Psychological interventions to enhance positive outcomes in adult cancer caregivers: A systematic review

This systematic review aims to examine the characteristics of psychological interventions that aim to enhance positive outcomes, such as wellbeing, post-traumatic growth, or hope in cancer caregivers. Studies published until December 2023 were searched on PubMed, Scopus, PsycINFO, WOS, PsycARTICLES and were included when examining interventions targeting positive outcomes with adult cancer caregivers. Of the 1424 articles retrieved through the databases, 16 studies were eligible for inclusion in this review, targeting 908 caregivers (70.2% female; Mage = 53.5). A narrative synthesis was used to describe the interventions, which were based on a variety of approaches such as psychoeducation, mindfulness, or Existential Behavioral Therapy, and reported positive gains for the positive outcomes. The results show few randomized controlled trials published to date, highlight the contrast between the focus shift towards these outcomes and the need for systematic testing of the interventions, to be able to inform evidence-based service delivery.

Which psychological interventions improve quality of life in patients with schizophrenia-spectrum disorders? A meta-analysis of randomized controlled trials

Quality of life (QoL) is a major patient reported outcome used to measure the psychological treatments success in people with schizophrenia-spectrum disorders. To date, the specific impact of different interventions on QoL remains undefined. A meta-analysis of Randomized Controlled Trials (RCTs) was carried out for this purpose. We searched Proquest, PUBMED/MEDLINE, PsycINFO, WOS, Scopus, the Cochrane Library for RCTs published until January 2023. We used multilevel meta-analysis to examine differences between intervention effectiveness of experimental and control conditions whilst accounting for data dependencies. By means of subgroup analyses, we investigated influences of intervention types (i.e. psychoeducation v. CBT v. cognitive v. combination of several types v. other, such as psychodynamic, systemic, etc.) and continuous moderators were examined with precision-weighted meta-regressions. The generalizability of results across moderators, their combinations, and analytical approaches was investigated with multiverse meta-analyses. We examined data of 60 independent studies, reporting intervention effects for objective and subjective QoL (k = 19 and 70 effect sizes based on N = 1024 and 6254 participants, respectively). Overall, psychological interventions seemed to be more effective for objective than for subjective QoL. However, specific intervention results were differentiated, suggesting largest effects of psychoeducation on objective and combined interventions on subjective QoL. Our findings suggest that QoL is a valid outcome criterion for testing intervention effectiveness, as it is sensitive to change. Additionally, psychological interventions can improve patients' QoL, though the effects are small. Further testing of less widely used interventions and a shift toward the multidimensional nature of QoL is still necessary.

A meta-analysis of cognitive interventions for patients with recent onset psychosis: are they effective for improving functioning?

The increasing popularity of cognitive interventions for patients with psychosis calls for further exploration on how these interventions may benefit functional outcomes. We conducted a meta-analysis of randomized controlled trials (RCTs) to examine the effectiveness of cognitive interventions (i.e. Cognitive Remediation, Cognitive Training, Social Cognition, and their combination) on functioning of patients with recent onset psychosis, established as the period within the first five years from the first episode. The following databases were searched: Proquest, PUBMED/MEDLINE, PsycINFO, WOS, Scopus for research published until January 2022. In total, 12 studies were eligible. The total number of participants was 759, of which 32.2% in the intervention and 30.8% in the control group were female. We extracted data to calculate the standardized mean change from pre-test to post-test comparing the intervention with the control conditions. Overall, there was no effect of any of the cognitive intervention types on functioning. None of the examined factors (intervention type, length, and modality; control condition, follow-up time; cognitive functions; medication; symptoms) seemed to moderate these findings. Our results indicate that cognitive interventions as standalone interventions do not appear to improve functioning in patients with recent onset psychosis. Given the small number of eligible studies, further RCTs with larger and more refined samples are needed to test whether these interventions should be applied as single interventions with these patients.

Psychosocial risk and protective factors associated with burnout in police officers: A systematic review

BACKGROUND

The specific factors that may influence burnout levels in police officers are not yet clear. Our aim was to systematically identify the psychosocial risk and protective factors associated with burnout among police officers.

METHODS

This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). A protocol was registered in PROSPERO. A search strategy was applied to Medline via OvidSP, PsycInfo, Scopus and Web of Science. The quality assessment entailed the use of the CASP checklist for cohort studies. The data was reported through a narrative synthesis.

RESULTS

After removing studies based on the selection criteria, 41 studies were included in this review. The findings were synthesized under the following subheadings: socio-demographic; organisational; operational; individual and coping strategies. Organisational and operational factors were found to be risk factors for burnout. Individual factors and coping strategies revealed risk and protective factors. Social interaction-related factors were mostly protective. Socio-demographic factors were weak in explaining burnout.

LIMITATIONS

Most studies are from high-income countries. Not all used the same burnout measurement tool. All relied on self-reported data. Lastly, 98 % had a cross-sectional design, causal inferences could not be made.

CONCLUSIONS

Burnout, despite being strictly defined as an occupational phenomenon, is related to factors outside of this context. Future research should focus on examining the reported associations by using more robust designs. More attention must be paid to police officers' mental health by investing in developing strategies to mitigate adverse factors and maximise the effects of protective factors.

Subjective quality of life factorial structure across mental disorders: should we switch to assessing dimensions?

A two-factor structure of subjective quality of life (SQoL) was established for patients with schizophrenia with the dimensions being 'Life and Health' and 'Living Environment'. This study investigated whether the same structure applies in patients with mood and anxiety disorders and, if so, whether the dimension scores differ between the three diagnostic groups. SQoL data of 1366 patients with mood and 419 patients with anxiety disorders obtained on the Manchester Short Assessment of Quality of Life (MANSA) were retrieved from 3 multisite studies. We performed Confirmatory Factor Analyses (CFAs) based on the MANSA SQoL items of each diagnostic sample. Next, through a series of Kruskal-Wallis and Mann-Whitney tests, we compared the scores of the two factors across patients with mood disorders, anxiety disorders and schizophrenia. The two CFAs showed adequate fit of the two-factor structure across mood and anxiety disorders. The dimension scores on 'Life and Health' differed significantly between all three diagnostic groups. They were lowest in patients with anxiety disorders, higher in patients with mood disorders and highest in patients with schizophrenia. However, on the 'Living Environment' dimension, patients with mood disorders had significantly higher scores than patients with schizophrenia, whilst patients with anxiety disorders did not differ significantly from either other group. The findings suggest that a two-factor structure of SQoL applies across mental disorders. The two dimensions vary across diagnostic groups in different ways. Assessing two dimensions of SQoL may provide more specific and relevant information than global scores.

The implementation of teletherapy with patients with Severe Mental Illness during the COVID-19 first wave and its longitudinal association with hospitalisations: A retrospective multicenter study from Spain

Introduction

The COVID-19 related restrictions such as social distancing forced the search for feasible alternatives to the provision of care for patients with severe mental illness (SMI), with services opting for teletherapy as an substitute of face-to-face treatment.

Objectives

To examine the implementation of teletherapy (telephone, videoconference) with patients with SMI during the COVID-19 first wave, and explore its associations with reduced hospitalisations after the first wave was over.

Methods

We performed a retrospective assessment of 270 records of patients visiting fifteen outpatient mental health services across Spain during 2020. We retrieved sociodemographic and clinical data, including modality of received therapy (in-person, telephone, videoconference) in three time points (before, during and after the first COVID-19 wave) and hospitalisation rates two, four and six months later.

Results

During the first wave, services implemented teletherapy (telephone and videoconference) extensively, whilst they reduced face-to-face therapy, though this returned to previous levels after the first wave. Hospitalisations two months later did not differ between patients who received teletherapy, and those who did not (p=.068). However, hospitalisations were lower for the first group of patients four (p =.004) and six months later (p <.001). Multilevel analyses suggested that receiving teletherapy by videoconference during the first wave was the factor that protected patients most against hospitalisations six months later (OR=0.25; p=.012).

Conclusions

Our findings suggest that teletherapy plays a protective role against hospitalisations, especially when face-to-face therapy is not feasible. Therefore, it can be considered a valid alternative to ensure continuity of care to patients with SMI.

Disclosure

No significant relationships.

How to involve carers in the acute care: An online training for clinicians across four sites in England

Introduction

Involving carers in the care of people with severe mental illness is known to bring positive treatment and psychosocial outcomes. However, evidence-based procedures to guide clinicians on how to involve carers in the acute care are lacking.

Objectives

To provide an online training to clinicians working in the acute care regarding the organisation of a standardised meeting with the service user and their carer within the first week of hospitalisation, and explore their views after its implementation.

Methods

We trained six clinicians across four urban and rural sites in England, asked them to incorporate the meeting in their routine care provision and interviewed them to explore their experiences.

Results

Clinicians reported training advantages such as ease of use, comprehensiveness and transferable skills, and meeting advantages such as shared goals development and acknowledgement of carer involvement value. They also mentioned challenges related to organisational/time constraints, expectations management, and distance to the hospital for carers. Clinicians suggested to further focus on carer motivation to engage, to use skills throughout admission rather than in a one-off session, and to provide a structured meeting summary. Those experiences were shared across sites, indicating similar benefits and challenges, not depending on the specific setting characteristics.

Conclusions

Providing structured training to clinicians may increase carer involvement in routine care in acute settings. Given the workload in such settings training endeavours should be brief and include skills that clinicians can apply to facilitate shared goal development and expectations management. The use of online meetings may allow increased carer participation in the acute care.

Disclosure

No significant relationships.

Stigma towards schizophrenia in Cyprus: Does studying a mental health related programme make a difference?

BACKGROUND AND AIMS

Students from mental health related programmes may display stigmatising attitudes towards people of schizophrenia, however there are no data available on this population in Cyprus. The purpose of the present study was (a) to examine the levels of contact and stigma towards schizophrenia in Cypriot students of programmes related to mental health and students of other programmes and (b) to examine whether the successful recognition of a person with schizophrenia through a vignette and the estimation of severity levels was related to stigmatising attitudes.

METHODS

The participants were undergraduate students purposively selected across Cypriot universities (N = 152). A vignette depicting a person with schizophrenia, followed by the OMI to examine stigma and the BAE to examine contact with mental illness were used to collect the data.

RESULTS

The results showed that studying a mental health related programme and being a man was associated with more positive views related to social integration. No further stigma dimensions were predicted by the included variables. Similarly, level of contact and being able to identify the mental condition and estimate its severity was not related to stigma.

CONCLUSION

The results emphasise the need to develop educational interventions to tackle stigma across students independently of their study programme and enhance mental health related programmes with opportunities for structured contact with patients with mental illness.

Carer involvement in the transition from inpatient to community mental healthcare: Experiences of stakeholders

Introduction

The involvement of informal carers (family and friends) in the care of people with severe mental illness (SMI) contributes to positive clinical outcomes, such as relapse prevention and symptom reduction. To date, the care pathway between inpatient and community care is not clearly defined impeding the smooth transition for patients, whilst carers are still barely involved in shared decision-making processes.

Objectives

To investigate the views and experiences of patients with SMI, carers and clinicians regarding the transition from inpatient to community mental health services.

Methods

Four mixed focus groups were conducted with individuals with SMI (n=12), carers (n=10) and clinicians (n=9) across four different mental health catchment areas in England. Participants discussed their experiences and provided their views on facilitators, barriers and solutions for carer involvement during the transition between mental health services. Data were analysed using thematic analysis.

Results

All stakeholders highlighted that factors that impede carer involvement are related to: confidentiality issues, unmet (structural and organisational) needs, and carer expectations. Patients with SMI, carers and clinicians agreed that carer involvement can be improved by providing psychoeducation to carers and training to staff, having accessible and transparent clinical procedures, and allocating specialised staff to carers.

Conclusions

The study findings emphasise that carer involvement is still overlooked, particularly when adults with SMI transition between services. The results provide guidance for practice emphasising the need for systematic involvement of carers across inpatient care, and for future research proposing effective ways of maximising carer involvement in mental health care.

Disclosure

No significant relationships.

Teletherapy and hospitalizations in patients with serious mental illness during the COVID-19 pandemic: A retrospective multicenter study

BACKGROUND

Interventions with patients with Serious Mental Illness (SMI) had to adapt rapidly to the COVID-19 safety restrictive measures, leading to the widespread use of teletherapy as an alternative.

OBJECTIVES

The aims of this study were to compare the use of different intervention modalities with patients with SMI during the first wave of the pandemic and examine their association with emergency hospital visits and hospitalization rates six months later.

METHODS

Records of 270 service users of fifteen outpatient mental health services across Spain, were retrospectively assessed. We retrieved clinical data and data on the modality of intervention received (in-person, over the phone, videoconferencing) in three time points (before, during and after the first COVID-19 wave). Also, data were retrieved regarding the frequency of their emergency hospital visits and hospitalization rates, two, four and six months later.

RESULTS

During the first wave of the pandemic, teletherapy (over the phone and videoconferencing) was the modality most widely used, whilst in-person therapy sessions were significantly reduced, though they seemed to return to pre-COVID levels after the first wave had passed. Importantly, patients receiving teletherapy during the first wave seemed to have significantly fewer emergency visits and hospitalization rates four and six months later (χ2 = 13.064; p < .001). Multilevel analyses revealed that patients receiving videoconferencing interventions had fewer hospitalizations six months after the first wave (OR = 0.25; p = .012).

CONCLUSIONS

Under challenging circumstances as those created by the COVID pandemic, teletherapy is a useful tool for protection against hospitalizations and can be used as an alternative to in-person therapy, to ensure continuity of care for patients with SMI.

Involvement of informal carers in discharge planning and transition between hospital and community mental health care: A systematic review

WHAT IS KNOWN ON THE SUBJECT

Family members and friends (informal carers) are very important for providing support to people with mental health difficulties. When these carers are included to care planning patients seem to benefit, as they are less likely to relapse.

WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE

There are three types of interventions including carers in the patients'transition 1) programmes that offer education in hospital; 2) programmes that involve carers in planning the patients discharge; and 3) programmes that involve carers in hospital care, discharge planning and also follow-up in the community. Interventions including carers that take place both in the hospital and the community have the clearest evidence for benefit on relapse reduction.

WHAT ARE THE IMPLICATIONS FOR PRACTICE

Comprehensive interventions have the best evidence for effectiveness but challenges in their implementation and resourcing should be considered. It might worth trying to identify and test simpler interventions focusing on discharge planning that can be used in busy services and require more limited resources whilst providing opportunities for the participation of carers.

ABSTRACT

INTRODUCTION: Involving informal carers (family and friends of patients) in mental health interventions can lead to positive clinical and psychosocial outcomes such as relapse prevention or treatment adherence.

AIM/QUESTION

To explore the evidence on the effectiveness of different models that involve carers in the transition between hospital and community mental health care.

METHODS

Five electronic databases (PsycINFO, CINAHL, MEDLINE, Embase and Scopus) and Grey literature (Open Grey and Grey Literature report) were systematically searched. The results were analysed using a narrative synthesis.

RESULTS

Fourteen papers were identified. They described twelve interventions that were categorized into three groups: 1) purely educational programmes in preparation of discharge; 2) programmes that involved carers in planning the transition from the mental health inpatient treatment to community mental health services; and 3) programmes that bridged into the aftercare involving carers in community follow-up. The most comprehensive interventions, i.e. those including psychoeducation, care planning and aftercare follow-up were better evaluated and showed a clearer benefit in improving long-term outcomes and, in particular, reduce re-hospitalization.

IMPLICATIONS FOR PRACTICE

Comprehensive interventions showed the clearest benefit in improving long-term clinical outcomes of patients. Future research should explore implementation, costs and cost-effectiveness, as comprehensive interventions delivered across different settings are likely to require wide-ranging organizational changes and significant resources.

Determinants of Suicidality in the European General Population: A Systematic Review and Meta-Analysis

Close to one million people commit suicide each year, with suicidal attempts being the main risk factor for suicide. The aim of this systematic review and meta-analysis is to achieve a greater understanding of suicidality in the general population of Europe by studying associated factors and their statistical significance with suicidality, as well as the effect of the temporal moment in which suicidality is observed in a relationship. A search strategy was carried out in electronic databases: Proquest's Psychology Database, Scopus, PsycINFO, Medline and Embase. Odds ratios (ORs), publication bias, influential studies on heterogeneity and analysis moderators were calculated. Twenty-six studies were included after meeting the inclusion criteria. Factors statistically associated with suicidality are female gender, age over 65 years, unemployment, low social support, adulthood adversity, childhood adversity, family history of mental disorder, any affective disorder, major depression, anxiety/stress/somatoform disorders, tobacco and substance use, any mental disorder and body mass index. As a limitation, a high heterogeneity between studies was found. Factors associated with suicidality in the general population are relevant for understanding the suicidal phenomenon.

Associations of Personality Traits and Emotional Intelligence: Comparing Individuals in Rehabilitation from Drug Misuse, Occasional Users and Non-Users

Background: Personality traits and Emotional Intelligence abilities have gained a central place in the etiology of drug use, although understudied until recently. Objective: To examine the associations between personality traits and Emotional Intelligence in people that are in process of rehabilitation from drug misuse, to compare them with occasional users and non-users and to estimate the factors associated with the likelihood of drug misuse. Methods: 244 individuals (52.5% male) participated in the study. Sixty of them were suffering from drug misuse disorders, thirty-two were individuals that used drugs occasionally and 142 were non-users. Personality was assessed with the EPQ and Emotional Intelligence with the WEILS. Results: Results suggested that in drug misuse, emotional use and regulation are positively correlated with extraversion, and negatively correlated with neuroticism, whilst people that misuse drugs differ from occasional and non-users in emotional use and regulation, and in all personality traits except extraversion. Regression analyses proposed that a combination of sex, age, emotional regulation, and neuroticism contributes to the likelihood of a person abusing drugs, as opposed to occasional or no use. Conclusion: Our findings showcase that Emotional Intelligence and personality traits indeed play an important role in drug use, specifically when considering factors that protect from or drive towards misuse. Such results call for the implementation of preventive programs for occasional drug users and therapeutic interventions for people that misuse drugs, targeting the levels of neuroticism and enhancing the ability of regulating the negative emotions, to protect from drug misuse.

Factorial structure of the Manchester Short Assessment of Quality of Life in patients with schizophrenia-spectrum disorders

Purpose

Subjective quality of life is a central patient-reported outcome in schizophrenia-spectrum disorders. The Manchester Short Assessment of Quality of Life (MANSA) is an established and widely used instrument for its assessment. The present study is a secondary analysis of large schizophrenia studies and aims to establish the factorial structure of the MANSA with a rigorous two-step methodology.

Methods

A sample of 3120 patients was randomly split into two datasets; the first includes two thirds of the patients and serves as the calibration sample (N = 2071) and the second includes one third of them and serves as the validation sample (N = 1049). We performed an exploratory factor analysis with the calibration sample followed by a confirmatory factor analysis with the validation sample.

Results

Our results for both samples revealed a model with adequate fit comprising two factors. The first factor encompasses eight items measuring satisfaction with a variety of life and health-related aspects of quality of life, whereas the second consists of four items assessing satisfaction with living environment comprising living alone or with others, accommodation, family, and safety. These two factors correlate in a different way with socio-demographic characteristics such as age and living conditions.

Conclusions

Future trials and service evaluation projects using the MANSA to measure quality of life should take into account that satisfaction with living environment may be distinct from satisfaction with other life and health-related aspects of quality of life.

Do male university students sleep well when they feel well? Exploring the role of depression and anxiety as mediators

The deterioration of sleep quality (SQ) can be a manifestation of mental health issues and lack of Self-Esteem (SE), especially in men, who express their mental discomfort in ways that can be distinct from those of women. The present study sought to examine whether depressive symptoms and trait anxiety mediate the association between SE and SQ in male university students. 142 university students were evaluated using the Rosenberg Self-Esteem scale, the Beck Depression Inventory, the Spielberger Trait Anxiety Inventory, and the Pittsburg Quality Sleep Index. The analysis was based on the Baron and Kenny four steps mediation model, and explored the potential mediator role of depression and trait anxiety through a series of simple and multiple linear regression analyses, followed by a Sobel test to corroborate the model's power. Our results showed that the association between SE and SQ is partially mediated by depression and trait anxiety. Such findings may indicate that both depression and trait anxiety contribute to the underlying mechanism through which SE influences SQ in male university students. Clinical and educational implications are discussed in the light of such results, proposing interventions to ameliorate the male students' emotional life and sleep quality.

Work-Related Psychological Distress and Its Management: The Perspective of Employees in the Financial Industry Compared With Those in Human Services

OBJECTIVE

Investigate psychological distress and its link to stress management interventions in the financial industry (FI) in comparison to the human services (HS) sector.

METHOD

Observational study across participating organizations in FI (66) and HS (81). Web-based version of depression anxiety stress scales (21 questions) and eight questions related to stress prevention interventions adopted by employers.

RESULTS

Indicated that FI workers are twice as likely as HS employees to present with stress and depression. Differences emerged on the availability of support at the workplace: FI workers reporting total lack of psychological support, although other forms of wellbeing promotion were more frequent. Close to 60% of individuals in the HS group reported no support (48% in the FI).

CONCLUSION

Workers in the FI industry have increased levels of workplace stress that could be possibly attributed to absence of prevention interventions at the workplace.

Psychosocial associations of emotion-regulation strategies in young adults residing in the United Arab Emirates

The management and expression of emotions can have a positive impact on psychological health and overall functioning. Thus, it is crucial to focus on the study of emotion regulation and the strategies young adults employ to achieve it, namely cognitive reappraisal and expressive suppression, as well as their associations with the long neglected psychosocial factors. The current study aimed at exploring the associations between psychosocial factors and the two emotion-regulation strategies, after controlling for potential sociodemographic confounders. This study used a sample of 136 participants from the Indian subcontinent living in Dubai, United Arab Emirates, aged 18-25 years, who completed instruments measuring social anxiety, social support, and parenting styles (authoritative, authoritarian, permissive) as well as the use of the emotion-regulation strategies of suppression and reappraisal. The results indicated that having experienced authoritarian parenting and perceiving low social support were associated with the use of suppression, while having experienced authoritative parenting and low levels of social anxiety were associated with the use of emotional reappraisal. Our study provides evidence on the importance of psychosocial factors for the use of emotion-regulation strategies and suggests their modification for the promotion of adaptive ways of managing emotions.

The influence of clerkship on students' stigma towards mental illness: a meta-analysis

CONTEXT

In university programmes preparing students to work with patients with mental illness, clerkship is proposed as a component that may contribute to the battle against stigma, through bringing students into contact with the patients' reality. Yet, the precise contribution of clerkship remains unclear, perhaps because of the variety of university programmes, clerkship characteristics or types of stigma explored. This is the first systematic meta-analysis of available evidence determining the precise effect size of the influence of clerkship on stigma and the potential moderators.

METHODS

We carried out a systematic literature review in Eric, PsycINFO, Pubmed, Scopus, UMI and Proquest dissertations, aiming to identify all the studies exploring health care students' stigma of mental illness (measured as overall stigma or as attitudes, affect and behavioural intentions) before and after a clerkship from 2000 to 2017. Twenty-two studies were included in the meta-analysis, providing data from 22 independent samples. The total sample consisted of 3161 students. The effects of programme (medicine, nursing, occupational therapy, and their combination), study design (paired-unpaired samples), publication year, sex, age and clerkship context, and inclusion of theoretical training and duration, were examined as potential moderators.

RESULTS

Our analyses yielded a highly significant medium effect size for overall stigma (Hedge's g = 0.35; p < 0.001; 95% confidence interval [CI], 0.20, 0.42), attitudes (Hedge's g = 0.308; p = 0.003; 95% CI, 0.10, 0.51) and behavioural intentions (Hedge's g = 0.247; p < 0.001; 95% CI, 0.17, 0.33), indicating a considerable change, whereas there was no significant change in the students' affect. Moderator analyses provided evidence for the distinct nature of each stigma outcome, as they were influenced by different clerkship and student characteristics such as clerkship context, theoretical training, age and sex.

CONCLUSIONS

The robust effect of clerkship on students' stigma of mental illness established by the present meta-analysis highlights its role as a crucial curriculum component for experiential learning and as a necessary agent for the battle against stigma.

Building Beautiful Minds: Teaching Through Movies to Tackle Stigma in Psychology Students in the UAE

OBJECTIVE

The use of movie-based educational interventions has been used widely and is considered an effective method aiming at changing the stigmatizing attitudes of future mental health professionals. The purpose of this study was to examine the effectiveness of a 10-week intervention that combined movies and related discussions in a sample of 26 psychology students in the United Arab Emirates, where the opportunities for real contact with patients with mental illness are limited.

METHODS

By means of mixed methods approach, students were assessed at two time points by the Opening Minds Stigma Scale for Health Care Providers [OMS-HC] (T1-T2) and by qualitative questions only at the end of the intervention (T2).

RESULTS

The results corroborated changes to some of the students' attitudes, namely agency, compassion, and proximity, but did not prove a general attitudinal change. Additionally, students acknowledged the benefit obtained by their participation with regard to their learning experience, pointing out the importance of combining theory with practical examples of mental illness for spreading awareness and tackling stigma.

CONCLUSION

The results are discussed in the light of their importance for the United Arab Emirates educational context.

Gender matters in schizophrenia-spectrum disorders: Results from a healthcare users epidemiological study in Malaga, Spain

PURPOSE

Women suffering from schizophrenia-spectrum disorders may differ from men in clinical course and outcome. Still, those differences can only be portrayed accurately by means of studies that derive information from multiple sources. One such study was performed in a well-defined area supported by a Mental Health Clinical Management Unit in Malaga, Spain.

METHODS

Data from 1640 patients (1048 men and 592 women) that were in contact with services during 2008 were examined for the purpose of the present analysis. Gender differences in sociodemographic and clinical characteristics and the role of gender for explaining clinical characteristics (diagnosis, disease severity and service use) beyond potential sociodemographic confounders were explored.

RESULTS

The chi-squared analysis results revealed that in comparison to men, women were older, married or widowed/divorced and living as housewives with their families in cities. Genders also differed across diagnoses, with men being at higher risk for suffering from paranoid schizophrenia, while women being at higher risk for persistent delusional, acute/transitory and schizoaffective disorders. Furthermore, men had greater disease severity and higher chances to visit the mental health rehabilitation unit (MHRU). Further regression analyses revealed that after controlling for confounders, gender differences remained significant across diagnoses and severity. However, they lost their significance under the influence of marital, living and occupational status when predicting the use of MHRU.

CONCLUSION

Results confirm the existence of gender differences and highlight the importance of other factors for designing effective psychosocial services that are tailor-made to the patients' needs.

Associations of Quality of Life with Service Satisfaction in Psychotic Patients: A Meta-Analysis

BACKGROUND

Quality of life (QoL) has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients. Yet, the relationship between the patients' satisfaction with services and QoL has not been clearly established, perhaps due to the multidimensionality of the QoL concept and the variability in its assessment.

AIM

This is the first systematic meta-analysis of all available evidence assessing the relationship between QoL and service satisfaction.

METHODS

In all, 19 studies reporting data of 21 independent samples (N = 5,337) were included in the present meta-analysis. In moderator analyses, effects of age, sex, diagnoses (schizophrenia vs. other psychoses), treatment context (inpatients vs. outpatients), study design (cross-sectional vs. longitudinal), and QoL domain (subjective vs. health-related) were examined.

RESULTS

Analyses revealed a highly significant medium-sized effect (r = .30, p < .001) for the associations of QoL and service satisfaction. Effect sizes were significantly stronger for subjective than health-related quality of life (r = .35 vs. r = .14, respectively). Moreover, associations with subjective QoL remained largely robust when accounting for moderating variables, although there was a trend of stronger associations for outpatients compared to inpatients. In contrast, effect sizes for health-related QoL were small and only observable for samples with longitudinal designs.

CONCLUSION

Associations between QoL and service satisfaction appear to be robust but are differentiated in regard to QoL domain. Our findings suggest that agents responsible for service design and implementation need to take the patients' perception of the service adequacy for achieving QoL enhancement into account.

Acute psychopathology as a predictor of global functioning in patients with ICD-10 non-affective psychosis: a prospective study in 11 European countries

This prospective analysis aimed to study the influence of psychopathological dimensions on the global functioning of persons suffering from psychotic disorders, taking into account the role of a broad range of potential confounders. A large international cohort (n=1888) with ICD-10 non-affective psychosis was evaluated both at baseline during a hospital admission and three months after discharge. Trained interviewers administered a global functioning scale (GAF) and a psychopathological scale (BPRS) at baseline and follow-up). Baseline BPRS psychopathological dimensions were extracted using Principal Component Analysis. Results of multiple linear regression analyses demonstrated that affective symptoms (depressive or manic) prospectively predict a better global functioning, whilst agitation/cognitive symptoms determined poorer global functioning. Other predictors showing an independent effect on better global functioning were medication compliance, country of residence, female gender, married or coupled status, younger age and having a diagnosis of schizoaffective disorder rather than schizophrenia or other ICD-10 psychosis. A predicting model for global functioning in patients with psychosis is provided, showing that assessment of affective and agitation/cognitive symptoms should be emphasised during admission as they can be more informative than positive/negative symptoms in prospectively planning follow-up care that is geared towards a better functional recovery.