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Nardelli C, Bonanno GA, Chen S, Bortolon C. Emotion regulation flexibility and psychosis: A longitudinal study disentangling components of flexibility in psychosis-proneness. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024; 63:54-72. [PMID: 37846929 DOI: 10.1111/bjc.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES Flexibility in self-regulation has emerged as an important component of mental health. Previous findings found that deficits in two components of regulatory flexibility were linked cross-sectionally to psychosis-proneness. We aimed to replicate and extend these findings longitudinally. METHODS We measured psychosis-proneness and components of emotion regulation flexibility (i.e. context sensitivity, repertoire and feedback) at two time points with three months in between. RESULTS Two flexibility components predicted psychotic-like experiences. The ability to detect the absence of contextual cues was implicated in both positive and negative dimensions but through opposite pathways. Expressive suppression ability-a subcomponent of repertoire-predicted positive symptoms. None of the flexibility components predicted distress related to the symptoms. CONCLUSIONS The current study provides further evidence on the implication of emotion regulation flexibility in the longer-term maintenance of psychotic-like experiences. Future studies can advance this work further by evaluating possible bidirectional relationships between psychotic-like experiences and deficits in emotion regulation flexibility.
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Affiliation(s)
- Carla Nardelli
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, LIP/PC2S, Grenoble, France
| | | | - Shuquan Chen
- Teachers College, Columbia University, New York, USA
| | - Catherine Bortolon
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, LIP/PC2S, Grenoble, France
- Institut Universitaire de France, Paris, France
- C3R - Réhabilitation psychosociale et remédiation cognitive, Centre Hospitalier Alpes Isère, Grenoble, France
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2
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Christy A, Cavero D, Navajeeva S, Murray-O’Shea R, Rodriguez V, Aas M, Trotta G, Moudiab S, Garrido N, Zamora B, Sideli L, Wrobel AL, Salazar de Pablo G, Alameda L. Association Between Childhood Adversity and Functional Outcomes in People With Psychosis: A Meta-analysis. Schizophr Bull 2023; 49:285-296. [PMID: 36107860 PMCID: PMC10016406 DOI: 10.1093/schbul/sbac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Despite the accepted link between childhood adversity (CA) and psychotic disorders, evidence on the relationship between CA and poor functional outcome remains less consistent and has never been reviewed quantitatively. The aim of this meta-analysis was to systematically examine the association between CA and functional outcomes in people with psychotic disorders. STUDY DESIGN The study protocol was registered on the International Prospective Register of Systematic Reviews (CRD42021254201). A search was conducted across EMBASE, MEDLINE, PsycINFO, and Cochrane Libraries (CENTRAL) using search terms related to psychosis; CA (general, sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect); and functional outcomes (social, occupational, and general functioning [GF]). We conducted random-effects models, sensitivity and heterogeneity analyses, meta-regressions, and we assessed quality. STUDY RESULTS Our meta-analysis comprised 35 studies, including 10 568 cases with psychosis. General CA was negatively associated with GF (28 studies; r = -0.109, 95%CI = -0.161 to -0.05, P < .001), with greater effects in prospective data (10 studies; r = -0.151, 95% CI = -0.236 to -0.063, P = .001). General CA was also associated with social functioning (r = -0.062, 95% CI = -0.120 to -0.004, P = .018) but not occupational outcomes. All CA subtypes except sexual abuse were significantly associated with GF, with emotional and physical neglect showing the largest magnitudes of effect (ranging from r = -0.199 to r = -0.250). CONCLUSIONS This meta-analysis provides evidence for a negative association between general CA, specific subtypes, and general and social functional outcomes in people with psychosis.
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Affiliation(s)
- Angeline Christy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Daniela Cavero
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sujeena Navajeeva
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Rachel Murray-O’Shea
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
- NORMENT, Centre for Research on Mental Disorders, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Socayna Moudiab
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nathalia Garrido
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
| | - Blanca Zamora
- Universidad Internacional de la Rioja (UNIR), Logroño, Spain
| | - Lucia Sideli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Human Science, LUMSA University, Rome, Italy
| | - Anna L Wrobel
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Gonzalo Salazar de Pablo
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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3
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The efficacy and safety of cariprazine in the early and late stage of schizophrenia: a post hoc analysis of three randomized, placebo-controlled trials. CNS Spectr 2023; 28:104-111. [PMID: 35012696 DOI: 10.1017/s1092852921000997] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND The aim of the post hoc analysis was to better understand the efficacy and safety of cariprazine in patients with schizophrenia for less than 5 years (early stage) and for more than 15 years (late stage). METHODS Data from three phase II/III randomized, double-blind, placebo-controlled trials with similar design in patients with acute exacerbation of schizophrenia were pooled and patients with early and late stage of schizophrenia were determined. A mixed-effects model for repeated measures approach was applied and least square (LS) mean changes from baseline to week 6 on the Positive and Negative Syndrome Scale (PANSS) total and factor scores were reported. Descriptive statistics were used for safety analyses including treatment emergent adverse events (TEAEs) and discontinuation rates. RESULTS Overall, 460 patients were identified as being in the early and 414 in the late stage of schizophrenia. The pooled analysis evaluating mean change from baseline to week 6 in the PANSS total score indicated statistically significant difference between cariprazine and placebo in favor of cariprazine in both the early (LS mean difference [LSMD] -7.5 P < .001) and late stage (LSMD -6.7, P < .01) subpopulation. Early stage patients experienced similar amount of TEAEs (CAR 67.3%, PBO 54.1%) as patients in the late stage (CAR 69.6%, PBO 65.6%). CONCLUSION In conclusion, cariprazine, a potent D3-D2 partial agonist has been found to be safe and effective in the treatment of early and late stage schizophrenia.
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A Scoping and Systematic Review of Employment Processes and Outcomes for Young Adults Experiencing Psychosis. Community Ment Health J 2022; 59:728-755. [PMID: 36463531 DOI: 10.1007/s10597-022-01056-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 11/11/2022] [Indexed: 12/07/2022]
Abstract
Young adults who experience psychosis want to work but are less likely to be employed than their peers. Sixty two studies relating to young adults with psychosis and employment were reviewed following a systematic search of five databases: CINAHL, PsycINFO, MEDLINE, SCOPUS and EMBASE. Publication date ranged from 1973 to 2019 with > 70% between 2010 and 2019. Intervention was considered in 29 papers; critical appraisal revealed 90% of these had moderate to good methodological quality with only three RCTs. Of 11 intervention types "Early Intervention" and "Individual Placement and Support" were most common; both demonstrating positive impact on obtaining employment. The review identified minimal participant perspectives and great variability in: terminology used; the reporting of participant attributes; intervention characteristics and ways employment outcomes were measured. Employment processes identified were preparing for, seeking, obtaining, keeping and re-obtaining employment, with current research efforts focused on obtaining work. More focus is required on keeping and re-obtaining employment.
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Madi HI, Ismael NT, Hamaideh SH, Jaber AF. Occupational performance and satisfaction of individuals with mental disorders in Jordan: A cross-sectional study. Br J Occup Ther 2022. [DOI: 10.1177/03080226221089853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Individuals with mental disorders face challenges while performing occupations. Existing evidence is limited to Western countries and certain daily life occupations that do not explore all factors related to occupational performance. This study aimed to explore occupational performance and satisfaction in individuals with mental disorders, explore the challenging occupations, investigate the relationship between demographic characteristics to occupational performance and satisfaction, and investigate the factors affecting the occupational performance of individuals with mental disorders. Methods: This was a descriptive correlational cross-sectional study that used the convenience sampling method. It included 95 individuals with mental disorders that had a mean age of (34.46 ± 12.22) years, and were from different mental health care facilities. Additionally, this study used the Canadian Occupational Performance Measure instrument. Results: Individuals with mental disorders had a low mean occupational performance and satisfaction scores (5.8 ± 1.7), (5.2 ± 2.0), respectively. Instrumental Activities of Daily Living were the most reported challenging occupations. There was a relationship between work status and both occupational performance and satisfaction (r = 0.243, p = 0.018), (r = 0.239, p = 0.020), respectively. Also, there was a relationship between the diagnosis and occupational performance (r =0.219, p = 0.033), and work status predicted occupational performance (α ≤ 0.05). Work status is a predictor of occupational performance in individuals with mental disorders.
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Affiliation(s)
- Hanan I Madi
- Lab Instructor and Clinical Supervisor, Physical and Occupational Therapy Department, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa’a, Jordan
| | - Noor T Ismael
- Rehabilitation Sciences Department, Faculty of Applied Medical Sciences, The Jordan University of Science and Technology, Irbid, Jordan
| | - Shaher H Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa’a, Jordan
| | - Ala’a F Jaber
- Rehabilitation Sciences Department, Faculty of Applied Medical Sciences, The Jordan University of Science and Technology, Irbid, Jordan
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6
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Inman J, Bannigan K, Akhurst J. Occupational therapy and psychosis: POINTER feasibility study for a pragmatic clinical trial. Br J Occup Ther 2021. [DOI: 10.1177/03080226211000257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The dearth of clinical trials of individualised occupational therapy with people with a diagnosis of psychosis limits the evidence base globally for occupational therapy practice. This study evaluated the feasibility of conducting a pragmatic clinical trial. Method Mixed methods design using a pragmatic perspective; two-centre, one-group pretest-posttest study, at six months. POINTER Occupational Intervention Specification captured routine individualised occupational therapy. Process evaluation included recruitment, retention, intervention delivery, fidelity, adherence and outcome measurement. The primary outcome was participation in activities of everyday life, measured by Time Use Survey, Participation Scale and Utrecht Scale for Evaluation of Rehabilitation-Participation. The Canadian Occupational Performance Measure measured self-reported experience of and satisfaction with occupational performance. The Short Form-36v2 Health Survey measured health-related quality of life, a secondary outcome. Participants’ experiences were explored using a questionnaire. Intervention providers’ perspectives were investigated via the POINTER occupational intervention log and focus groups. Results Recruitment was (20/36) and drop-out 20% (4/20). Fidelity was 77%, and adherence was good; POINTER had validity and utility. Outcome measurement was acceptable to participants, indicating increased participation in activities of everyday life. Conclusion A larger clinical trial is merited; recruitment processes need further exploration, and outcome measurement needs refining.
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Affiliation(s)
- Joanne Inman
- Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
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Pothier W, Lecomte T, Cellard C, Delfosse C, Fortier S, Corbière M. La réinsertion professionnelle et le retour aux études chez les personnes en début d’évolution d’un trouble psychotique. SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1088182ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pothier W, Roy MA, Corbière M, Thibaudeau É, Achim AM, Wykes T, Reeder C, Chagnon Y, Cellard C. Personalized cognitive remediation therapy to facilitate return to work or to school in recent-onset psychosis. Neurocase 2020; 26:340-352. [PMID: 33119429 DOI: 10.1080/13554794.2020.1841797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Cognitive deficits are barriers to job acquisition or return to school, and can be reduced through Cognitive remediation therapy (CRT). The main goal of this multiple case study was to investigate the effect of personalized CRT on occupational status in three participants with a recent-onset psychosis. Two cases improved their occupational status at post-treatment, and showed improvements in cognitive, psychological, and/or clinical variables. This study suggests that personalized CRT may facilitate job acquisition or return to school. However, the different pathways showed by our cases indicate that personalized CRT may influence occupational status through multiple mechanisms, underlining the relevance of treatment personalization.
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Affiliation(s)
- William Pothier
- École De Psychologie, Université Laval , Québec, QC, Canada.,Centre De Recherche CERVO , Québec, QC, Canada
| | - Marc-André Roy
- Centre De Recherche CERVO , Québec, QC, Canada.,Département De Psychiatrie Et Neurosciences, Université Laval , Québec, QC, Canada
| | - Marc Corbière
- Département d'éducation et pédagogie, Université Du Québec À Montréal (UQÀM) , Montréal, Qc, Canada.,Centre De Recherche De l'Institut Universitaire En Santé Mentale De Montréal , Montréal, QC, Canada
| | - Élisabeth Thibaudeau
- École De Psychologie, Université Laval , Québec, QC, Canada.,Centre De Recherche CERVO , Québec, QC, Canada
| | | | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London , London, UK
| | - Clare Reeder
- Institute of Psychiatry, Psychology and Neuroscience, King's College London , London, UK
| | - Yvon Chagnon
- École De Psychologie, Université Laval , Québec, QC, Canada
| | - Caroline Cellard
- École De Psychologie, Université Laval , Québec, QC, Canada.,Centre De Recherche CERVO , Québec, QC, Canada
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Noiriel A, Verneuil L, Osmond I, Manolios E, Revah-Levy A, Sibeoni J. The Lived Experience of First-Episode Psychosis: A Systematic Review and Metasynthesis of Qualitative Studies. Psychopathology 2020; 53:223-238. [PMID: 33120385 DOI: 10.1159/000510865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 08/11/2020] [Indexed: 11/19/2022]
Abstract
Both research and care have focused on first episodes of psychosis (FEPs) as a way to address the issue of early stages of schizophrenia and to reduce the duration of untreated psychosis. The objective of this study was to explore specifically the lived experience of FEP from the point of view of patients and their families by applying a metasynthetic approach, including a systematic review of the literature and analyses of qualitative studies on the subject. This metasynthesis follows thematic synthesis procedures. Four databases were systematically searched for qualitative studies reporting FEP from the patient or family's perspective. Article quality was assessed with the Critical Appraisal Skills Program. Thematic analysis was used to identify key themes and synthesize them. Thirty-eight articles were included, covering data from 554 participants (378 patients and 176 relatives). Three themes emerged from the analyses: (1) When and how does a FEP start? (2) What are its negative and positive aspects? (3) How do patients and families recount FEPs? Our results found important discrepancies between the experiences of patients and those of their families, especially regarding positive aspects. In light of the confusion reported by patients and notable in our results, we also discuss the gap between the name, FEP, and the lived experience of patients and family members in order to explore its practical implications.
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Affiliation(s)
| | | | - Ingrid Osmond
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
| | - Emilie Manolios
- ECSTRA Team, UMR-1153, Inserm, Université de Paris, Paris, France.,Service de Psychologie et Psychiatrie de Liaison et d'Urgences, Hôpital Européen Georges Pompidou AP-HP, Hôpitaux Universitaires Paris Ouest, Paris, France
| | - Anne Revah-Levy
- ECSTRA Team, UMR-1153, Inserm, Université de Paris, Paris, France.,Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
| | - Jordan Sibeoni
- ECSTRA Team, UMR-1153, Inserm, Université de Paris, Paris, France, .,Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France,
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10
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Pothier W, Cellard C, Corbière M, Villotti P, Achim AM, Lavoie A, Turcotte M, Vallières C, Roy MA. Determinants of occupational outcome in recent-onset psychosis: The role of cognition. SCHIZOPHRENIA RESEARCH-COGNITION 2019; 18:100158. [PMID: 31463205 PMCID: PMC6710235 DOI: 10.1016/j.scog.2019.100158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 01/18/2023]
Abstract
Working or studying is a common goal among people with recent-onset psychosis. Cognitive deficits have been reported to influence occupational outcome, but to date few studies have evaluated if cognitive deficits independently predict occupational outcome when taking into account other important determinants, such as self-esteem, motivation, length of time absent from employment/school, job/school search behaviours, subjective cognitive complaints and psychotic symptoms. Hence, this longitudinal study aimed to evaluate the role of cognition, as well as other key factors relevant to occupational outcome, to predict occupational status six months after baseline in people with recent-onset psychosis. A total of 27 participants receiving treatment in rehabilitation programs were included in the study. Neuropsychological, psychological, clinical and occupational measures were administered at baseline, and occupational status was collected six months later. Ordinal regression indicated that working memory and length of time absent from employment/school at baseline predicted 48.1% of the variance of occupational status at six months, with both variables showing a unique significant contribution to the model. These results suggest that working memory could be integrated in comprehensive models of occupational outcome in people with recent-onset psychosis. In addition, supported employment and education programs could target cognitive deficits and length of time absent from employment/school to help these individuals to acquire a job or return to school given their strong predictive value on occupational outcome.
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Affiliation(s)
- William Pothier
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Caroline Cellard
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Marc Corbière
- Université du Québec à Montréal (UQÀM), 405 Rue Sainte-Catherine Est, H2L 2C4, Montréal, Canada.,Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401 Rue Hochelaga, Pavillon Riel, Aile 228, H1N 3M5 Montréal, Canada
| | - Patrizia Villotti
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401 Rue Hochelaga, Pavillon Riel, Aile 228, H1N 3M5 Montréal, Canada
| | - Amélie M Achim
- Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Andréanne Lavoie
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Mélissa Turcotte
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Chantal Vallières
- Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Marc-André Roy
- Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada.,Département de psychiatrie et neurosciences de l'Université Laval, 1050 avenue de la Médecine, G1V 0A6 Québec, Canada
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11
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Giordano G, Tomassini L, Cuomo I, Amici E, Perrini F, Callovini G, Carannante A, Kotzalidis GD, De Filippis S. Aripiprazole Long-Acting Injection During First Episode Schizophrenia-An Exploratory Analysis. Front Psychiatry 2019; 10:935. [PMID: 31969843 PMCID: PMC6960223 DOI: 10.3389/fpsyt.2019.00935] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/25/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Long-acting injectable (LAI) aripiprazole was found to be efficacious in schizophrenia. In common clinical practice, the use of LAIs is often restricted to chronic patients with frequent relapses and poor adherence. Recently, some investigators advanced the idea of early LAI use also in young people with schizophrenia at their first psychotic episode (FEP). Objective: Our study aimed to assess the effect of LAI aripiprazole once monthly (AOM) in the treatment of FEP in patients aged 18-26 years. Methods: We included 50 patients with DSM-5 schizophrenia as assessed with SCID, and used the Clinical Global Impressions Scale-Severity of Illness (CGI-S) and the Positive and Negative Syndrome Scale (PANSS) to assess symptom severity and the World Health Organization Quality of Life (WHOQOL), the Short Form Health Survey (SF-36) and the Personal and Social Performance Scale (PSP) to assess quality of life (QoL) and global health perception at baseline and 3, 6, 9, and 12 months after the first AOM injection. Results: AOM was associated with a progressive improvement, compared to baseline, of both positive (p < 0.001) and negative (p < 0.001) symptoms and in general psychopathology (p < 0.001) and decrease in global severity (p < 0.001). We also observed progressive improvement in QoL and social and personal functioning. Treatment adherence was 78% at study endpoint. Our results support that AOM may improve psychotic symptoms, QoL and social functioning in young FEP patients. Further studies should compare AOM to its oral formulation in the treatment of young patients with schizophrenia at the outset of their illness.
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Affiliation(s)
| | | | - Ilaria Cuomo
- ASL Roma 1, Istituto Penitenziario Regina Coeli, Rome, Italy
| | - Emanuela Amici
- Villa Von Siebenthal Neuropsychiatric Clinic, Rome, Italy
| | - Filippo Perrini
- Istituto A.T. Beck-Diagnostic Centre, Research and Training in Cognitive-Behavioral Psychotherapy, Rome, Italy
| | | | | | - Georgios D Kotzalidis
- Villa Von Siebenthal Neuropsychiatric Clinic, Rome, Italy.,NESMOS Department Neurosciences-Mental Health- and Sensory Organs, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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12
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Boychuk C, Lysaght R, Stuart H. Career Decision-Making Processes of Young Adults With First-Episode Psychosis. QUALITATIVE HEALTH RESEARCH 2018; 28:1016-1031. [PMID: 29557298 DOI: 10.1177/1049732318761864] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The first episode of psychosis often emerges during young adulthood, when individuals are pursuing important educational and career goals that can become derailed because of the development of major impairments. Past research has neglected the developmental nature of employment and education decisions that young adults with first-episode psychosis make within the context of their lives. The purpose of this grounded theory study was to advance a model of the career decision-making processes of young adults with first-episode psychosis, and the influences that affect their career decision-making. The career decision-making of young adults with first-episode psychosis emerged as a multistaged, iterative process that unfolded over three phases of illness, and was affected by several internal and environmental influences. These findings suggest the phase of illness and career decision-making stage should be considered in future vocational programming for young adults with first-episode psychosis.
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Early Intervention in Psychosis: Health of the Nation Outcome Scales (HoNOS) Outcomes From a Five-Year Prospective Study. Arch Psychiatr Nurs 2017; 31:553-560. [PMID: 29179820 DOI: 10.1016/j.apnu.2017.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 06/09/2017] [Accepted: 07/15/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Over the last two decades, mental health services internationally have shifted towards intervening early in psychosis. The critical period for intervention is estimated to be five-years and many specialised programs target early psychosis. AIM/QUESTION This prospective cohort study aimed to evaluate five-year outcomes from an early psychosis program (EPP) that adopted an integrated model, providing nursing and multidisciplinary community mental healthcare to clients aged 16-65years, beyond the typical age range of 16-25years. METHOD We examined one routine outcome measure, the Health of the Nation Outcome Scales (HoNOS) across episodes of care for clients receiving EPP over a 5year period (n=239), comparing these results with HoNOS outcomes in an Australian national dataset for all public mental health clients. RESULTS HoNOS improvements were highly significant from intake to discharge and from review to discharge for EPP clients, and these compared well with national outcome performance. CONCLUSION There is potential for mental health nurses and other clinicians to significantly improve client symptoms and functioning, in a model of early psychosis treatment beyond a youth focus.
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Posters. Br J Occup Ther 2014. [DOI: 10.1177/03080226140770s804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hitch D, Pepin G, Stagnitti K. Engagement in Activities and Occupations by People Who Have Experienced Psychosis: A Metasynthesis of Lived Experience. Br J Occup Ther 2013. [DOI: 10.4276/030802213x13603244419194] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose: The purpose of this study was to answer the question ‘How do people who have experienced psychosis describe their engagement in activities of daily living and occupations?’ Procedures: A qualitative metasynthesis was undertaken on nine studies (encompassing 73 participants) published in occupational therapy literature. Only studies that had used individual qualitative interviews were included to highlight lived experience on a personal level. The quality of the evidence was assessed across all studies and found to be generally high. Findings: Four overarching themes across the nine studies were identified: my emotions and identity; my own health and wellbeing; my relationships with family, friends and community; and my activities and occupations. The overarching themes are not intended to be considered categorically, as they all influence and interact with each other. Conclusion and relevance: There is considerable synchronicity between the experiences of people who have experienced psychosis and the values of the profession. A client's meaningful engagement in activities and occupation is evidence towards how therapists provide authentic, respectful and effective support to these clients, in a manner that meets their needs as individuals.
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Affiliation(s)
- Danielle Hitch
- Lecturer and Fieldwork Educator, Occupational Science and Therapy Programme, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Genevieve Pepin
- Senior Lecturer, Occupational Science and Therapy Programme, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Karen Stagnitti
- Professor, Occupational Science and Therapy Programme, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
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