. Significant results were reported in a minority of trials, but methodological limitations, such as small sample size, restricted conclusions from many studies. CONCLUSION The evidence is not yet strong enough to make specific recommendations for practice. Preliminary evidence suggests that promising interventions may include cognitive modification for subjective social isolation, and interventions with mixed strategies and supported socialisation for objective social isolation. We highlight the need for more thorough, theory-driven intervention development and for well-designed and adequately powered RCTs.
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Affiliation(s)
- Ruimin Ma
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, England, UK
| | - Farhana Mann
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, England, UK
| | - Jingyi Wang
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, England, UK
| | - Brynmor Lloyd-Evans
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, England, UK
| | - James Terhune
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, England, UK
| | - Ahmed Al-Shihabi
- UCL Medical School, University College London, 74 Huntley Street, London, WC1E 6BT, England, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, England, UK.
- Camden and Islington NHS Foundation Trust, St. Pancras Hospital, 4 St. Pancras Way, London, NW1 0PE, England, UK.
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Brooks HL, Bee P, Lovell K, Rogers A. Negotiating support from relationships and resources: a longitudinal study examining the role of personal support networks in the management of severe and enduring mental health problems. BMC Psychiatry 2020; 20:50. [PMID: 32028906 PMCID: PMC7006131 DOI: 10.1186/s12888-020-2458-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 01/23/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Personal communities or personal support networks comprise a variety of social ties considered important to individuals in their everyday lives. This set of active and significant ties influence the capacity to manage mental health problems because of the potential to access social support. However, little is known in the context of people's everyday management of mental health about how relationships with people, places, objects and activities are navigated and negotiated. This study aimed to explore the nature and negotiation of support from personal communities in the everyday management of severe and enduring mental health problems. METHODS A longitudinal qualitative study undertaken in the UK incorporating 79 interviews with 29 participants based on personal network mapping. 29 users of mental health services with a diagnosis of severe and enduring mental illness were interviewed at three time points. Data was analysed using an inductive thematic approach underpinned by the Network Episode Model. RESULTS The presence and maintenance of interpersonal trust was a fundamental condition of the relational work required to develop, undertake and sustain relationships with others. Whilst relationships with spouses, family members and friends were generally viewed positively, the work required to engage human others was contingent, vicarious and overlain with felt and enacted stigma. Developing relationships with others was hindered by a lack of confidence fuelled by the experience of mental illness and a fear of rejection or failure. By contrast, weaker ties and inanimate objects and places offered and provided a sense of reliability and security. Strategies employed by participants in order to garner sufficient support for condition management in the light of these particular challenges are illuminated by the discussion of who and what is relevant and valued in personal support networks. CONCLUSIONS Access to valued activities, hobbies and things should be considered alongside human relationships in providing a means of ongoing support and resource for the everyday management of life for those experiencing severe and enduring mental health problems.
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Affiliation(s)
- Helen Louise Brooks
- Department of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.
| | - Penny Bee
- grid.5379.80000000121662407Mental Health Research Group, Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Karina Lovell
- grid.5379.80000000121662407Mental Health Research Group, Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK ,grid.450837.d0000 0004 0430 6955Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Anne Rogers
- grid.5491.90000 0004 1936 9297NIHR CLAHRC Wessex, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
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Tee H, Priebe S, Santos C, Xanthopoulou P, Webber M, Giacco D. Helping people with psychosis to expand their social networks: the stakeholders' views. BMC Psychiatry 2020; 20:29. [PMID: 31996175 PMCID: PMC6990576 DOI: 10.1186/s12888-020-2445-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/16/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND People with psychosis experience more social isolation than any other diagnostic group and have smaller social networks than the general population. This isolation can have a detrimental effect on quality of life. No direct, standardised interventions have been developed to specifically target this issue. Stakeholders input appears crucial in the process of developing such an intervention. This study aimed to identify the main considerations when developing an intervention aiming to reduce social isolation in people with psychosis. METHODS Focus groups and individual interviews were conducted with patients, carers and mental health staff. Data was thematically analysed. RESULTS Thirty four patients with psychosis, 26 carers of people experiencing psychosis and 22 mental health professionals participated in the study. Suggested aspects to be considered in a novel intervention were: i) finding and training the right staff member; ii) discussing negative social attitudes and patients' previous negative experiences, iii) addressing personal ambivalence; iv) establishing how best to provide information about social activities; v) facilitating access to social activities, vi) striking a balance between support and independence. CONCLUSION The suggestions identified can help to develop more targeted approaches to reduce social isolation within this patient group. A patient-centred approach and generic communication skills appear to be underpinning most of the helpful elements identified, whilst specific techniques and skills can help to overcome negative past experiences and motivational barriers.
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Affiliation(s)
- Helena Tee
- Unit for Social and Community Psychiatry, (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, Glen Road, London, E13 8SP, UK. .,East London NHS Foundation Trust, Glen Road, London, E13 8SP, UK.
| | - Stefan Priebe
- 0000 0001 2171 1133grid.4868.2Unit for Social and Community Psychiatry, (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, Glen Road, London, E13 8SP UK
| | - Carlos Santos
- 0000 0004 0426 7183grid.450709.fEast London NHS Foundation Trust, Glen Road, London, E13 8SP UK
| | - Penny Xanthopoulou
- 0000 0004 1936 8024grid.8391.3College of Medicine and Health, University of Exeter. St Luke’s Campus, Exeter, EX2 4TH UK
| | - Martin Webber
- 0000 0004 1936 9668grid.5685.eDepartment of Social Policy and Social Work, University of York, Heslington, York, YO10 5DD UK
| | - Domenico Giacco
- 0000 0001 2171 1133grid.4868.2Unit for Social and Community Psychiatry, (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, Glen Road, London, E13 8SP UK ,0000 0000 8809 1613grid.7372.1Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7HL UK
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Bosnjak Kuharic D, Kekin I, Hew J, Rojnic Kuzman M, Puljak L. Interventions for prodromal stage of psychosis. Cochrane Database Syst Rev 2019; 2019:CD012236. [PMID: 31689359 PMCID: PMC6823626 DOI: 10.1002/14651858.cd012236.pub2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Psychosis is a serious mental condition characterised by a loss of contact with reality. There may be a prodromal period or stage of psychosis, where early signs of symptoms indicating onset of first episode psychosis (FEP) occur. A number of services, incorporating multimodal treatment approaches (pharmacotherapy, psychotherapy and psychosocial interventions), developed worldwide, now focus on this prodromal period with the aim of preventing psychosis in people at risk of developing FEP. OBJECTIVES The primary objective is to assess the safety and efficacy of early interventions for people in the prodromal stage of psychosis. The secondary objective is, if possible, to compare the effectiveness of the various different interventions. SEARCH METHODS We searched Cochrane Schizophrenia's study-based Register of studies (including trials registers) on 8 June 2016 and 4 August 2017. SELECTION CRITERIA All randomised controlled trials (RCTs) evaluating interventions for participants older than 12 years, who had developed a prodromal stage of psychosis. DATA COLLECTION AND ANALYSIS Review authors independently inspected citations, selected studies, extracted data, and assessed study quality. MAIN RESULTS We included 20 studies with 2151 participants. The studies analysed 13 different comparisons. Group A comparisons explored the absolute effects of the experimental intervention. Group B were comparisons within which we could not be clear whether differential interactive effects were also ongoing. Group C comparisons explored differential effects between clearly distinct treatments. A key outcome for this review was 'transition to psychosis'. For details of other main outcomes please see 'Summary of findings' tables. In Group A (comparisons of absolute effects) we found no clear difference between amino acids and placebo (risk ratio (RR) 0.48 95% confidence interval (CI) 0.08 to 2.98; 2 RCTs, 52 participants; very low-quality evidence). When omega-3 fatty acids were compared to placebo, fewer participants given the omega-3 (10%) transitioned to psychosis compared to the placebo group (33%) during long-term follow-up of seven years (RR 0.24 95% CI 0.09 to 0.67; 1 RCT, 81 participants; low-quality evidence). In Group B (comparisons where complex interactions are probable) and in the subgroup focusing on antipsychotic drugs added to specific care packages, the amisulpiride + needs-focused intervention (NFI) compared to NFI comparison (no reporting of transition to psychosis; 1 RCT, 102 participants; very low-quality evidence) and the olanzapine + supportive intervention compared to supportive intervention alone comparison (RR 0.58 95% CI 0.28 to 1.18; 1 RCT, 60 participants; very low-quality evidence) showed no clear differences between groups. In the second Group B subgroup (cognitive behavioural therapies (CBT)), when CBT + supportive therapy was compared with supportive therapy alone around 8% of participants allocated to the combination of CBT and supportive therapy group transitioned to psychosis during follow-up by 18 months, compared with double that percentage in the supportive therapy alone group (RR 0.45 95% CI 0.23 to 0.89; 2 RCTs, 252 participants; very low-quality evidence). The CBT + risperidone versus CBT + placebo comparison identified no clear difference between treatments (RR 1.02 95% CI 0.39 to 2.67; 1 RCT, 87 participants; very low-quality evidence) and this also applies to the CBT + needs-based intervention (NBI) + risperidone versus NBI comparison (RR 0.75 95% CI 0.39 to 1.46; 1 RCT, 59 participants; very low-quality evidence). Group C (differential effects) also involved six comparisons. The first compared CBT with supportive therapy. No clear difference was found for the 'transition to psychosis' outcome (RR 0.74 95% CI 0.28 to 1.98; 1 RCT, 72 participants; very low-quality evidence). The second subgroup compared CBT + supportive intervention was compared with a NBI + supportive intervention, again, data were equivocal, few and of very low quality (RR 6.32 95% CI 0.34 to 117.09; 1 RCT, 57 participants). In the CBT + risperidone versus supportive therapy comparison, again there was no clear difference between groups (RR 0.76 95% CI 0.28 to 2.03; 1 RCT, 71 participants; very low-quality evidence). The three other comparisons in Group C demonstrated no clear differences between treatment groups. When cognitive training was compared to active control (tablet games) (no reporting of transition to psychosis; 1 RCT, 62 participants; very low quality data), family treatment compared with enhanced care comparison (RR 0.54 95% CI 0.18 to 1.59; 2 RCTs, 229 participants; very low-quality evidence) and integrated treatment compared to standard treatment comparison (RR 0.57 95% CI 0.28 to 1.15; 1 RCT, 79 participants; very low-quality evidence) no effects of any of these approaches was evident. AUTHORS' CONCLUSIONS There has been considerable research effort in this area and several interventions have been trialled. The evidence available suggests that omega-3 fatty acids may prevent transition to psychosis but this evidence is low quality and more research is needed to confirm this finding. Other comparisons did not show any clear differences in effect for preventing transition to psychosis but again, the quality of this evidence is very low or low and not strong enough to make firm conclusions.
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Affiliation(s)
- Dina Bosnjak Kuharic
- University Psychiatric Hospital VrapčeBolnicka cesta 32ZagrebGrad ZagrebCroatia10000
| | - Ivana Kekin
- Clinical Hospital Centre ZagrebDepartment of PsychiatryKispaticeva 1210 000ZagrebCroatia
| | - Joanne Hew
- South London and Maudsley NHS Foundation TrustDepartment of Acute Care PsychiatryLadywell Unit, University Hospital LewishamLondonUK
| | - Martina Rojnic Kuzman
- Clinical Hospital Centre ZagrebDepartment of PsychiatryKispaticeva 1210 000ZagrebCroatia
| | - Livia Puljak
- Catholic University of CroatiaCenter for Evidence‐Based Medicine and Health CareIlica 242ZagrebCroatia10000
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Pinto da Costa M, Chevalier A, Farreny A, Cassidy M, Leverton M, Toner S, Priebe S. How would patients with psychosis like to be in contact with a volunteer: Face-to-face or digitally? PLoS One 2019; 14:e0216929. [PMID: 31095611 PMCID: PMC6522036 DOI: 10.1371/journal.pone.0216929] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 05/01/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction Volunteer befriending can be used to address social isolation in patients with psychosis. Traditionally this involves face-to-face encounters between a volunteer and a patient, but modern digital technology also makes it possible to have these interactions remotely. This study aimed to explore the views and interests of patients with psychosis about different formats of volunteering, face-to-face or digitally. Methods A survey was conducted with patients with psychotic disorders in community mental health teams in London. Questions covered socio-demographic characteristics, quality of life, loneliness, views on the different formats of volunteering and types of volunteers, and their interest in getting volunteering support, face-to-face or digitally. Binary logistic regressions were used to investigate potential predictors of interest in getting volunteering support face-to-face or digitally. Results A total of 151 patients with psychotic disorders were included in this study. More than half of the patients (n = 87, 57.6%) had not heard about these volunteering programs. Many were interested in getting face-to-face (n = 87, 57.6%) and digital (n = 56, 37.1%) volunteering. For the face-to-face encounters, most preferred them to be weekly (n = 36, 41.4%), for one-hour (n = 32, 36.8%), and with an open-ended relationship (n = 45, 51.7%). For the digital contacts, most preferred them to be weekly (n = 17, 30.9%) and through text messages (n = 26, 46.4%). A minority of patients (n = 20, 13.2%) did not use digital technology. Patients with lower quality of life were significantly more likely to prefer face-to-face volunteering (p < .05). Younger patients and with fewer years of diagnosis were significantly more likely to prefer digital volunteering (p < .05). Conclusions The variability in patients’ interests suggests that different formats of volunteer support should be offered. Digital volunteering may become more important in the future, since many younger patients are interested in it.
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Affiliation(s)
- Mariana Pinto da Costa
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom
- Hospital de Magalhães Lemos, Porto, Portugal
- Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
- * E-mail:
| | - Agnes Chevalier
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom
| | - Aida Farreny
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom
| | - Megan Cassidy
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom
| | - Monica Leverton
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom
| | - Sarah Toner
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom
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Gillespie A. Together We Can Improve Outcomes in Kidney Failure: Examining Social Networks in Hemodialysis. Kidney Med 2019; 1:79-82. [PMID: 32734941 PMCID: PMC7380405 DOI: 10.1016/j.xkme.2019.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- Avrum Gillespie
- Division of Nephrology, Hypertension, and Kidney Transplantation, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
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Menec VH, Newall NE, Mackenzie CS, Shooshtari S, Nowicki S. Examining individual and geographic factors associated with social isolation and loneliness using Canadian Longitudinal Study on Aging (CLSA) data. PLoS One 2019; 14:e0211143. [PMID: 30707719 PMCID: PMC6358157 DOI: 10.1371/journal.pone.0211143] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/08/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND A large body of research shows that social isolation and loneliness have detrimental health consequences. Identifying individuals at risk of social isolation or loneliness is, therefore, important. The objective of this study was to examine personal (e.g., sex, income) and geographic (rural/urban and sociodemographic) factors and their association with social isolation and loneliness in a national sample of Canadians aged 45 to 85 years. METHODS The study involved cross-sectional analyses of baseline data from the Canadian Longitudinal Study on Aging that were linked to 2016 census data at the Forward Sortation Area (FSA) level. Multilevel logistic regression analyses were conducted to examine the association between personal factors and geographic factors and social isolation and loneliness for the total sample, and women and men, respectively. RESULTS The prevalence of social isolation and loneliness was 5.1% and 10.2%, respectively, but varied substantially across personal characteristics. Personal characteristics (age, sex, education, income, functional impairment, chronic diseases) were significantly related to both social isolation and loneliness, although some differences emerged in the direction of the relationships for the two measures. Associations also differed somewhat for women versus men. Associations between some geographic factors emerged for social isolation, but not loneliness. Living in an urban core was related to increased odds of social isolation, an effect that was no longer significant when FSA-level factors were controlled for. FSAs with a higher percentage of 65+ year old residents with low income were consistently associated with higher odds of social isolation. CONCLUSION The findings indicate that socially isolated individuals are, to some extent, clustered into areas with a high proportion of low-income older adults, suggesting that support and resources could be targeted at these areas. For loneliness, the focus may be less on where people live, but rather on personal characteristics that place individuals at risk.
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Affiliation(s)
- Verena H. Menec
- Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
| | - Nancy E. Newall
- Department of Psychology, Brandon University, Manitoba, Canada
| | | | - Shahin Shooshtari
- Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
| | - Scott Nowicki
- Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
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Twyman L, Cowles C, Walsberger SC, Baker AL, Bonevski B. 'They're Going to Smoke Anyway': A Qualitative Study of Community Mental Health Staff and Consumer Perspectives on the Role of Social and Living Environments in Tobacco Use and Cessation. Front Psychiatry 2019; 10:503. [PMID: 31379622 PMCID: PMC6652148 DOI: 10.3389/fpsyt.2019.00503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 06/25/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Addressing the high prevalence of tobacco use experienced by people with severe mental illness (SMI) requires consideration of the influence of wider cultural, socioeconomic and environmental factors. This qualitative study aimed to examine the impact of social and living environments on tobacco use and cessation by people with SMI accessing community managed mental health services. The perspectives of both staff and consumers with SMI were explored. Methods: Semi-structured focus groups were undertaken with a purposive sample of community mental health staff and consumers from three sites in three major cities in NSW, Australia. Two sites provided outreach support, and one site provided residential support. Data were collected (2017-2018) until saturation was reached. Focus groups were audio-recorded and transcribed, and thematic analysis was conducted. Results: Thirty-one staff and 17 consumers participated separately in six focus groups. Themes identified by staff included a degree of fatalism, conceptualising tobacco use as choice rather than addiction and tensions between cessation support and broader models of care. Staff viewed smoke-free home and mental health service policies as effective at promoting quitting but contradictory to recovery-oriented models of care. Consumers identified smoking as an integral part of life and social networks, as a way of maintaining control and lack of social support to quit as key themes. While many consumers reported smoking inside the home, others described enforcing smoke-free rules. Conclusion: Social and living environments played an integral role in tobacco use and cessation for both staff and consumers. The role of community managed mental health organisations in addressing tobacco use within social and living environments was not strongly supported by staff and sometimes seen as antithetical to recovery-oriented models of care. Potential ways to address this include education and training for prospective and current community mental health organisation staff highlighting the synergy between the recovery-oriented model and provision of preventive health support.
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Affiliation(s)
- Laura Twyman
- Tabacco Control Unit, Cancer Council NSW, Woolloomooloo, NSW, Australia.,School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Carla Cowles
- Human Capital Alliance, Potts Point, NSW, Australia
| | | | - Amanda L Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
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Visentini C, Cassidy M, Bird VJ, Priebe S. Social networks of patients with chronic depression: A systematic review. J Affect Disord 2018; 241:571-578. [PMID: 30165323 DOI: 10.1016/j.jad.2018.08.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/31/2018] [Accepted: 08/07/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION AND AIM The social networks of patients are an important factor for the prognosis of mental disorders and can be potentially targeted through psycho-social interventions. We aimed to explore these networks in patients with chronic depression, by conducting a systematic review on the characteristics of social networks in this patient group. METHODS Six databases, three key journals and grey literature were searched. Two reviewers screened the articles, assessed the risk of bias and extracted the information needed. Findings were descriptively synthesised. RESULTS Nineteen articles met the inclusion criteria reporting the findings of a total of 873 patients with chronic depression. Four papers presented results without a comparison group (six in comparison to a healthy population, eight to patients with non-chronic major depression and three to patients with other mental disorders). Social networks of patients with chronic depression appeared to be smaller than those of healthy individuals, patients with non-chronic major depression and other disorders. LIMITATIONS Studies used different concepts of chronic depression and inconsistent methodologies for assessing social networks. Only three studies adopted objective measures. CONCLUSIONS Whilst the evidence on social networks of patients with chronic depression is limited, the networks appear smaller than in most comparison groups, including patients with non-chronic depression.
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Affiliation(s)
- Chiara Visentini
- School of Specialisation in Psychiatry, University of Modena and Reggio Emilia, Italy
| | - Megan Cassidy
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, UK.
| | - Victoria Jane Bird
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, UK
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Mazzi F, Baccari F, Mungai F, Ciambellini M, Brescancin L, Starace F. Effectiveness of a social inclusion program in people with non-affective psychosis. BMC Psychiatry 2018; 18:179. [PMID: 29879925 PMCID: PMC5992655 DOI: 10.1186/s12888-018-1728-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/04/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND People with psychotic illness suffer from reduced quality of life and often from an insufficient level of social inclusion. These variables are associated with several negative outcomes, such as higher neuro-cognitive deficits, negative symptoms, internalised stigma, increased cardiovascular risk and, most importantly, excess mortality. To date, only a minority of social interventions in psychosis have been investigated. Since 2011, the Department of Mental Health and Substance Abuse in Modena introduced the "Social Point" program, which provides social inclusion interventions to promote active social participation for patients suffering from severe mental illness. The aim of this study was to assess whether a social inclusion intervention is associated with better outcomes in terms of personal and social recovery, with particular reference to the areas of social functioning and activity, and subjective dimensions such as self-esteem, self-stigma and perceived quality of life. METHODS A cross-sectional design was adopted to compare 30 subjects, selected at the completion of "Social Point" program, with a group of subjects, matched for socio-demographic and clinical features, selected from a wait list for "Social Point". All subjects were evaluated by means of instruments assessing: level of disability, level of functioning, severity of psychopathology, self-esteem, internalised stigma and quality of life. RESULTS Overall, the results of the study suggest that social inclusion interventions may be effective in people suffering from non-affective psychosis. A dose-effect relationship was also found between higher number of activities per patient and better outcomes within both social and psychopathological domains. However, due to the cross-sectional design of the study no definitive causality can be inferred. CONCLUSION Psychosocial interventions promoting social inclusion are likely to represent an effective approach to improve personal and social recovery.
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Affiliation(s)
- Fausto Mazzi
- 0000 0004 1756 2640grid.476047.6Department of Mental Health and Drug Abuse, AUSL Modena, Viale L Muratori 201, 41124 Modena, Italy
| | - Flavia Baccari
- 0000 0004 1756 2640grid.476047.6Department of Mental Health and Drug Abuse, AUSL Modena, Viale L Muratori 201, 41124 Modena, Italy
| | - Francesco Mungai
- Department of Mental Health and Drug Abuse, AUSL Modena, Viale L Muratori 201, 41124, Modena, Italy.
| | | | - Lisa Brescancin
- Social Point Modena – Centro Servizi Volontariato, Modena, Italy
| | - Fabrizio Starace
- 0000 0004 1756 2640grid.476047.6Department of Mental Health and Drug Abuse, AUSL Modena, Viale L Muratori 201, 41124 Modena, Italy
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Georgaca E, Zissi A. Living with psychosis: strategies and social conditions for recovery. PSYCHOSIS 2018. [DOI: 10.1080/17522439.2018.1447595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Eugenie Georgaca
- School of Psychology, Aristotle University of Thessaloniki , Thessaloniki, Greece
| | - Anastasia Zissi
- Department of Sociology, University of the Aegean , Mytilene, Greece
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Vaeggemose U, Ankersen PV, Aagaard J, Burau V. Co-production of community mental health services: Organising the interplay between public services and civil society in Denmark. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:122-130. [PMID: 28670769 DOI: 10.1111/hsc.12468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/08/2017] [Indexed: 06/07/2023]
Abstract
Co-production involves knowledge and skills based on both lived experiences of citizens and professionally training of staff. In Europe, co-production is viewed as an essential tool for meeting the demographic, political and economic challenges of welfare states. However, co-production is facing challenges because public services and civil society are rooted in two very different logics. These challenges are typically encountered by provider organisations and their staff who must convert policies and strategies into practice. Denmark is a welfare state with a strong public services sector and a relatively low involvement of volunteers. The aim of this study was to investigate how provider organisations and their staff navigate between the two logics. The present analysis is a critical case study of two municipalities selected from seven participating municipalities, for their maximum diversity. The study setting was the Community Families programme, which aim to support the social network of mental health users by offering regular contact with selected private families/individuals. The task of the municipalities was to initiate and support Community Families. The analysis built on qualitative data generated at the organisational level in the seven participating municipalities. Within the two "case study" municipalities, qualitative interviews were conducted with front-line co-ordinators (six) and line managers (two). The interviews were recorded, transcribed verbatim and coded using the software program NVivo. The results confirm the central role played by staff and identify a close interplay between public services and civil society logics as essential for the organisation of co-production. Corresponding objectives, activities and collaborative relations of provider organisations are keys for facilitating the co-productive practice of individual staff. Organised in this way, co-production can succeed even in a mental health setting associated with social stigma and in a welfare state dominated by public services.
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Affiliation(s)
- Ulla Vaeggemose
- DEFACTUM - Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark
| | - Pia Vedel Ankersen
- DEFACTUM - Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark
| | - Jørgen Aagaard
- Unit for Psychiatric Research and Department S, Aalborg University Hospital, Psychiatric Hospital, Aalborg, Denmark
- Unit for Psychiatric Research and Department M, Aarhus University Hospital, Risskov, Denmark
| | - Viola Burau
- DEFACTUM - Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Degnan A, Berry K, Sweet D, Abel K, Crossley N, Edge D. Social networks and symptomatic and functional outcomes in schizophrenia: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2018; 53:873-888. [PMID: 29951929 PMCID: PMC6133157 DOI: 10.1007/s00127-018-1552-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 06/14/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To conduct a systematic review and meta-analysis to examine the strength of associations between social network size and clinical and functional outcomes in schizophrenia. METHOD Studies were identified from a systematic search of electronic databases (EMBASE, Medline, PsycINFO, and Web of Science) from January 1970 to June 2016. Eligible studies included peer-reviewed English language articles that examined associations between a quantitative measure of network size and symptomatic and/or functional outcome in schizophrenia-spectrum diagnoses. RESULTS Our search yielded 16 studies with 1,929 participants. Meta-analyses using random effects models to calculate pooled effect sizes (Hedge's g) found that smaller social network size was moderately associated with more severe overall psychiatric symptoms (N = 5, n = 467, g = - 0.53, 95% confidence interval (CI) = - 0.875, - 0.184, p = 0.003) and negative symptoms (N = 8, n = 577, g = - 0.75, 95% CI = - 0.997, - 0.512, p = 0.000). Statistical heterogeneity was observed I2 = 63.04%; I2 = 35.75%,) which could not be explained by low-quality network measures or sample heterogeneity in sensitivity analyses. There was no effect for positive symptoms (N = 7, n = 405, g = - 0.19, 95% CI = 0.494, 0.110, p = 0.213) or social functioning (N = 3, n = 209, g = 0.36, 95% CI = - 0.078, 0.801, p = 0.107). Narrative synthesis suggested that larger network size was associated with improved global functioning, but findings for affective symptoms and quality of life were mixed. CONCLUSION Psychosocial interventions which support individuals to build and maintain social networks may improve outcomes in schizophrenia. The review findings are cross-sectional and thus causal direction cannot be inferred. Further research is required to examine temporal associations between network characteristics and outcomes in schizophrenia and to test theoretical models relating to explanatory or mediating mechanisms.
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Affiliation(s)
- Amy Degnan
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Zochonis Building; Oxford Road, Manchester, M13 9PL, UK.
| | - Katherine Berry
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Daryl Sweet
- School of Social Sciences, Education and Social Work, Queen's University, Belfast, UK
| | - Kathryn Abel
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Nick Crossley
- School of Social Sciences, The University of Manchester, Manchester, UK
| | - Dawn Edge
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
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Laxhman N, Greenberg L, Priebe S. Satisfaction with sex life among patients with schizophrenia. Schizophr Res 2017; 190:63-67. [PMID: 28270338 DOI: 10.1016/j.schres.2017.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/26/2017] [Accepted: 03/02/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Whilst subjective quality of life has been extensively studied in patients with schizophrenia, little is known specifically about their satisfaction with their sex lives. Aim To assess the level of satisfaction with sex lives of patients with schizophrenia and explore patient characteristics associated with lower satisfaction. METHOD Data of five independent samples of patients with schizophrenia or related disorders (ICD-10 F20-29) were analysed. Quality of life including satisfaction with sex life was assessed on the Manchester Short Assessment of Quality of Life. RESULTS Across all patients (N=1404), satisfaction with sex life was significantly lower than satisfaction with any other life domain, and in each sample mean scores were below the middle scale point, indicating explicit dissatisfaction. Lower satisfaction was associated with male gender, being unmarried and more affective symptoms. CONCLUSION Patients with schizophrenia experience their sex life as an area of particular dissatisfaction. Future research should identify context and reasons for this dissatisfaction.
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Affiliation(s)
- Neelam Laxhman
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Newham Centre for Mental Health, E13 8SP London, UK.
| | - Lauren Greenberg
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London E1 2AB, United Kingdom
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Newham Centre for Mental Health, E13 8SP London, UK
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Falk EB, Bassett DS. Brain and Social Networks: Fundamental Building Blocks of Human Experience. Trends Cogn Sci 2017; 21:674-690. [PMID: 28735708 PMCID: PMC8590886 DOI: 10.1016/j.tics.2017.06.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/16/2017] [Accepted: 06/20/2017] [Indexed: 01/10/2023]
Abstract
How do brains shape social networks, and how do social ties shape the brain? Social networks are complex webs by which ideas spread among people. Brains comprise webs by which information is processed and transmitted among neural units. While brain activity and structure offer biological mechanisms for human behaviors, social networks offer external inducers or modulators of those behaviors. Together, these two axes represent fundamental contributors to human experience. Integrating foundational knowledge from social and developmental psychology and sociology on how individuals function within dyads, groups, and societies with recent advances in network neuroscience can offer new insights into both domains. Here, we use the example of how ideas and behaviors spread to illustrate the potential of multilayer network models.
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Affiliation(s)
- Emily B Falk
- Annenberg School of Communication, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Marketing, Wharton School, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Butter S, Murphy J, Shevlin M, Houston J. Social isolation and psychosis-like experiences: a UK general population analysis. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2017. [DOI: 10.1080/17522439.2017.1349829] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sarah Butter
- School of Psychology, Ulster University, Derry, UK
| | - Jamie Murphy
- School of Psychology, Ulster University, Derry, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, UK
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