1
|
Martinelli A, Bonetto C, Pozzan T, Procura E, Cristofalo D, Ruggeri M, Killaspy H. Exploring gender impact on collaborative care planning: insights from a community mental health service study in Italy. BMC Psychiatry 2023; 23:834. [PMID: 37957583 PMCID: PMC10644654 DOI: 10.1186/s12888-023-05307-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION Personal recovery is associated with socio-demographic and clinical factors, and gender seems to influence the recovery process. This study aimed to investigate: i) differences in the recovery goals of men and women users of a community mental health service in Italy; ii) any differences by gender in recovery over six months using the Mental Health Recovery Star (MHRS). METHODS Service users and staff completed the MHRS together at recruitment and six months later to agree the recovery goals they wished to focus on. Socio-demographic and clinical characteristics and ratings of symptoms (BPRS), needs (CAN), functioning (FPS), and functional autonomy (MPR) were collected at recruitment and six months follow-up. Comparisons between men and women were made using t-tests. RESULTS Ten women and 15 men completed the MHRS with 19 mental health professionals. Other than gender, men and women had similar socio-demographic, and clinical characteristics at recruitment. Women tended to choose recovery goals that focused on relationships whereas men tended to focus on work related goals. At follow-up, both men and women showed improvement in their recovery (MHRS) and women were less likely to focus on relationship related goals, perhaps because some had found romantic partners. There were also gains for both men and women in engagement with work related activities. Ratings of functional autonomy (MPR) improved for both men and women, and men also showed improvement in symptoms (BPRS) and functioning (FPS). CONCLUSIONS Our findings suggest that collaborative care planning tools such as the MHRS can assist in identifying individualized recovery goals for men and women with severe mental health problems as part of their rehabilitation.
Collapse
Affiliation(s)
| | - Chiara Bonetto
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Tecla Pozzan
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Elena Procura
- Mental Health Center, Isola Della Scala, Ospedale Di Bussolengo, Verona, Italy
| | - Doriana Cristofalo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Mirella Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Helen Killaspy
- Division of Psychiatry, University College London, London, UK
| |
Collapse
|
2
|
Matsuoka S. Development of a Culturally Sensitive Recovery-Oriented Nursing Care Model in Community Psychiatric Nursing. J Psychosoc Nurs Ment Health Serv 2023; 61:25-33. [PMID: 36479868 DOI: 10.3928/02793695-20221202-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
The current study aimed to develop a culturally sensitive recovery-oriented nursing care model in community psychiatric nursing. Through an exploration of recovery-oriented nursing care based on cultural sensitivity, which was done in a prior study and through a literature review, an initial model with six categories was developed. Semi-structured interviews were performed with eight community psychiatric nurses who used the model for 2 months in practice. Qualitative description was used to analyze the data. Participants completed a list of care items in each category of the model to compare ease of practice. The model was further refined to three levels of culturally sensitive nursing care. The model showed the importance of reflection based on recognition of cultural influences, relinquishing the power of the profession, and cooperation that accepts diverse values. [Journal of Psychosocial Nursing and Mental Health Services, 61(8), 25-33.].
Collapse
|
3
|
Concerto C, Rodolico A, Mineo L, Ciancio A, Marano L, Romano CB, Scavo EV, Spigarelli R, Fusar-Poli L, Furnari R, Petralia A, Signorelli MS. Exploring Personal Recovery in Schizophrenia: The Role of Mentalization. J Clin Med 2023; 12:4090. [PMID: 37373783 PMCID: PMC10299717 DOI: 10.3390/jcm12124090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Recovery is a broadly debated concept in the field of psychiatry research and in schizophrenia. Our study aims to understand the correlation between personal recovery from schizophrenia and factors such as mentalization, disability, quality of life, and antipsychotic side effects; Methods: Participants with schizophrenia (according to DSM-5 criteria) were consecutively recruited from the Psychiatry Unit of the University of Catania, Italy. Participants were assessed with the Recovery Assessment Scale (RAS), the Multidimensional Mentalizing Questionnaire (MMQ), the brief version of the WHO Disability Assessment Schedule (WHO-DAS), the EuroQoL-5 dimensions-5 levels, the Insight Orientation Scale (IOS) and the Glasgow Antipsychotic Side Effect Scale (GASS); Results: 81 patients were included. Our findings showed a positive correlation between RAS total scores and MMQ scores, especially in "good mentalizing" subdomains. IOS scores also had a positive association with RAS and MMQ scores. In contrast, poor mentalizing abilities negatively correlated with WHO-DAS 2.0 scores. While antipsychotic side effects influenced functioning, they did not impact perceived recovery. Conclusions: The study's results identified potential predictors of personal recovery from schizophrenia. These findings could contribute to creating tailored interventions to facilitate the recovery process.
Collapse
Affiliation(s)
- Carmen Concerto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Ludovico Mineo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Alessia Ciancio
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Leonardo Marano
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Carla Benedicta Romano
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Elisa Vita Scavo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Riccardo Spigarelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Laura Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Rosaria Furnari
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Antonino Petralia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| | - Maria Salvina Signorelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (C.C.); (A.C.); (E.V.S.); (A.P.); (M.S.S.)
| |
Collapse
|
4
|
Lakshman SJ, Mohd Daud TI, Midin M, Ahmad F, Tommy K. Validation of the Malay-Version of Recovery Knowledge Inventory among mental health providers in Malaysia. Front Psychiatry 2023; 14:1078423. [PMID: 37383615 PMCID: PMC10293667 DOI: 10.3389/fpsyt.2023.1078423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/30/2023] [Indexed: 06/30/2023] Open
Abstract
Background The Recovery Knowledge Inventory (RKI) is a widely used self-report instrument that assesses recovery-oriented knowledge among mental health professionals. The purpose of this study is to translate the RKI into the Malay language (RKI-M) and to examine its psychometric properties among Malaysian health care workers. Methods A cross-sectional study involving 143 participants was conducted at an urban teaching hospital, an urban government hospital, and a rural government hospital. Following the translation of the RKI, its internal reliability was determined using Cronbach's alpha. Construct validity was also determined using confirmatory factor analysis. Results The Malay-Version RKI (RKI-M) has good internal reliability with a Cronbach's alpha of 0.83. However, the Malay-version RKI failed to replicate the original four-factor structure. The final model only achieved the best model fit after the removal of 9 items with two-factor loadings: (GFI = 0.92; AGFI = 0 0.87; CFI = 0.91; RMSEA = 0.074). Conclusion The 20-item RKI-M is reliable but has poor construct validity. However, the modified 11-item Malay-version RKI is a more reliable measure as it has good construct validity, with room for future studies to examine the psychometric properties of the modified 11-item RKI among mental health care workers. More training on recovery knowledge should be done, and a simple worded questionnaire should be developed in keeping with local practitioners.
Collapse
Affiliation(s)
- Stella Jane Lakshman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
- Department of Psychiatry, Hospital Selayang, Batu Caves, Selangor, Malaysia
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | | | - Kezia Tommy
- Faculty of Business and Economics, University Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
5
|
Ponce-Correa F, Caqueo-Urízar A, Berrios R, Escobar-Soler C. Defining recovery in schizophrenia: A review of outcome studies. Psychiatry Res 2023; 322:115134. [PMID: 36871410 DOI: 10.1016/j.psychres.2023.115134] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/07/2023]
Abstract
Schizophrenia is a chronic disorder with a heterogenous course and different ways in which recovery is measured or perceived. Recovery in schizophrenia is a complex process that it can be defined either from a clinical perspective focused on sustained symptom and functional remission, or from a patient-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. Until now, studies analysed these domains separately, without examining their mutual relations and changes over time. Therefore, this meta-analysis aimed to examine the relationship of global measures of subjective recovery with each of the components of clinical recovery such as symptom severity and functioning, in patients with schizophrenia spectrum disorders. The results showed that the association between different indicators of personal recovery and remission are weak and inverse (dIG+ = -0.18, z = -2.71, p < 0.01), however, this finding is not substantial according to the sensitivity indicators. With respect to functionality and personal recovery, there was a moderate relationship (dIG+ = 0.26, z = 7.894, p < 0.01) with adequate sensitivity indices. In addition, a low consensus exists between subjective measures that are more related to the patient's perspective and clinical measures based on experts and clinician's viewpoint.
Collapse
Affiliation(s)
- Felipe Ponce-Correa
- Programa Doctorado en Psicología, Escuela de Psicología y Filosofía, Facultad de Ciencias Sociales y Jurídicas, Universidad de Tarapacá, Avenida 18 de Septiembre N 2222, Casilla 7-D, Arica, Chile
| | | | - Raúl Berrios
- Departamento de administración, Facultad de administración y economía, Universidad de Santiago de Chile, Chile
| | - Carolang Escobar-Soler
- Programa Doctorado en Psicología, Escuela de Psicología y Filosofía, Facultad de Ciencias Sociales y Jurídicas, Universidad de Tarapacá, Avenida 18 de Septiembre N 2222, Casilla 7-D, Arica, Chile
| |
Collapse
|
6
|
Tan BL, Shi J, Yang S, Loh H, Ng D, Choo C, Medalia A. The use of virtual reality and augmented reality in psychosocial rehabilitation for adults with neurodevelopmental disorders: A systematic review. Front Psychiatry 2022; 13:1055204. [PMID: 36590624 PMCID: PMC9794993 DOI: 10.3389/fpsyt.2022.1055204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives Virtual reality and augmented reality have been used in psychosocial rehabilitation for adults with neurodevelopmental disorders in recent years, to provide functional training in a scaffolded and appealing manner. This systematic review attempted to evaluate (1) how virtual reality or augmented reality technology was deployed, when used as an intervention for adults with neurodevelopmental disorders; and (2) how virtual or augmented reality-assisted psychosocial rehabilitation programs impacted on the functional domains of community living, employment and social participation. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was adopted and a search of publications between June 2012 and June 2022 was carried out. The target groups were adults with schizophrenia/schizoaffective disorders, autism spectrum disorder, intellectual disabilities and attention deficit hyperactivity disorder. Interventions that targeted at least one functional domain were included. Results The database search generated 1,267 records and 38 studies met the inclusion criteria. Three studies utilized augmented reality while the rest utilized virtual reality. The virtual scenarios were displayed in various ways, such as head-mounted displays, computer screens, mobile devices and cave rooms. A few studies also used features such as speech recognition, eye tracking and motion-capture device to provide real-time feedback to participants during rehabilitation. Eleven studies reported interventions that addressed community living, 15 studies addressed vocational skills and nine studies trained participants in social skills or social cognition. Three studies sought to improve quality of life using virtual scenarios to expose participants to various situations. Majority of these studies reported preliminary promising results, with improvement in the functional domains addressed. However, several studies had small sample sizes and many single-arm pretest-posttest studies were assessed to be of serious or critical risk of bias. Conclusion Virtual reality and augmented reality are deployed in various ways to augment psychosocial rehabilitation for adults with neurodevelopmental disorders. Most interventions target skills training or strategy learning in the areas of community living, work and social participation. Preliminary positive findings of their effects on functional performance were reported. Larger and robust studies using ecologically valid outcome measures will be needed to establish their effects on real-world functional outcomes. Systematic review registration identifier: CRD42022335443.
Collapse
Affiliation(s)
- Bhing-Leet Tan
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
- Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Jing Shi
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Suyi Yang
- Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Hannah Loh
- Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Desiree Ng
- Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Cherie Choo
- Occupational Therapy Department, Institute of Mental Health, Singapore, Singapore
| | - Alice Medalia
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| |
Collapse
|
7
|
Mezes B, Lobban F, Costain D, Hillier L, Longson D, Varese F, Jones SH. Recovery beyond clinical improvement - Recovery outcomes measured for people with bipolar disorder between 1980 and 2020. J Affect Disord 2022; 309:375-392. [PMID: 35469910 DOI: 10.1016/j.jad.2022.04.075] [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: 12/03/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Outcome measurement in bipolar disorder (BD) traditionally focused on clinical improvement without considering other domains. Improvement trajectories in clinical and social-functional domains are different and can simultaneously appear in one while not in other domains. Measuring personal recovery (PR) has become a priority internationally. This review explored the shift in research investigating operational recovery definitions and underpinning factors of recovery in BD over the past four decades. METHODS Studies defining recovery domains (other than clinical recovery) in BD were systematically reviewed; operational recovery definitions and factors assessed in association with recovery were thematically categorised and integrated in a narrative synthesis. RESULTS Thirty-three studies, comprising 3638 participants from 19 countries were included. Identified operational recovery definition themes included i) PR ii) social-functional (SFR), and iii) occupational-residential (ORR) recovery. Examined factors were grouped as demographic, clinical and psychosocial factors. Predominantly demographic factors were linked to ORR and clinical factors to SFR. Depressive symptomatology was the only clinical factor associated with PR. Research investigating psychosocial factors in PR is emerging and has showed that resilience and appraisals of mood seem to be associated with PR. LIMITATIONS Studies not available in English or examining functioning without defining recovery were excluded. CONCLUSIONS Earlier operational recovery definitions of ORR and SFR were often arbitrary and inconsistent, and predominantly focused on clinical and demographic underpinning factors. While research attempts to follow the significant policy shifts towards personalised care by measuring what matters to individuals and exploring broader underpinning psychosocial factors, it is still lagging behind.
Collapse
Affiliation(s)
- Barbara Mezes
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK; Centre of Resilience for Social Justice, School of Sport and Health Sciences, University of Brighton, Brighton, UK.
| | - Fiona Lobban
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK
| | - Deborah Costain
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
| | - Laura Hillier
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK
| | - Damien Longson
- Manchester Academic Health Science Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Filippo Varese
- Manchester Academic Health Science Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK; Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, the University of Manchester, Manchester, UK
| | - Steven H Jones
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK
| |
Collapse
|
8
|
Effects of Recovery Measures on Internalized Stigma in Patients Diagnosed with Schizophrenia. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00847-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
|
9
|
Kanehara A, Koike H, Fujieda Y, Yajima S, Kabumoto A, Kumakura Y, Morita K, Miyamoto Y, Nochi M, Kasai K. Culture-dependent and universal constructs and promoting factors for the process of personal recovery in users of mental health services: qualitative findings from Japan. BMC Psychiatry 2022; 22:105. [PMID: 35144562 PMCID: PMC8832737 DOI: 10.1186/s12888-022-03750-4] [Citation(s) in RCA: 3] [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: 02/20/2021] [Accepted: 01/28/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The conceptualization of personal recovery began in Europe and North America and has spread worldwide. However, the concept of personal recovery in addition to recovery-promoting factors may be influenced by culture. We explored how users of mental health services in Japan perceive their own personal recovery and the factors that promote it. METHODS We conducted semi-structured interviews and focus group interviews with individuals using mental health services. The interview data were analysed using thematic analysis with a grouped framework analysis approach. We used a coding framework based on the existing CHIME framework (connectedness, hope and optimism about the future, identity, meaning in life, and empowerment). RESULTS Data were obtained from 30 users of mental health services (mean age: 40.4 years; 46.7% women; 50.0% with schizophrenia). "Compassion for others" was newly extracted in "Connectedness", and "Rebuilding/redefining identity not being as shaped by social norms" was newly extracted in "Identity" as personal recovery. "Positive experiences in childhood" (including positive parenting support from neighbours) was newly extracted as a recovery-promoting factor. CONCLUSIONS Our unique findings on the rebuilding identity/defining identity free from conformity to social norms due to interactions with familiar people, including peers, may be culture dependent. This study raises overarching questions regarding how socio-cultural values influence the development of identity and personal values and how they are in turn reflected in personal recovery.
Collapse
Affiliation(s)
- Akiko Kanehara
- Department of Neuropsychiatry, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Haruna Koike
- grid.419280.60000 0004 1763 8916Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yumiko Fujieda
- grid.412708.80000 0004 1764 7572Department of Rehabilitation, University of Tokyo Hospital, Tokyo, Japan
| | - Sayaka Yajima
- grid.412708.80000 0004 1764 7572Department of Rehabilitation, University of Tokyo Hospital, Tokyo, Japan
| | - Asami Kabumoto
- grid.412708.80000 0004 1764 7572Department of Rehabilitation, University of Tokyo Hospital, Tokyo, Japan
| | - Yousuke Kumakura
- grid.26999.3d0000 0001 2151 536XDepartment of Mental Health/ Psychiatric Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Kentaro Morita
- grid.412708.80000 0004 1764 7572Department of Rehabilitation, University of Tokyo Hospital, Tokyo, Japan
| | - Yuki Miyamoto
- grid.26999.3d0000 0001 2151 536XDepartment of Psychiatric Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Masahiro Nochi
- grid.26999.3d0000 0001 2151 536XDepartment of Clinical Psychology, University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- grid.26999.3d0000 0001 2151 536XDepartment of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan ,grid.26999.3d0000 0001 2151 536XThe International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
| |
Collapse
|
10
|
Chirio-Espitalier M, Schreck B, Duval M, Hardouin JB, Moret L, Bronnec MG. Exploring the Personal Recovery Construct in Bipolar Disorders: Definition, Usage and Measurement. A Systematic Review. Front Psychiatry 2022; 13:876761. [PMID: 35815013 PMCID: PMC9263970 DOI: 10.3389/fpsyt.2022.876761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022] Open
Abstract
Personal recovery from psychiatric disorders is a journey toward a satisfying and hopeful life despite the possible persistence of symptoms. This concept has gained interest and become an increasingly important goal in mental health care programmes. Personal Recovery is well described in the context of severe mental illnesses in general, but little is known about this journey in bipolar disorders and the factors underlying it. A systematic review was conducted according to the PRISMA recommendations, focusing on studies exploring personal recovery in bipolar disorder specifically. The latter have integrated a comprehensive approach to the concept, the existing means of measurement or have explored the levers of recovery in care. Twenty-four articles were selected, including seven qualitative, 12 observational, and five interventional studies. The Bipolar Recovery Questionnaire was the only scale developed de novo from qualitative work with bipolar people. Personal recovery did not correlate very closely with symptomatology. Some elements of personal recovery in bipolar disorder were similar to those in other severe mental illnesses: meaning in life, self-determination, hope, and low self-stigma. Specific levers differed: mental relationships with mood swings, including acceptance and decrease in hypervigilance, and openness to others, including trust and closeness. The studies highlighted the role of caregiver posture and the quality of communication within care, as well as the knowledge gained from peers. The choice to exclude articles not focused on bipolar disorder resulted in the provision of very specific information, and the small number of articles to date may limit the scope of the evidence. New components of personal recovery in bipolar disorder emerged from this review; these components could be taken into account in the construction of care tools, as well as in the caregiving posture. Strengthening skills of openness to others could also be a central target of recovery-focused care.
Collapse
Affiliation(s)
- Marion Chirio-Espitalier
- Nantes University, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France.,Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Benoit Schreck
- Nantes University, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France.,Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Melanie Duval
- Department of Public Health, University Hospital of Nantes, Nantes, France
| | - Jean-Benoit Hardouin
- Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Leila Moret
- Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France.,Department of Public Health, University Hospital of Nantes, Nantes, France
| | - Marie Grall Bronnec
- Nantes University, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France.,Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| |
Collapse
|
11
|
Mitsunaga-Ohmuro N, Ohmuro N. Longitudinal changes in personal recovery in individuals with psychotic disorders through hospitalisation in a psychiatric ward: preliminary findings. BMC Psychiatry 2021; 21:340. [PMID: 34238286 PMCID: PMC8265086 DOI: 10.1186/s12888-021-03347-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aimed to investigate whether personal recovery indices in individuals with psychotic disorders would change through hospitalisation in a psychiatric ward and to identify factors associated with these changes. METHODS Participants underwent assessments for personal recovery using the Questionnaire about the Process of Recovery, Recovery Assessment Scale, and Self-Identified Stage of Recovery Part A and B; clinical symptoms using the Positive And Negative Syndrome Scale; self-efficacy using the General Self-Efficacy Scale; and self-esteem using the Rosenberg Self-Esteem Scale at baseline and before hospital discharge. Wilcoxon signed-rank tests were administered for longitudinal comparisons between baseline and follow-up. Spearman's rank correlation tests were conducted to assess correlations of longitudinal changes in personal recovery with baseline values of personal recovery as well as baseline values or changes in the Positive And Negative Syndrome Scale, General Self-Efficacy Scale, and Rosenberg Self-Esteem Scale. RESULTS Thirty-four individuals with psychotic disorders completed the assessments. The average duration of the current hospitalisation was 81.9 days (SD, 15.3; median, 85.0; range, 51-128 days). No significant changes were observed in personal recovery, self-efficacy, and self-esteem, although clinical symptoms significantly improved. Significant correlations were found between positive changes in the Recovery Assessment Scale and improvements in negative symptoms; between positive changes in the General Self-Efficacy Scale and those in personal recovery assessed with the Questionnaire about the Process of Recovery, Recovery Assessment Scale, and Self-Identified Stage of Recovery part A; and between positive changes in the Rosenberg Self-Esteem Scale and those in the Self-Identified Stage of Recovery part B. CONCLUSION This study revealed longitudinal relationships between changes in personal recovery and amelioration of negative symptoms or enhancement of self-efficacy and self-esteem through moderate length of hospitalisation in individuals with psychotic disorders. Considering the small sample size in this study, further studies with a larger sample size are needed to confirm the present finding. TRIAL REGISTRATION The protocol of this study is registered in the UMIN Clinical Trials Registry (UMIN-CTR; ID: UMIN000035131 ).
Collapse
Affiliation(s)
- Norika Mitsunaga-Ohmuro
- Department of Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - Noriyuki Ohmuro
- grid.459827.50000 0004 0641 2751Department of Psychiatry, Osaki Citizen Hospital, Osaki, Miyagi Japan
| |
Collapse
|
12
|
Argentzell E, Bäckström M, Lund K, Eklund M. Exploring mediators of the recovery process over time among mental health service users, using a mixed model regression analysis based on cluster RCT data. BMC Psychiatry 2020; 20:520. [PMID: 33126873 PMCID: PMC7602343 DOI: 10.1186/s12888-020-02924-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/19/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Personal recovery is associated with many significant health-related factors, but studies exploring associations between activity factors and personal recovery among service users are scarce. The aims of this study were hence to; 1) investigate if various aspects of activity may mediate change in recovery while also acknowledging clinical, sociodemographic and well-being factors; 2) explore the effects of two activity-based interventions, Balancing Everyday Life (BEL) or standard occupational therapy (SOT), on personal recovery among service users. METHODS Two-hundred-and-twenty-six service users were included in a cluster RCT, 133 from BEL units and 93 from SOT units. Participants commonly had a diagnosis of mood disorder and the mean age was 40. Instruments used targeted activity, mastery and functioning. A mixed-model regression analysis was employed. RESULTS The model tested was whether selected variables could be used to mediate the change in recovery from the start to a six-month follow-up after intervention. Participants' personal recovery increased after treatment and increased further at the follow-up. The general level of recovery was negatively related to a diagnosis of depression/anxiety, both before and after treatment, but depressed/anxious service users still increased their recovery. There were no significant relations between recovery and sex or age. The interactions between change in recovery and changes in depression/anxiety, satisfaction with activities, sex, and age were all non-significant. All possible treatment mediators included were related to change in recovery, the strongest being occupational engagement and mastery, followed by activity satisfaction and symptoms. Mediation was shown by the decrease in the effect of the time factor (from intervention start to completion) when the covariates were introduced. In all cases the time variable was still significant. When testing a model with all variables simultaneously as covariates, occupational engagement and mastery were strongly significant. There was no difference between interventions regarding recovery improvement. CONCLUSION The treatments were equally beneficial and were effective regardless of gender, age and diagnosis. Those who gained most from the treatment also gained in feelings of mastery and activity engagement. Activity engagement also moderated the level of recovery. To enhance recovery, interventions should facilitate meaningful activities and gaining control in life. TRIAL REGISTRATION The study was registered with ClinicalTrials.gov . Reg. No. NCT02619318 . Retrospectively registered: December 2, 2015.
Collapse
Affiliation(s)
- Elisabeth Argentzell
- Lund University, Department of Health Sciences, the Mental Health, Activity and Participation (MAP) group, Box 157, 221 00, Lund, Sweden.
| | - Martin Bäckström
- grid.4514.40000 0001 0930 2361Lund University, Department of Psychology, Box 213, 221 00 Lund, Sweden
| | - Kristine Lund
- grid.4514.40000 0001 0930 2361Lund University, Department of Health Sciences, the Mental Health, Activity and Participation (MAP) group, Box 157, 221 00 Lund, Sweden
| | - Mona Eklund
- grid.4514.40000 0001 0930 2361Lund University, Department of Health Sciences, the Mental Health, Activity and Participation (MAP) group, Box 157, 221 00 Lund, Sweden
| |
Collapse
|
13
|
Tan BL, Zhen Lim MW, Xie H, Li Z, Lee J. Defining Occupational Competence and Occupational Identity in the Context of Recovery in Schizophrenia. Am J Occup Ther 2020; 74:7404205120p1-7404205120p11. [PMID: 32602451 DOI: 10.5014/ajot.2020.034843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
IMPORTANCE The Occupational Self Assessment (OSA) measures two constructs from the Model of Human Occupation: occupational competence and occupational identity. In the field of mental health, the recovery movement has sparked discussions about what constitutes personal, clinical, and functional recovery. However, how occupation-based terminologies are related to the recovery framework is unclear. OBJECTIVE To elucidate how domains of recovery and psychological constructs are related to the OSA's constructs of occupational competence and occupational identity in order to inform occupational therapy practice in the recovery arena. DESIGN Cross-sectional study. SETTING Outpatient mental health unit. PARTICIPANTS Sixty-six community-dwelling adults with schizophrenia recruited through convenience sampling. OUTCOMES AND MEASURES Participants completed the OSA and clinical, functional, and personal recovery assessments. They also completed five scales that measured psychological constructs of recovery such as hope, resilience, empowerment, internalized stigma, and subjective well-being. Participants also identified up to four OSA items that were priorities for change. Tests of association and multiple regression analyses were conducted to identify predictors of occupational competence and occupational identity. RESULTS Personal recovery predicted occupational competence, whereas depressive symptoms and hope predicted occupational identity. Functional and clinical recovery did not predict occupational competence. The top three OSA priorities for change were performance items: "managing my finances," "concentrating on my tasks," and "taking care of myself." CONCLUSIONS AND RELEVANCE Occupational therapy interventions should not be limited to functional improvement. Instead, they should account for clients' affective states and seek to instill recovery-oriented psychological states such as hope and efficacy. WHAT THIS ARTICLE ADDS Occupational competence is achieved by enhancing personal states of self-efficacy in fulfilling valued occupations rather than through functional improvement. The top three occupations prioritized for change were performance tasks that were observable by service users and immediate caregivers. Empowering clients to partake in these everyday performance tasks such as finance management, concentrating on tasks, and self-care may pave the way to enhancing occupational competence and identity.
Collapse
Affiliation(s)
- Bhing-Leet Tan
- Bhing-Leet Tan, PhD, is Associate Professor, Programme Director (Occupational Therapy), and Deputy Cluster Director (Applied Learning), Singapore Institute of Technology, and Principal Occupational Therapist, Institute of Mental Health, Singapore; or
| | - Madeline Wei Zhen Lim
- Madeline Wei Zhen Lim, BA, PSY, is Research Psychologist, Research Division, Institute of Mental Health, Singapore
| | - Huiting Xie
- Huiting Xie, PhD, RN, is Senior Nurse Educator, Institute of Mental Health, Singapore
| | - Ziqiang Li
- Ziqiang Li, PhD, RN, is Nurse Educator, Institute of Mental Health, Singapore
| | - Jimmy Lee
- Jimmy Lee, MBBS, is Psychiatrist and Senior Consultant, Department of Psychosis, Institute of Mental Health, and Associate Professor, Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| |
Collapse
|
14
|
Development and Evaluation of a Recovery-Oriented Cognitive Behavioural Workshop for People Diagnosed with Schizophrenia. Behav Cogn Psychother 2018; 47:400-406. [PMID: 30375308 DOI: 10.1017/s1352465818000607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is a need to develop culturally adapted interventions that support the personal recovery and real-world functioning of people diagnosed with schizophrenia. AIMS This study reports on the development and evaluation of a culturally adapted, recovery-oriented, cognitive behavioural workshop for service users with schizophrenia. METHOD The feasibility and acceptability were assessed, as were changes over time in personal recovery and psychosocial functioning (primary outcomes) along with psychopathology and health-related behaviours (secondary outcomes), using multi-level modelling. It was also assessed whether personal recovery predicts psychosocial functioning. RESULTS The workshop was feasible and was received favourably. Participants improved over time regarding confidence and hope, feeling less dominated by symptoms, psychosocial functioning, and psychopathology. Personal recovery predicted decreased psychosocial difficulties. CONCLUSIONS The workshop is a promising intervention. It shows potential in terms of both improving personal recovery as well as real-life functioning of people diagnosed with schizophrenia. Further workshop evaluation in a randomized controlled study is required.
Collapse
|
15
|
Chan SHW, Tse S. Coping with amplified emotionality among people with bipolar disorder: A longitudinal study. J Affect Disord 2018; 239:303-312. [PMID: 30031250 DOI: 10.1016/j.jad.2018.07.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/20/2018] [Accepted: 07/08/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The amplified emotionality characteristics of bipolar disorder (BD) may interfere with goal pursuit in the recovery process. This is the first study to test the coping flexibility model empirically among people with BD. Finding ways to cope with goal-striving life events should shed light on managing elevated mood states. METHODS Using a 12-month longitudinal follow-up design, this study examined the stability in coping flexibility with experimentally-devised Behavioral Approach System (BAS) activating life events and mood states at 6- and 12-month time points for individuals with BD (n = 83) and healthy controls (n = 89). Hierarchical linear modeling tested the individual growth model by studying the longitudinal data. RESULTS The findings showed fluctuations in different components of coping flexibility and mood states across time. They confirmed the amplified emotionality characteristics of BD. Moreover, coping flexibility took precedence over BAS sensitivity and psychosocial functioning levels in predicting mood states. LIMITATIONS Measurements of BAS sensitivity may focus on trait nature only and prone to subjective bias. The assessment of mood or coping flexibility may not accurately capture actual experience in daily life. Lack of respective data on bipolar subtypes and significant differences in some dimensions between the BD and control groups are further limitations of the study. CONCLUSIONS The study's findings have implications for coping with amplified emotionality within the personal recovery process for people with BD. Judicious application of coping strategies and adjustment of perceived controllability are crucial for individuals to reach goals pertinent to personal recovery and manage potential manic mood symptoms.
Collapse
Affiliation(s)
- Sunny H W Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Samson Tse
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
16
|
Chiba R, Umeda M, Goto K, Miyamoto Y, Yamaguchi S, Kawakami N. The property of the Japanese version of the Recovery Knowledge Inventory (RKI) among mental health service providers: a cross sectional study. Int J Ment Health Syst 2017; 11:71. [PMID: 29299055 PMCID: PMC5745615 DOI: 10.1186/s13033-017-0178-7] [Citation(s) in RCA: 9] [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: 08/16/2017] [Accepted: 12/11/2017] [Indexed: 12/22/2022] Open
Abstract
Background The Recovery Knowledge Inventory (RKI) is one of the influential scales to assess knowledge and attitude toward recovery-oriented practices among mental health service providers. In the present study, we aimed to develop a Japanese version of RKI and examine the validity and reliability. Methods We translated RKI into Japanese by reference to the guidelines for translating and adapting psychometric scales. A cross-sectional questionnaire survey was conducted with mental health service providers. Of a total of 475 eligible professionals, we used data from the 299 participants without missing value for the analyses (valid response rate = 62.9%). The questionnaire included Japanese RKI, Recovery Attitudes Questionnaire, The positive attitudes scale, and Japanese-language version of the Social Distance Scale. To examine the factorial validity of RKI, explanatory factor analysis and confirmatory factor analysis was employed. Convergent validity was assessed by calculating Pearson’s correlation coefficients between the total RKI score and the scores for the other three scales. We also calculated Cronbach’s α coefficients for the total score and for each domain of RKI to assess internal consistency reliability. Results The participants’ mean age was 40.4 years and 30.4% were men. 20-item RKI did not provide any adequate or interpretable factor solutions at any number of factors by EFAs. Thus four items (#1, 4, 5, and 13) were subsequently eliminated in stages, then 16-item RKI was employed as a consequence for further analyses. EFA with four factor structures yielded marginally interpretable constitution. Each factor represented the knowledge regarding psychiatric symptoms and recovery; knowledge about the recovery process; the understanding of what is important for recovery; and the understanding of the challenges and responsibility in recovery, respectively. Subsequent CFA suggested good fit to the data. Good convergent validity and understandable internal consistency reliability were also observed. Conclusions The Japanese 16-item RKI revealed reasonable factorial validity, good convergent validity, and understandable internal consistency reliability among mental health professionals. Japanese cultural settings seemed to influence the four-factor structure in the present study. It can be used for future study in Japan, while future large-scale research is required to ensure robust verification.
Collapse
Affiliation(s)
- Rie Chiba
- Research Institute of Nursing Care for People and Community, University of Hyogo, 13-71 Kitaoji-cho, Akashi, Hyogo 673-8588 Japan
| | - Maki Umeda
- Department of Public Health Nursing, Graduate School of Nursing, St Luke's International University, 10-1, Akashi-cho, Chuo-ku, Tokyo, 104-0044 Japan
| | - Kyohei Goto
- Tokyo Musashino Hospital, 4-11-11, Komone, Itabashi-ku, Tokyo, 173-0037 Japan
| | - Yuki Miyamoto
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Sosei Yamaguchi
- Department of Psychiatric Rehabilitation, Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8553 Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| |
Collapse
|
17
|
Grover S, Hazari N, Aneja J, Chakrabarti S, Sharma S, Avasthi A. Recovery and its correlates among patients with bipolar disorder: A study from a tertiary care centre in North India. Int J Soc Psychiatry 2016; 62:726-736. [PMID: 27815514 DOI: 10.1177/0020764016676214] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM The goal of treatment in mental illness has evolved from a symptom-based approach to a personal recovery-based approach. The aim of this study was to evaluate the predictors of personal recovery among patients with bipolar disorder. METHODOLOGY A total of 185 patients with bipolar disorder, currently in remission, were evaluated on Recovery Assessment Scale (RAS), Internalized Stigma of Mental Illness Scale (ISMIS), Brief Religious coping scale (RCOPE), Duke University Religiosity Index (DUREL), Religiousness Measures Scale, Hamilton depression rating scale (HDRS), Young Mania rating scale (YMRS) and Global Assessment of Functioning (GAF) scale. RESULTS The mean age of the sample was 40.5 (standard deviation (SD), 11.26) years. Majority of the participants were male, married, working, Hindu by religion and belonged to extended/joint families of urban background. In the regression analysis, RAS scores were predicted significantly by discrimination experience, stereotype endorsement and alienation domains of ISMIS, level of functioning as assessed by GAF, residual depressive symptoms as assessed by HDRS and occupational status. The level of variance explained for total RAS score and various RAS domains ranged from 36.2% to 46.9%. CONCLUSION This study suggests that personal recovery among patients with bipolar disorder is affected by stigma, level of functioning, residual depressive symptoms and employment status of patients with bipolar disorder.
Collapse
Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Nandita Hazari
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Jitender Aneja
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sunil Sharma
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| |
Collapse
|
18
|
Oliveira-Maia AJ, Mendonça C, Pessoa MJ, Camacho M, Gago J. The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness. Front Psychol 2016; 7:1679. [PMID: 27857698 PMCID: PMC5093119 DOI: 10.3389/fpsyg.2016.01679] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/12/2016] [Indexed: 12/20/2022] Open
Abstract
Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective well-being in patients suffering from SMI.
Collapse
Affiliation(s)
- Albino J Oliveira-Maia
- Champalimaud Clinical Centre, Champalimaud Centre for the UnknownLisboa, Portugal; Champalimaud Research, Champalimaud Centre for the UnknownLisboa, Portugal; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa OcidentalLisboa, Portugal; Department of Psychiatry and Mental Health, NOVA School of Medicine - Faculdade de Ciências Médicas, Universidade Nova de LisboaLisboa, Portugal
| | - Carina Mendonça
- Department of Psychiatry and Mental Health, Centro Hospitalar Cova da Beira Covilhã, Portugal
| | - Maria J Pessoa
- Department of Psychiatry and Mental Health, Centro Hospitalar Cova da Beira Covilhã, Portugal
| | - Marta Camacho
- Champalimaud Research, Champalimaud Centre for the Unknown Lisboa, Portugal
| | - Joaquim Gago
- Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa OcidentalLisboa, Portugal; Department of Psychiatry and Mental Health, NOVA School of Medicine - Faculdade de Ciências Médicas, Universidade Nova de LisboaLisboa, Portugal
| |
Collapse
|
19
|
Lo TL, Warden M, He Y, Si T, Kalyanasundaram S, Thirunavukarasu M, Amir N, Hatim A, Bautista T, Lee C, Emsley R, Olivares J, Yang YK, Kongsakon R, Castle D. Recommendations for the optimal care of patients with recent-onset psychosis in the Asia-Pacific region. Asia Pac Psychiatry 2016; 8:154-71. [PMID: 27062665 PMCID: PMC4834614 DOI: 10.1111/appy.12234] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 12/29/2015] [Indexed: 12/31/2022]
Abstract
Providing optimal care to patients with recent-onset psychosis can improve outcomes and reduce relapse. However, there is a lack of consistency of the implementation of guidelines for such patients across the Asia-Pacific region. We determined a pragmatic set of recommendations for use on a day-to-day basis to help provide optimal care at this crucial stage of illness. The recommendations were developed over a series of meetings by an international faculty of 15 experts from the Asia-Pacific region, Europe, and South Africa. A structured search of the PubMed database was conducted. This was further developed based on the faculty's clinical experience and knowledge of the literature into 10 key aspects of optimal care for patients during the first five years of a diagnosis of a psychotic disorder, with particular relevance to the Asia-Pacific region. Several common principles emerged: adherence to antipsychotic medications is crucial; substance abuse, psychiatric and medical comorbidities should be addressed; psychosocial interventions play a pivotal role; and family members can play a vital role in overall patient care. By following these recommendations, clinicians may improve outcomes for patients with recent-onset psychosis.
Collapse
Affiliation(s)
| | - Matthew Warden
- Hobart and Southern CMHTTasmanian Health Organisation – SouthTasmaniaAustralia
| | - Yanling He
- Department of Epidemiology Shanghai Mental Health CenterShanghai Jiao Tong UniversitySchool of MedicineShanghaiChina
| | - Tianmei Si
- Department of PsychopharmacologyPeking University Institute of Mental HealthPekingChina
| | | | | | - Nurmiati Amir
- Department of Psychiatry National General HospitalCiptomangunkusumo/Faculty of MedicineUniversity of IndonesiaJakartaIndonesia
| | - Ahmad Hatim
- Department of Psychological MedicineUniversity of MalayaKuala LumpurMalaya
| | - Tomas Bautista
- College of Medicine Philippine General HospitalUniversity of the PhilippinesManilaPhilippines
| | - Cheng Lee
- Department of Community PsychiatryInstitute of Mental HealthSingapore
| | - Robin Emsley
- Department of PsychiatryUniversity of StellenboschStellenboschSouth Africa
| | - Jose Olivares
- Department of PsychiatryComplejo Hospitalario Universitario de VigoVigoSpain
| | - Yen Kuang Yang
- Department of PsychiatryNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainan CityTaiwan
| | | | - David Castle
- Department of PsychiatrySt. Vincent's HospitalThe University of MelbourneMelbourneAustralia
| |
Collapse
|
20
|
Chiba R, Umeda M, Goto K, Miyamoto Y, Yamaguchi S, Kawakami N. Psychometric properties of the Japanese version of the Recovery Attitudes Questionnaire (RAQ) among mental health providers: a questionnaire survey. BMC Psychiatry 2016; 16:32. [PMID: 26883208 PMCID: PMC4755029 DOI: 10.1186/s12888-016-0740-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 02/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND "Recovery" is a central concept in mental health, particularly for mental health services and policy-makers. The present study examined the factorial and concurrent validity, internal consistency reliability, and test-retest reliability of the Japanese version of the 7-item Recovery Attitudes Questionnaire (RAQ) among mental health service providers in community and inpatient settings in Japan. METHODS We conducted a cross-sectional questionnaire with a number of eligible professional groups, including psychiatrists, registered/assistant nurses, public health nurses, clinical psychologists, pharmacists, occupational therapists, and social workers. Participants were drawn from two psychiatric hospitals and 56 psychiatric clinics or community service agencies. In total, 331 participants completed the questionnaire. After excluding those with missing RAQ values, 307 participants were included in the analysis; the participants' mean age was 40.2 years and 29.6 % were men. The questionnaire comprised the Japanese version of the 7-item RAQ developed by the present authors, the revised scale of the positive attitudes of staff toward persons with mental disorder (the positive attitudes scale), and the Japanese-language version of the Social Distance Scale (SDSJ). Confirmatory factor analyses were used to examine factorial validity of a two-factor structure reported in a previous study (Borkin et al., 2000) as well as a single-factor structure. Concurrent validity was determined by calculating correlations between RAQ and the other two scales. Internal consistency reliability was assessed with Cronbach's alpha coefficients and inter-item correlations. Test-retest reliability was assessed by the intraclass correlation coefficient (ICC), with a weighted kappa in a subsample of participants (n = 13). RESULTS The two-factor structure showed acceptable factorial validity. RAQ scores were significantly and positively correlated with the positive attitudes scale, and there was a significant inverse correlation with the SDSJ (p < 0.01). The RAQ had an overall Cronbach's alpha coefficient of 0.64. Four inter-item correlations were not significant. The ICC and weighted kappa values indicated unsatisfactory test-retest reliability. CONCLUSION The Japanese RAQ showed acceptable factorial validity, reasonable concurrent validity, and unsatisfactory reliability in community and inpatient mental health settings in Japan. Further large-scale research is required to ensure robust verification.
Collapse
Affiliation(s)
- Rie Chiba
- School of Nursing, Jichi Medical University, 3311-159, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.
| | - Maki Umeda
- Faculty of Community Health Nursing/ Public Health Nursing, St Luke's, International University, 10-1, Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan.
| | - Kyohei Goto
- Tokyo Musashino Hospital, 4-11-11, Komone, Itabashi-ku, Tokyo, 173-0037, Japan.
| | - Yuki Miyamoto
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Sosei Yamaguchi
- Department of Psychiatric Rehabilitation, Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8553, Japan.
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| |
Collapse
|
21
|
Abstract
BACKGROUND Two discourses exist in mental health research and practice. The first focuses on the limitations associated with disability arising from mental disorder. The second focuses on the possibilities for living well with mental health problems. DISCUSSION This article was prompted by a review to inform disability policy. We identify seven findings from this review: recovery is best judged by experts or using standardised assessment; few people with mental health problems recover; if a person no longer meets criteria for a mental illness, they are in remission; diagnosis is a robust basis for characterising groups and predicting need; treatment and other supports are important factors for improving outcome; the barriers to receiving effective treatment are availability, financing and client awareness; and the impact of mental illness, in particular schizophrenia, is entirely negative. We selectively review a wider range of evidence which challenge these findings, including the changing understanding of recovery, national mental health policies, systematic review methodology and undertainty, epidemiological evidence about recovery rates, reasoning biased due to assumptions about mental illness being an illness like any other, the contested nature of schizophrenia, the social construction of diagnoses, alternative explanations for psychosis experiences including the role of trauma, diagnostic over-shadowing, stigma, the technological paradigm, the treatment gap, social determinants of mental ill-health, the prevalence of voice-hearing in the general population, and the sometimes positive impact of psychosis experience in relation to perspective and purpose. CONCLUSION We propose an alternative seven messages which are both empirically defensible and more helpful to mental health stakeholders: Recovery is best judged by the person living with the experience; Many people with mental health problems recover; If a person no longer meets criteria for a mental illness, they are not ill; Diagnosis is not a robust foundation; Treatment is one route among many to recovery; Some people choose not to use mental health services; and the impact of mental health problems is mixed.
Collapse
Affiliation(s)
- Mike Slade
- King's College London, Health Service and Population Research Department (Box P029), Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill, London, SE5 8AF, UK.
| | - Eleanor Longden
- Institute of Psychology, Health and Society, University of Liverpool, Block B, 2nd Floor, Waterhouse Building, Liverpool, L69 3GL, UK.
| |
Collapse
|