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GEZGİN YAZICI H, ŞAHİNER İV, DİDİN M, ÖNER S. Weight Gain, Mental Symptoms and Self-Esteem in Patients with Schizophrenia. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1113719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of this study is to examine the weight gain, mental symptoms and self-esteem in patients with schizophrenia undergoing treatment at a community mental health center (CMHC). The study is conducted with 103 schizophrenic patients between 01.08.2021 – 01.02.2022. The data was collected with Personal Information Form, Rosenberg Self-esteem Scale, and Positive and Negative Syndrome Scale (PANSS). 35% of the patients are women, 43.7% are single, and 48.5% are between the ages of 45-64. There was no significant increase between the patients’ weigh measurement value in the first month (x̄=81.185) and the measurement value at the end of six months (x̄=81.320). The decrease in the self-esteem scale mean score at the end of six months (x̄=1.317) was not found significant, when compared to the self-esteem scale mean score in the first month (x̄=1452). The PANSS General Psychopathology subscale mean score was found to be statistically lower at the end of the six-month follow-up (x̄=26.418), compared to the first month mean score (x̄=27.136). There was no significant difference between weight gain, self-esteem, and PANSS positive/negative symptoms in the six-month follow-up of patients with schizophrenia enrolled in CMHC. A significant difference was discovered between the first and sixth-month measurements in PANSS general psychopathology symptoms. It is detected that gender, working status, atypical and mixed antipsychotics use, smoking status, and changes in daytime sleeping habits affect mental symptoms.
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Wang L, Zou HO, Liu J, Hong JF. Associations between adverse childhood experiences and overweight, obese, smoking and binge drinking among adult patients with depression in China. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03798-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Improving the Physical Health of Psychiatric Hospital Residents: An Evaluation of an Obesity Education Program for Mental Health Professionals. Healthcare (Basel) 2022; 10:healthcare10101851. [PMID: 36292296 PMCID: PMC9601487 DOI: 10.3390/healthcare10101851] [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: 07/21/2022] [Revised: 09/06/2022] [Accepted: 09/19/2022] [Indexed: 11/19/2022] Open
Abstract
Background: People living with mental health disorders are at increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the obesity rate is 36% in the general population and more than 50% for people living with mental health disorders. Although mental health clinicians concentrate on managing psychiatric disorders, they seldom recognize the gradual increase in body mass index of their patients. The result is a disconnection between the clinical management of psychiatric disorders and the medical management of obesity. Purpose: This study assessed the effectiveness of an evidence-based education program for improving the obesity management practices of mental health clinicians caring for residents at a state psychiatric hospital. Methods: This was a quasi-experimental study design with a pretest and posttest evaluation. Convenience sampling was used to recruit mental health professionals, or clinicians, at a large psychiatric hospital in the Southern region of the United States. Data was collected with the Advising and Treating Overweight and Obese Patient questionnaire (17 items). Data analysis included descriptive and inferential statistics. The findings were reported in accordance with the TREND and GREET guidelines. Results: The education program was completed by 50 MHCs. The pretest indicated that 76% of MHCs were not involved in helping obese residents manage their weight, but the posttest indicated 90% were involved. There was a significant increase in MHC knowledge about obesity management and reported actions 90-days after the program. MHCs were unable to arrange follow-up visits for residents, a task not directly within their control. Conclusions: Mental health clinicians reported increased knowledge and improved clinical practice after an education program. Because the outcomes were reported at 90-days after the program, further research needs to evaluate the longitudinal impact of this type of program, where the reported behaviors are correlated to process and clinical outcome measures for obesity.
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Mueller-Stierlin AS, Cornet S, Peisser A, Jaeckle S, Lehle J, Moerkl S, Teasdale SB. Implications of Dietary Intake and Eating Behaviors for People with Serious Mental Illness: A Qualitative Study. Nutrients 2022; 14:nu14132616. [PMID: 35807799 PMCID: PMC9268504 DOI: 10.3390/nu14132616] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
The impact of poor diet quality and nutritional inadequacies on mental health and mental illness has recently gained considerable attention in science. As the opinions and experiences of people living with serious mental illness on dietary issues are unknown, we aimed to understand the role of nutrition in a biopsychosocial approach. In total, 28 semi-structured interviews were conducted with people living with serious mental illness (SMI) in Australia, Germany and Austria, and a generic thematic analysis approach was applied. Four positive (positive effects on the body and mind, therapeutic effects in treating somatic illnesses, pleasure and opportunity for self-efficacy) and three negative (impairment related to mental illness and its treatment, perceived stigma and negative effects on the body and mind) implications of diet were identified. A key issue for most of the participants was the mental burden arising from their body weight. This might indicate that negative implications, such as guilt and stigma, were of primary importance for people with SMI when talking about their dietary behavior. In conclusion, diet-related support is urgently needed for people with SMI. However, especially participants from Germany and Austria reported that this is not yet widely available in mental health settings, leading to hopelessness and resignation.
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Affiliation(s)
- Annabel S. Mueller-Stierlin
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Sebastian Cornet
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Anna Peisser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria;
| | - Selina Jaeckle
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Jutta Lehle
- Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany; (A.S.M.-S.); (S.C.); (S.J.); (J.L.)
| | - Sabrina Moerkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Austria;
- Correspondence:
| | - Scott B. Teasdale
- Discipline of Psychiatry and Mental Health, University of New South Wales (UNSW) Sydney, Sydney, NSW 2052, Australia;
- Mindgardens Neuroscience Network, Sydney, NSW 2052, Australia
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Metri NJ, Ee C, Wardle J, Ng CH, Siskind D, Brakoulias V, Ho FYY, Wong VWH, Naidoo U, Eaton M, Firth J, Sarris J. Assessing dietary, exercise, and non-pharmacological modalities within psychiatric hospitals. Gen Hosp Psychiatry 2022; 76:31-35. [PMID: 35358900 DOI: 10.1016/j.genhosppsych.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Najwa-Joelle Metri
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia.
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Chee H Ng
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, Victoria, Australia
| | - Dan Siskind
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Vlasios Brakoulias
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Western Sydney Local Health District Mental Health Services, Sydney, NSW, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | | | - Uma Naidoo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Melissa Eaton
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Division of Psychology & Mental Health, The University of Manchester, Manchester, UK
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Maidment ID, Wong G, Duddy C, Upthegrove R, Oduola S, Robotham D, Higgs S, Ahern A, Birdi G. REalist Synthesis Of non-pharmacologicaL interVEntions for antipsychotic-induced weight gain (RESOLVE) in people living with severe mental illness (SMI). Syst Rev 2022; 11:42. [PMID: 35264212 PMCID: PMC8906356 DOI: 10.1186/s13643-022-01912-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with severe mental illnesses (SMI) such as schizophrenia die on average 15 to 20 years earlier than everyone else. Two thirds of these deaths are from preventable physical illnesses such as hypertension, cardiovascular disease, and diabetes, which are worsened by weight gain. Antipsychotics are associated with significant weight gain. In REalist Synthesis Of non-pharmacologicaL interVEntions (RESOLVE), a realist synthesis, combining primary and secondary data, will be used to understand and explain how, why, for whom, and in what contexts non-pharmacological interventions can help service users to manage antipsychotic-induced weight gain. METHODS A five-step approach will be used to develop guidance: 1. Developing the initial programme theory An initial (candidate) programme theory, which sets out how and why outcomes occur within an intervention, will be developed. 2. Developing the search The initial programme theory will be refined using academic and grey literature. The proposed initial sampling frame are as follows: Context: people living with SMI, taking antipsychotics, different types of SMI. INTERVENTION non-pharmacological interventions. MECHANISMS triggered by the intervention. Outcomes e.g. weight, metabolic adverse events, quality of life, adherence, burden, economic. Searching for relevant documents will continue until sufficient data is found to conclude that the refined programme theory is coherent and plausible. Lived experience (service users) and stakeholder (practitioners) groups will provide feedback. 3. Selection, appraisal and data extraction Documents will be screened against inclusion and exclusion criteria. The text extracted from these documents will be coded as contexts, mechanisms and their relationships to outcomes. 4. Primary data collection Realist interviews with up to 30 service users and informal carers, and 20 practitioners will gather data to support, refute or refine the programme theory. 5. Data analysis A realist logic of analysis will be used to develop and refine the programme theory from secondary and primary data. The analysis will aim to identify practical intervention strategies to change contexts so that key mechanisms are triggered to produce desired outcomes. Guidance will be produced based on these strategies. DISCUSSION This realist synthesis aims to develop guidance for service users and practitioners on the most appropriate interventional strategies to manage and limit antipsychotic weight gain. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42021268697.
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Affiliation(s)
- Ian D Maidment
- College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, UK.
| | - Geoffrey Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Claire Duddy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Rachel Upthegrove
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Sheri Oduola
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Dan Robotham
- The McPin Foundation, 7-14 Great Dover St, London, SE1 4YR, UK
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Amy Ahern
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Gurkiran Birdi
- College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, UK
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Lee C, Piernas C, Stewart C, Michalopoulou M, Hajzadeh A, Edwards R, Aveyard P, Waite F. Identifying effective characteristics of behavioral weight management interventions for people with serious mental illness: A systematic review with a qualitative comparative analysis. Obes Rev 2022; 23:e13355. [PMID: 34672069 PMCID: PMC8952200 DOI: 10.1111/obr.13355] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022]
Abstract
People with serious mental illness (SMI) have identified barriers to engaging in behavioral weight management interventions (BWMIs). We assessed whether BWMIs that addressed these barriers were more effective. First, we systematically reviewed qualitative literature and used a thematic analysis to identify the characteristics of BWMIs that promote engagement for adults with SMI. Second, we systematically reviewed randomized controlled trials (RCTs) of BWMIs in adults with SMI. Data on the characteristics that promoted engagement and weight outcomes were extracted. We then used a crisp-set qualitative comparative analysis (CsQCA) to identify which characteristics were associated with weight loss. For the qualitative review, 20 studies in 515 people with SMI were analyzed and nine characteristics were reported to promote engagement in BWMIs. For the systematic review, 34 RCTs testing 36 interventions in 4305 participants were included. The active interventions resulted in more weight loss (mean = -4.37 to +1 kg at 6 weeks to 18 months follow-up) compared with controls (-1.64 to +3.08 kg). The CsQCA showed BWMIs that offered regular contact, tools to support enactment, and tailored materials were associated with effectiveness. As these are all supplementary strategies, it may be possible to augment BWMIs available for the general population to engage people with SMI.
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Affiliation(s)
- Charlotte Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Cristina Stewart
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Moscho Michalopoulou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Anisa Hajzadeh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Rhiannon Edwards
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.,Bassetlaw Hospital, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Worksop, Nottinghamshire, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Felicity Waite
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, Oxfordshire, UK.,Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK
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Jenkin G, McIntosh J, Hoek J, Mala K, Paap H, Peterson D, Marques B, Every-Palmer S. There's no smoke without fire: Smoking in smoke-free acute mental health wards. PLoS One 2021; 16:e0259984. [PMID: 34780542 PMCID: PMC8592473 DOI: 10.1371/journal.pone.0259984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND People who smoke with serious mental illness carry disproportionate costs from smoking, including poor health and premature death from tobacco-related illnesses. Hospitals in New Zealand are ostensibly smoke-free; however, some mental health wards have resisted implementing this policy. AIM This study explored smoking in acute metal health wards using data emerging from a large sociological study on modern acute psychiatric units. METHODS Eighty-five in-depth, semi-structured interviews were conducted with staff and service users from four units. Data were analysed using a social constructionist problem representation approach. RESULTS Although high-level smoke-free policies were mandatory, most participants disregarded these policies and smoking occurred in internal courtyards. Staff reasoned that acute admissions were not the time to quit smoking, citing the sceptres of distress and possibly violence; further, they found smoking challenging to combat. Inconsistent enforcement of smoke-free policies was common and problematic. Many service users also rejected smoke-free policies; they considered smoking facilitated social connections, alleviated boredom, and helped them feel calm in a distressing environment - some started or increased smoking following admission. A minority viewed smoking as a problem; a fire hazard, or pollutant. No one mentioned its health risks. CONCLUSION Psychiatric wards remain overlooked corners where hospital smoke-free policies are inconsistently applied or ignored. Well-meaning staff hold strong but anachronistic views about smoking. To neglect smoking cessation support for people with serious mental illness is discriminatory and perpetuates health and socioeconomic inequities. However, blanket applications of generic policy are unlikely to succeed. Solutions may include myth-busting education for service users and staff, local champions, and strong managerial support and leadership, with additional resourcing during transition phases. Smoke-free policies need consistent application with non-judgemental NRT and, potentially, other treatments. Smoking cessation would be supported by better designed facilities with more options for alleviating boredom, expressing autonomy, facilitating social connections, and reducing distress.
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Affiliation(s)
- Gabrielle Jenkin
- Department of Psychological Medicine, Suicide and Mental Health Research Group, University of Otago Wellington, Wellington, New Zealand
| | - Jacqueline McIntosh
- School of Architecture, Victoria University of Wellington, Wellington, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Krishtika Mala
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Hannah Paap
- Department of Psychological Medicine, Suicide and Mental Health Research Group, University of Otago Wellington, Wellington, New Zealand
| | - Debbie Peterson
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Bruno Marques
- School of Architecture, Victoria University of Wellington, Wellington, New Zealand
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand
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Schnor H, Linderoth S, Midtgaard J. Patient and Mental Health Care Professionals' Perspectives on Health Promotion in Psychiatric Clinical Practice: A Focus Group Study. Issues Ment Health Nurs 2021; 42:870-879. [PMID: 34048320 DOI: 10.1080/01612840.2021.1899349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The need to protect the physical health of people with mental illness is increasingly acknowledged. We conducted six focus groups with 14 patients and 12 mental health care professionals to explore their individual and mutual perspectives on health promotion in daily clinical practice. Three main themes: Health as a balancing act; Dilemmas for health promotion; and Ideals and responsibility for health promotion in clinical practice were identified using thematic analysis. We discuss how aligning mutual expectations and creating an authentic dialogue based on the identification of and respect for patients' individual resources can support health promotion in clinical psychiatry.
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Affiliation(s)
- Helle Schnor
- Mental Health Centre Glostrup, Glostrup, Denmark.,University College Copenhagen, Copenhagen, Denmark
| | | | - Julie Midtgaard
- Mental Health Centre Glostrup, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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10
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Grammatikopoulou MG, Lampropoulou MΑ, Milapidou M, Goulis DG. At the heart of the matter: Cardiovascular health challenges among incarcerated women. Maturitas 2021; 149:16-25. [PMID: 34134886 DOI: 10.1016/j.maturitas.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 12/17/2022]
Abstract
Many factors appear to contribute to an increased risk for cardiovascular disease (CVD) among incarcerated women. Imprisonment is associated with a bodyweight gain and an increased prevalence of overweight and obesity. Inadequate physical activity and unhealthy nutrition further contribute to this positive energy balance. Classical CVD risk factors are common, including hypertension, diabetes mellitus, metabolic syndrome, and smoking. Moreover, imprisonment is associated with an increased incidence of mental health issues, such as depression and anxiety, with coping mechanisms, including substance abuse, being frequently adopted. Specific attitudes in the correctional environment, including hunger strikes, bullying, abuse and solitary confinement, are effectors of cardiovascular and mental ill-health. Furthermore, the plethora of psychological stressors induces an accelerated aging process, paired with CVD risk. Communicable diseases, mainly human immunodeficiency virus, opportunistic infections and inadequate sunlight exposure increase cardiovascular dysregulation. Health care needs associated with the female sex are not always met, adding to the frustration and compromised well-being. All these factors act independently and cumulatively, increasing CVD risk among incarcerated women.
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Affiliation(s)
- Maria G Grammatikopoulou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Thessaloniki, Greece
| | - Maria Α Lampropoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Thessaloniki, Greece
| | - Maria Milapidou
- Dr. Juris, Post Doc Researcher, Faculty of Law, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Rezaie L, Maazinezhad S, Fogelberg DJ, Khazaie H, Sadeghi-Bahmani D, Brand S. Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores. Life (Basel) 2021; 11:life11050368. [PMID: 33919250 PMCID: PMC8143081 DOI: 10.3390/life11050368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: Individuals with obstructive sleep apnea (OSA) are at increased risk to suffer from further somatic and sleep-related complaints. To assess OSA, demographic, anthropometric, and subjective/objective sleep parameters are taken into consideration, but often separately. Here, we entered demographic, anthropometric, subjective, and objective sleep- and breathing-related dimensions in one model. Methods: We reviewed the demographic, anthropometric, subjective and objective sleep- and breathing-related data, and polysomnographic records of 251 individuals with diagnosed OSA. OSA was considered as a continuous and as categorical variable (mild, moderate, and severe OSA). A series of correlational computations, X2-tests, F-tests, and a multiple regression model were performed to investigate which demographic, anthropometric, and subjective and objective sleep dimensions were associated with and predicted dimensions of OSA. Results: Higher apnea/hypopnea index (AHI) scores were associated with higher BMI, higher daytime sleepiness, a higher respiratory disturbance index, and higher snoring. Compared to individuals with mild to moderate OSA, individuals with severe OSA had a higher BMI, a higher respiratory disturbance index (RDI) and a higher snoring index, while subjective sleep quality and daytime sleepiness did not differ. Results from the multiple regression analysis showed that an objectively shorter sleep duration, more N2 sleep, and a higher RDI predicted AHI scores. Conclusion: The pattern of results suggests that blending demographic, anthropometric, and subjective/objective sleep- and breathing-related data enabled more effective discrimination of individuals at higher risk for OSA. The results are of practical and clinical importance: demographic, anthropometric, and breathing-related issues derived from self-rating scales provide a quick and reliable identification of individuals at risk of OSA; objective assessments provide further certainty and reliability.
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Affiliation(s)
- Leeba Rezaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
| | - Soroush Maazinezhad
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
| | - Donald J. Fogelberg
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA;
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
- Correspondence: (H.K.); or (S.B.)
| | - Dena Sadeghi-Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
- Departments of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35209, USA
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Department of Clinical Research, University of Basel, 4031 Basel, Switzerland
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 25529, Iran
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- Correspondence: (H.K.); or (S.B.)
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Davarinejad O, Mohammadi Majd T, Golmohammadi F, Mohammadi P, Radmehr F, Alikhani M, Motaei T, Moradinazar M, Brühl A, Sadeghi Bahmani D, Brand S. Identification of Risk Factors to Predict the Occurrences of Relapses in Individuals with Schizophrenia Spectrum Disorder in Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020546. [PMID: 33440817 PMCID: PMC7827717 DOI: 10.3390/ijerph18020546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 02/03/2023]
Abstract
Schizophrenia Spectrum Disorder (SSD) is a chronic psychiatric disorder with a modest treatment outcome. In addition, relapses are commonplace. Here, we sought to identify factors that predict relapse latency and frequency. To this end, we retrospectively analyzed data for individuals with SSD. Medical records of 401 individuals with SSD were analyzed (mean age: 25.51 years; 63.6% males) covering a five-year period. Univariate and multivariate Penalized Likelihood Models with Shared Log-Normal Frailty were used to determine the correlation between discharge time and relapse and to identify risk factors. A total of 683 relapses were observed in males, and 422 relapses in females. The Relapse Hazard Ratio (RHR) decreased with age (RHR = 0.99, CI: (0.98–0.998)) and with participants’ adherence to pharmacological treatment (HR = 0.71, CI: 0.58–0.86). In contrast, RHR increased with a history of suicide attempts (HR = 1.32, CI: 1.09–1.60), and a gradual compared to a sudden onset of disease (HR = 1.45, CI: 1.02–2.05). Gender was not predictive. Data indicate that preventive and therapeutic interventions may be particularly important for individuals who are younger at disease onset, have a history of suicide attempts, have experienced a gradual onset of disease, and have difficulties adhering to medication.
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Affiliation(s)
- Omran Davarinejad
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (O.D.); (M.A.)
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (T.M.M.); (F.G.); (P.M.); (F.R.); (T.M.); (M.M.)
| | - Tahereh Mohammadi Majd
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (T.M.M.); (F.G.); (P.M.); (F.R.); (T.M.); (M.M.)
| | - Farzaneh Golmohammadi
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (T.M.M.); (F.G.); (P.M.); (F.R.); (T.M.); (M.M.)
| | - Payam Mohammadi
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (T.M.M.); (F.G.); (P.M.); (F.R.); (T.M.); (M.M.)
| | - Farnaz Radmehr
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (T.M.M.); (F.G.); (P.M.); (F.R.); (T.M.); (M.M.)
| | - Mostafa Alikhani
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (O.D.); (M.A.)
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (T.M.M.); (F.G.); (P.M.); (F.R.); (T.M.); (M.M.)
| | - Tayebeh Motaei
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (T.M.M.); (F.G.); (P.M.); (F.R.); (T.M.); (M.M.)
| | - Mehdi Moradinazar
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (T.M.M.); (F.G.); (P.M.); (F.R.); (T.M.); (M.M.)
| | - Annette Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, 4002 Basel, Switzerland; (A.B.); (D.S.B.)
| | - Dena Sadeghi Bahmani
- Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, 4002 Basel, Switzerland; (A.B.); (D.S.B.)
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
- Departments of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35209, USA
| | - Serge Brand
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (O.D.); (M.A.)
- Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, 4002 Basel, Switzerland; (A.B.); (D.S.B.)
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
- Department of Sport, Exercise, and Health, University of Basel, 4002 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Tehran 1416753955, Iran
- Correspondence:
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13
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Hancox LE, Lee PS, Armaghanian N, Hirani V, Wakefield G. Nutrition risk screening methods for adults living with severe mental illness: A scoping review. Nutr Diet 2021; 79:349-363. [PMID: 33416212 DOI: 10.1111/1747-0080.12652] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 11/30/2022]
Abstract
AIM Adults living with severe mental illness experience a greater burden of physical comorbidities and earlier mortality than the general population. Malnutrition, overnutrition, dysphagia, constipation and disordered eating have been observed in this population and can lead to poor nutritional status. Early identification of such conditions may reduce their impact on functional status, quality of life and health outcomes. This scoping review aimed to identify all nutrition risk screening methods published in English internationally for use with adults living with severe mental illness and ascertain which, if any, were validated for the target population. METHODS A four-step search strategy was used to search six electronic databases and grey literature, from inception to April 2020, for articles reporting nutrition risk screening methods used in this population. Information on the content and validity of screening methods was extracted and analysed by three independent reviewers. RESULTS Seventeen nutrition risk screening methods were identified, of which three were validated within a population of adults with severe mental illness. One screening method was found for both malnutrition and dysphagia risk, respectively, and three for constipation risk. No single method was found for overnutrition. Eleven screening methods were identified for disordered eating risk, of which two were validated for the target population. CONCLUSIONS Nutrition risk screening methods and their validation in adults living with severe mental illness are inadequately researched. This scoping review highlights the need for future research to develop new or validate existing screening methods specifically for the target population.
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Affiliation(s)
- Lauren E Hancox
- Nutrition and Dietetics Group, School of Life and Environmental Sciences at the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Pui S Lee
- Nutrition and Dietetics Group, School of Life and Environmental Sciences at the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Natasha Armaghanian
- Faculty of Medicine and Health, Kolling Institute of Medical Research, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Vasant Hirani
- School of Life and Environmental Science at the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Georgia Wakefield
- Wellbeing Unit, Macquarie Hospital, Sydney, New South Wales, Australia
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14
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Furness T, Giandinoto JA, Wordie-Thompson E, Woolley S, Dempster V, Foster K. Improving physical health outcomes for people with severe mental illness: A proof-of-concept study of nurse practitioner candidate practice. Int J Ment Health Nurs 2020; 29:266-277. [PMID: 31793176 DOI: 10.1111/inm.12680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2019] [Indexed: 01/20/2023]
Abstract
People with severe mental illness have significantly reduced life expectancy and higher risk of cardiovascular diseases than the general population. There is a critical need for quality physical health care to improve consumers' health outcomes. There is minimal knowledge, however, on the impact of mental health nurse practitioner candidate (NPC) practices on consumers' health outcomes. The aim of this proof-of-concept study was to describe the impacts of NPC practices on the quality of physical healthcare provision and physical health outcomes (cardiovascular and cardiometabolic) of consumers in community mental health service settings. Using a mixed methods design, quantitative data were collected for 12 months prior to (Period 1), and 12 months during (Period 2), the candidacy period. Qualitative interviews were conducted with a purposive sample of n = 10 consumers to explore their perspectives on physical healthcare provision by the NPCs. During the 12-month candidacy period, the number of metabolic monitoring assessments rose from n = 55 in Period 1 to n = 146 in Period 2 (P < 0.01, χ2 = 41.20). Advanced practices provided by NPCs included taking an extensive holistic history and clinical examination, ordering diagnostic pathology, and clinical simulation of physical health medication prescription (under medical supervision). Analysis of consumer interviews resulted in two themes: (i) positive and helpful NPC health care and (ii) improvements in physical and mental health. The findings add new knowledge on specialist mental health nurse practitioner candidate roles and demonstrate the benefits these roles can have in reducing the significant morbidity and mortality of mental health consumers.
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Affiliation(s)
- Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Jo-Ann Giandinoto
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Emily Wordie-Thompson
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - Steve Woolley
- NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Vesna Dempster
- NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Kim Foster
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
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15
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Mellor C, Blackman J, Barker E, Bhula Z, Sibanda E, Rawlings E, Harrington D, Combe G. Wellbeing Wednesdays: nurse-led clinic for improving physical health care in a general adolescent inpatient unit. ACTA ACUST UNITED AC 2020; 29:230-235. [PMID: 32105537 DOI: 10.12968/bjon.2020.29.4.230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Young people with mental illness are at high risk of physical health complications. Physical healthcare on a general adolescent inpatient unit is complex. AIM To establish a wellbeing clinic to improve efficiency and quality of the physical healthcare offered and increase health promotion. METHODS Plan, Do, Study, Act (PDSA) cycles were used to drive this quality-improvement project. The authors audited 12 records before establishing the clinic and 12 at three further time points (6, 18 and 30 months post-intervention) to guide changes. RESULTS Results progressively improved over PDSA cycles. Time taken for initial investigations dropped. Compliance with medication monitoring and management of important physical health domains rose from zero in some cases to 100% in all but one area. CONCLUSIONS Establishing a dedicated physical health clinic in this setting is feasible and leads to improved performance against local and national standards. Mental health teams need to ensure physical health is prioritised.
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Affiliation(s)
- Catriona Mellor
- Specialty Doctor in Child and Adolescent Psychiatry, Oxford Health NHS Foundation Trust
| | - Jonathan Blackman
- Specialty Registrar in Old Age Psychiatry, Aneurin Bevan University Health Board
| | | | | | - Evelyn Sibanda
- Health Care Support Worker, Oxford Health NHS Foundation Trust
| | - Emma Rawlings
- Health Care Support Worker, Oxford Health NHS Foundation Trust
| | | | - Gillian Combe
- Consultant Child and Adolescent Psychiatrist, Oxford Health NHS Foundation Trust
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16
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Every-Palmer S, Romans SE, Stubbs R, Tomlinson A, Gandhi S, Huthwaite M. Experiences of Weight-Loss Surgery in People With Serious Mental Illness: A Qualitative Study. Front Psychiatry 2020; 11:419. [PMID: 32477191 PMCID: PMC7236816 DOI: 10.3389/fpsyt.2020.00419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 04/23/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Bariatric surgery is seldom accessed by people with serious mental illness, despite high rates of obesity in this population. It is sometimes assumed that patients with complex psychiatric histories will have poor post-surgical weight loss or exacerbation of psychiatric symptoms, although this is unsubstantiated. OBJECTIVES A qualitative descriptive study to explore personal experiences and the impact of bariatric surgery on physical and mental well-being and life-quality in individuals with serious mental illness. METHODS Nine adults with a history of bariatric surgery and concurrent severe depressive disorder, bipolar disorder, or schizoaffective disorder were interviewed about their experiences of bariatric surgery and its outcomes using semi-structured interview schedules. Data were transcribed and inductive thematic analysis undertaken. RESULTS Five broad themes emerged: (1) surgery was highly effective for weight loss, and resulted in subjective improvements in physical health, quality of life, and mental health described as being able to live a life; (2) recovering from surgery was a tough road, notably in the post-operative period where negative sequelae often anteceded benefits; (3) post-operative support was important, but sometimes insufficient, including from families, mental health services, and surgical teams; (4) most considered surgery life-changing, recommending it to others with mental illness and obesity, two had different experiences; (5) participants considered it discriminatory that people with mental illness were not referred or declined weight loss surgery. CONCLUSIONS Participants benefited from bariatric surgery and felt it should be offered to others with mental illness, but with additional care and support.
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Affiliation(s)
- Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
- *Correspondence: Susanna Every-Palmer,
| | - Sarah E. Romans
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Richard Stubbs
- Wakefield Obesity Surgery, Wakefield Hospital, Wellington, New Zealand
| | - Anneka Tomlinson
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Sophie Gandhi
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Mark Huthwaite
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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17
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Every-Palmer S, Flewett T, Dean S, Hansby O, Colman A, Weatherall M, Bell E. Eye movement desensitization and reprocessing (EMDR) therapy for posttraumatic stress disorder in adults with serious mental illness within forensic and rehabilitation services: a study protocol for a randomized controlled trial. Trials 2019; 20:642. [PMID: 31753032 PMCID: PMC6868700 DOI: 10.1186/s13063-019-3760-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 09/26/2019] [Indexed: 02/06/2023] Open
Abstract
Background Eye movement desensitization and reprocessing (EMDR) is an evidenced-based treatment for posttraumatic stress disorder (PTSD). Forensic mental health services provide assessment and treatment of people with mental illness and a history of criminal offending, or those who are at risk of offending. Forensic mental health services include high, medium, and low-security inpatient settings as well as prison in-reach and community outpatient services. There is a high prevalence of PTSD in forensic settings and posttraumatic experiences can arise in people who violently offend in the context of serious mental illness (SMI). Successful treatment of PTSD may reduce the risk of relapse and improve clinical outcomes for this population. This study aims to assess the efficacy, risk of harm, and acceptability of EMDR within forensic and rehabilitation mental health services, as compared to treatment as usual (routine care). Methods This is a single-blind, randomized controlled trial comparing EMDR therapy to the waiting list (routine care). Adult forensic mental health service users (n = 46) with SMI and meeting the criteria for PTSD will be included in the study. Participants will be randomized after baseline assessment to either treatment as usual plus waiting list for EMDR or to treatment as usual plus EMDR. The EMDR condition comprises nine sessions, around 60 min in length delivered weekly, the first of which is a case conceptualization session. The primary outcomes are clinician and participant-rated symptoms of PTSD, and adverse events. Secondary outcomes include psychotic symptoms, social functioning, level of disability, self-esteem, depressive symptoms, post-trauma cognitions, and broad domains of complex posttraumatic difficulties. A trained assessor blinded to the treatment condition will assess outcomes at baseline, 10 weeks, and 6 months. Additionally, grounded theory qualitative methods will be used to explore participant experience of EMDR for a subset of participants. Discussion This study will contribute to the currently limited evidence base for EMDR for PTSD in forensic settings. It is the first randomized clinical trial to assess the efficacy, risk of harm, and acceptability of EMDR for PTSD in people with SMI in either forensic, mental health inpatient, or custodial settings. Trial registration Australia and New Zealand Clinical Trials Network, ACTRN12618000683235. Registered prospectively on 24 April 2018.
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Affiliation(s)
| | - Tom Flewett
- Capital and Coast District Health Board, Wellington, New Zealand
| | | | | | | | | | - Elliot Bell
- University of Otago, Wellington, New Zealand
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