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Marcó-García S, Ariyo K, Owen GS, David AS. Decision making capacity for treatment in psychiatric inpatients: a systematic review and meta-analysis. Psychol Med 2024; 54:1074-1083. [PMID: 38433596 DOI: 10.1017/s0033291724000242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Decision-making capacity (DMC) among psychiatric inpatients is a pivotal clinical concern. A review by Okai et al. (2007) suggested that most psychiatric inpatients have DMC for treatment, and its assessment is reliable. Nevertheless, the high heterogeneity and mixed results from other studies mean there is considerable uncertainty around this topic. This study aimed to update Okai's research by conducting a systematic review with meta-analysis to address heterogeneity. We performed a systematic search across four databases, yielding 5351 results. We extracted data from 20 eligible studies on adult psychiatric inpatients, covering DMC assessments from 2006 to May 2022. A meta-analysis was conducted on 11 papers, and a quality assessment was performed. The study protocol was registered on PROSPERO (ID: CRD42022330074). The proportion of patients with DMC for treatment varied widely based on treatment setting, the specific decision and assessment methods. Reliable capacity assessment was feasible. The Mini-Mental State Examination (MMSE), Global Assessment of Function (GAF), and Brief Psychiatric Rating Scale (BPRS) predicted clinical judgments of capacity. Schizophrenia and bipolar mania were linked to the highest incapacity rates, while depression and anxiety symptoms were associated with better capacity and insight. Unemployment was the only sociodemographic factor correlated with incapacity. Assessing mental capacity is replicable, with most psychiatric inpatients able to make treatment decisions. However, this capacity varies with admission stage, formal status (involuntary or voluntary), and information provided. The severity of psychopathology is linked to mental capacity, though detailed psychopathological data are limited.
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Affiliation(s)
- Silvia Marcó-García
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopathogenesis and treatment of severe mental disorders (MERITT), Sant Joan de Déu Research Institute, Sant Joan de Déu Foundation, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain
| | - Kevin Ariyo
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gareth S Owen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anthony S David
- Division of Psychiatry, UCL Institute of Mental Health, University College London, London, UK
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Silaule O, Adams F, Nkosi NG. Health effects of caregiving and coping with severe mental disorders: A caregivers' experience. S Afr J Psychiatr 2024; 30:2144. [PMID: 38628903 PMCID: PMC11019034 DOI: 10.4102/sajpsychiatry.v30i0.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/24/2024] [Indexed: 04/19/2024] Open
Abstract
Background Informal caregivers are an essential health resource in the care of persons with severe mental disorders, particularly in South Africa where access to mental healthcare services is limited. Aim The study aimed to explore and describe the coping strategies used by informal caregivers and the specific health impacts they face in the context of severe mental disorders in South Africa. Setting The study was conducted in Bushbuckridge municipality situated in the northeastern parts of Mpumalanga province, South Africa. Methods A descriptive qualitative methodology was used to conduct semi-structured interviews with 12 purposefully selected participants. Audio-recorded interviews were translated, transcribed and analysed inductively on NVivo12 using reflexive thematic analysis. Results The themes identified were caregivers' experience of consequences of caregiving and caregivers' experience of coping with their caregiving role. Participants experienced negative consequences on their emotional, mental and physical health. The participants use internal and external resources to cope with the challenges they face, and many highlighted using emotion-focused coping strategies. Conclusion The findings revealed an urgent need to develop support strategies to strengthen informal caregivers' coping and promote good health particularly in rural South Africa where informal caregivers play a crucial role in the management of severe mental disorders. Contribution The finding demands that policymakers and healthcare providers prioritise the health and well-being of the informal caregivers. There should be policies targeted specifically at developing and implementing caregiver-orientated healthcare services.
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Affiliation(s)
- Olindah Silaule
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Fasloen Adams
- Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nokuthula G. Nkosi
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Sampogna G, Luciano M, Di Vincenzo M, Toni C, D’Ambrosio E, Rampino A, Rossi A, Rossi R, Amore M, Calcagno P, Siracusano A, Niolu C, Dell’Osso L, Carpita B, Fiorillo A. Physical activity influences adherence to pharmacological treatments in patients with severe mental disorders: results from the multicentric, randomized controlled LIFESTYLE trial. Front Pharmacol 2023; 14:1285383. [PMID: 38152689 PMCID: PMC10752611 DOI: 10.3389/fphar.2023.1285383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/20/2023] [Indexed: 12/29/2023] Open
Abstract
Introduction: Poor adherence to pharmacological treatment is frequent in people with severe mental disorders and it often causes lack of effectiveness of many psychotropic drugs. Thus, efforts should be made to improve adherence to pharmacological treatments in patients with these disorders. Methods: In this paper, based on the LIFESTYLE randomized, controlled multicentric trial, we aim to: 1) assess the level of adherence in a real-world sample of patients with severe mental disorders; 2) evaluate differences in treatment adherence according to patients' socio-demographic and clinical characteristics; 3) evaluate the impact of an innovative psychosocial intervention, on patients' adherence to treatments. The Lifestyle Psychosocial Group Intervention consists of group sessions, focused on different lifestyle behaviours, including healthy diet; physical activity; smoking habits; medication adherence; risky behaviours; and regular circadian rhythms. At end of each session a 20-min moderate physical activity is performed by the whole group. Results: The sample consists of 402 patients, mainly female (57.1%, N = 229), with a mean age of 45.6 years (±11.8). Less than 40% of patients reported a good adherence to pharmacological treatments. Adherence to treatments was not influenced by gender, age, diagnosis and duration of illness. At the end of the intervention, patients receiving the experimental intervention reported a significant improvement in the levels of adherence to treatments (T0: 35.8% vs. T3: 47.6%, p < 0.005). Patients practicing moderate physical activity reported a two-point improvement in the levels of adherence [odds ratio (OR): 1,542; 95% confidence intervals (CI): 1,157-2,055; p < 0.001], even after controlling for several confounding factors. Discussion: The experimental lifestyle intervention, which can be easily implemented in the routine clinical practice of mental health centres, was effective in improving adherence to pharmacological treatments.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Claudia Toni
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Enrico D’Ambrosio
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Rampino
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Mario Amore
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Pietro Calcagno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Cinzia Niolu
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
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Riera-Molist N, Assens-Tauste M, Roura-Poch P, Guimerà-Gallent M, Santos-López JM, Serra-Millas M, Frau-Rosselló N, Gallego-Peña E, Foguet-Boreu Q. A Cardiovascular Risk Optimization Program in People With Schizophrenia: A Pilot Randomized Controlled Clinical Trial. J Psychiatr Pract 2023; 29:456-468. [PMID: 37948170 PMCID: PMC10631505 DOI: 10.1097/pra.0000000000000743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND Cardiovascular disease is one of the leading causes of premature death in people with schizophrenia. Some modifiable factors that have been implicated include unhealthy lifestyle, medication side effects, and physical comorbidities. The goal of this study was to assess the efficacy of a 6-month, multifactorial cardiovascular risk intervention to reduce cardiovascular risk (CVR) in people with schizophrenia. METHODS We conducted a 2-arm, parallel, randomized clinical trial in a regional mental health center. Participants with at least 1 poorly controlled cardiovascular risk factor (CVRF) (hypertension, diabetes mellitus, hypercholesterolemia, or tobacco smoking) were randomly assigned to the intervention group or to a control group. The subjects in the intervention group received a patient-centered approach that included promoting a healthy lifestyle, pharmacological management of CVRFs, psychotropic drug optimization, and motivational follow-up [Programa d'optimització del RISc CArdiovascular (PRISCA)]. The main outcome was change in CVR as assessed using the Framingham-REGICOR function, after 6 months compared with the baseline in both groups. RESULTS Forty-six participants were randomly assigned to the PRISCA group (n=23) or the control group (n=23). The most prevalent CVRFs at baseline were hypercholesterolemia (84.8%) and tobacco smoking (39.1%). The PRISCA group showed a significant reduction in the REGICOR score (-0.96%; 95% CI: -1.60 to -0.32, P=0.011) after 6 months (relative risk reduction of 20.9%), with no significant changes in the control group (0.21%; 95% CI: -0.47 to 0.89, P=0.706). In the PRISCA group, low-density lipoprotein cholesterol also decreased significantly (-27.14 mg/dL; 95% CI: -46.28 to -8.00, P=0.008). CONCLUSION A patient-centered, multifactorial cardiovascular risk intervention improved CVR in people with schizophrenia after 6 months, which was achieved mainly by improving the lipid profile.
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Cunningham R, Imlach F, Haitana T, Every-Palmer S, Lacey C, Lockett H, Peterson D. It's not in my head: a qualitative analysis of experiences of discrimination in people with mental health and substance use conditions seeking physical healthcare. Front Psychiatry 2023; 14:1285431. [PMID: 37908598 PMCID: PMC10613695 DOI: 10.3389/fpsyt.2023.1285431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/04/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction Clinician bias contributes to lower quality healthcare and poorer health outcomes in people with mental health and substance use conditions (MHSUC). Discrimination can lead to physical conditions being overlooked (diagnostic overshadowing) or substandard treatment being offered to people with MHSUC. This research aimed to utilise experiences of people with MHSUC to identify discrimination by clinicians, including the role of clinician's beliefs and assumptions in physical health service provision. Methods We surveyed people with MHSUC who accessed physical healthcare services. Of 354 eligible participants, 253 responded to open-ended questions about experiences of those services. Thematic descriptive analysis of survey responses was completed using existing stigma frameworks and inductive coding. Results One dominant theme from survey responses was that diagnostic overshadowing by clinicians was driven by clinician mistrust. Another theme was that clinicians assumed respondent's physical symptoms, including pain, were caused by MHSUC. This influenced decisions not to initiate investigations or treatment. Respondents perceived that clinicians focused on mental health over physical health, contributing to suboptimal care. Discussion Discrimination based on MHSUC leads to poor quality care. Health systems and clinicians need to focus quality improvement processes on access to and delivery of equitable physical healthcare to people with MHSUC, address stereotypes about people with MHSUC and improve integration of mental and physical healthcare.
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Affiliation(s)
- Ruth Cunningham
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Fiona Imlach
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Tracy Haitana
- Māori/Indigenous Health Institute (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Cameron Lacey
- Māori/Indigenous Health Institute (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Helen Lockett
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Debbie Peterson
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
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Marcó-García S, Ribas-Muñoz N, Guilera G, Balsells-Mejía S, Huerta-Ramos E. RECAPACITA PROJECT: Impact of the New York Convention on capacity modification judgments in persons with severe mental disorders: A comparative study using mixed methodology. Med Sci Law 2023:258024231206863. [PMID: 37817639 DOI: 10.1177/00258024231206863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
In 2013, Spain aligned its capacity modification processes (CM) legislation with the UN Convention on the rights of persons with disabilities, specifically for individuals with severe mental disorders (SMD). The reforms replaced incapacity verdicts with support provision and introduced the term "CM". However, the social impact of these changes remains uncertain. The RECAPACITA project was initiated to generate knowledge on SMD and CM, and this study aims to investigate modifications in CM sentences and associated terminology. Using a qualitative-quantitative methodology, content analysis was conducted on 56 sentences from individuals with SMD. Terminology analysis utilized 19 sentences to achieve information saturation. A comparison was made between sentences prior to 2013 and those spanning 2014 to 2023, analyzing the data through ANOVA and Bonferroni tests (significance level: 0.05). The analysis revealed that psychiatric illness, its evolution, lack of self-governance, and economic management were frequently mentioned aspects in the sentences. However, no significant correlations were found. Qualitatively, mentions of self-governance were more prevalent in sentences before 2013. Conversely, after 2013, there was an increased focus on substances use, lack of insight and medical adherence, and the need for support in daily life. The term "incapable person" appeared in 100% of the sentences, indicating no differences in terminology. The study suggests that current CM sentences provide increasingly individualized information, addressing the specific support needs of individuals. To enhance future legal proceedings, incorporating neuroscience in studying SMD individuals and reconsidering terminology based on Convention guidelines is recommended.
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Affiliation(s)
- Silvia Marcó-García
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Sant Joan de Déu Research Institute, Sant Joan de Déu Foundation, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | | | - Georgina Guilera
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Group of Invariance Studies for the Measurement and Analysis of Change in the Social and Health Environments (GEIMAC), Institute of Neurosciences (UBNeuro), University of Barcelona, Barcelona, Spain
| | - Sol Balsells-Mejía
- Research Promotion and Management Department. Statistical Support, Hospital Sant Joan de Déu (HSJD), Barcelona, Spain
| | - Elena Huerta-Ramos
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Sant Joan de Déu Research Institute, Sant Joan de Déu Foundation, Barcelona, Spain
- Biomedical Research in the Mental Health Network (CIBERSAM), Carlos III Health Institute, Madrid, Spain
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Hsu JW, Chen LC, Bai YM, Huang KL, Tsai SJ, Su TP, Chen MH. Appetite hormone dysregulation, body mass index, and emotional dysregulation in nonobese adolescents with first-episode schizophrenia, bipolar disorder, and major depressive disorder: a cross-sectional association study. CNS Spectr 2023; 28:629-636. [PMID: 36762484 DOI: 10.1017/s1092852923000081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Evidence has suggested that emotional dysregulation is a transdiagnostic feature in schizophrenia and major affective disorders. However, the relationship between emotional dysregulation and appetite hormone disturbance remains unknown in nonobese adolescents with first-episode schizophrenia, bipolar disorder, and major depressive disorder. METHODS In total, 22 adolescents with schizophrenia; 31 with bipolar disorder; 33 with major depressive disorder; and 41 healthy age-, sex-, and body mass index (BMI)/BMI percentile-matched controls were enrolled for assessing levels of appetite hormones, namely leptin, ghrelin, insulin, and adiponectin. Emotional regulation symptoms were measured using the parent-reported Child Behavior Checklist-Dysregulation Profile. RESULTS Adolescents with first-episode schizophrenia, bipolar disorder, and major depressive disorder exhibited greater emotional dysregulation symptoms than the control group (P = .037). Adolescents with bipolar disorder demonstrated higher log-transformed levels of insulin (P = .029) and lower log-transformed levels of leptin (P = .018) compared with the control group. BMI (P < .05) and log-transformed ghrelin levels (P = .028) were positively correlated with emotional dysregulation symptoms. DISCUSSION Emotional dysregulation and appetite hormone disturbance may occur in the early stage of severe mental disorders. Further studies are required to clarify the unidirectional or bidirectional association of emotional dysregulation with BMI/BMI percentile and appetite hormones among patients with severe mental disorder.
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Affiliation(s)
- Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Chi Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Steen NE, Rahman Z, Szabo A, Hindley GFL, Parker N, Cheng W, Lin A, O’Connell KS, Sheikh MA, Shadrin A, Bahrami S, Karthikeyan S, Hoseth EZ, Dale AM, Aukrust P, Smeland OB, Ueland T, Frei O, Djurovic S, Andreassen OA. Shared Genetic Loci Between Schizophrenia and White Blood Cell Counts Suggest Genetically Determined Systemic Immune Abnormalities. Schizophr Bull 2023; 49:1345-1354. [PMID: 37319439 PMCID: PMC10483470 DOI: 10.1093/schbul/sbad082] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Immune mechanisms are indicated in schizophrenia (SCZ). Recent genome-wide association studies (GWAS) have identified genetic variants associated with SCZ and immune-related phenotypes. Here, we use cutting edge statistical tools to identify shared genetic variants between SCZ and white blood cell (WBC) counts and further understand the role of the immune system in SCZ. STUDY DESIGN GWAS results from SCZ (patients, n = 53 386; controls, n = 77 258) and WBC counts (n = 56 3085) were analyzed. We applied linkage disequilibrium score regression, the conditional false discovery rate method and the bivariate causal mixture model for analyses of genetic associations and overlap, and 2 sample Mendelian randomization to estimate causal effects. STUDY RESULTS The polygenicity for SCZ was 7.5 times higher than for WBC count and constituted 32%-59% of WBC count genetic loci. While there was a significant but weak positive genetic correlation between SCZ and lymphocytes (rg = 0.05), the conditional false discovery rate method identified 383 shared genetic loci (53% concordant effect directions), with shared variants encompassing all investigated WBC subtypes: lymphocytes, n = 215 (56% concordant); neutrophils, n = 158 (49% concordant); monocytes, n = 146 (47% concordant); eosinophils, n = 135 (56% concordant); and basophils, n = 64 (53% concordant). A few causal effects were suggested, but consensus was lacking across different Mendelian randomization methods. Functional analyses indicated cellular functioning and regulation of translation as overlapping mechanisms. CONCLUSIONS Our results suggest that genetic factors involved in WBC counts are associated with the risk of SCZ, indicating a role of immune mechanisms in subgroups of SCZ with potential for stratification of patients for immune targeted treatment.
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Affiliation(s)
- Nils Eiel Steen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Zillur Rahman
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Attila Szabo
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Guy F L Hindley
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nadine Parker
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Weiqiu Cheng
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Aihua Lin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kevin S O’Connell
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Mashhood A Sheikh
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Alexey Shadrin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Shahram Bahrami
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Sandeep Karthikeyan
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Eva Z Hoseth
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health, Helse Møre Romsdal HF, Kristiansund, Norway
| | - Anders M Dale
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
- Department of Cognitive Sciences, University of California, San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Olav B Smeland
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
- K.G. Jebsen—Thrombosis Research and Expertise Center (TREC), University of Tromsø, Tromsø, Norway
| | - Oleksandr Frei
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway
| | - Srdjan Djurovic
- NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Ramonet M, Genest P. [Can intensive home care solve the problem of overcrowded psychiatric beds?]. Soins Psychiatr 2023; 44:39-43. [PMID: 37479357 DOI: 10.1016/j.spsy.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
The growing demand for psychiatric care raises questions about the place and value of alternatives to hospitalization. Community-based intensive care, such as home-based intensive care teams, are models that have been extensively studied and precisely described in international literature. They make it possible to avoid or shorten hospital stays, and have interesting variations for providing access to care in rural areas.
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Affiliation(s)
- Marianne Ramonet
- Secteur 4, Pôle de psychiatrie, CHRU de Brest, CH Bohars, route de Ploudalmézeau, 29820 Bohars, France.
| | - Philippe Genest
- Secteur 4, Pôle de psychiatrie, CHRU de Brest, CH Bohars, route de Ploudalmézeau, 29820 Bohars, France
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10
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Li Y, Zhuo Y, Liu Y. Community Participation Among Individuals with Severe Mental Disorders During COVID-19 Pandemic. Community Ment Health J 2023; 59:486-497. [PMID: 36269512 PMCID: PMC9589758 DOI: 10.1007/s10597-022-01032-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/18/2022] [Accepted: 09/18/2022] [Indexed: 12/03/2022]
Abstract
Utilizing a sample of 286 community-dwelling adults with severe mental disorders (SMDs) in Beijing, this study examined their social and community participation during COVID-19 pandemic. The descriptive results showed that adults with SMDs living in the pandemic Beijing mostly engaged in social activities, followed by productive and leisure/recreational activities. More than two-thirds of the participants indicated that their participation was not sufficient. The multivariate analyses revealed that higher social support and self-esteem predicted more participation days, higher social support and independent usage of Health Kit were linked to more participation items, while higher social support and stronger self-stigma were associated with lower perceived participation sufficiency. Thus, community mental health professionals need to provide more tailored interventions to people with SMDs to enhance their participation performance and perceived participation sufficiency during the pandemic era.
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Affiliation(s)
- Ying Li
- School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Yue Zhuo
- Department of Sociology & Anthropology, St. John’s University, 8000 Utopia Parkway, 11439 Queens, NY USA
| | - Ying Liu
- School of Medical Humanities, Capital Medical University, Beijing, China
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11
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Gallego J, Cangas AJ, Mañas I, Aguilar-Parra JM, Langer ÁI, Navarro N, Lirola MJ. Effects of a Mindfulness and Physical Activity Programme on Anxiety, Depression and Stress Levels in People with Mental Health Problems in a Prison: A Controlled Study. Healthcare (Basel) 2023; 11. [PMID: 36833089 DOI: 10.3390/healthcare11040555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/26/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
Recent studies in the general population have shown an inverse relationship between mindfulness and symptoms of anxiety and depression, as well as the benefits of physical activity on these symptoms. These relationships have not yet been studied in a population with severe mental disorder (SMD) in prison, where symptoms of anxiety and depression and impulsive behaviours have a high incidence. A controlled study was developed to assess the benefits of a mindfulness-based protocol whereby elements of Acceptance and Commitment Therapy were evaluated and compared to an adapted sport program. Twenty-two inmates from the "El Acebuche" prison aged between 23 and 58 years old participated in this study, which included a pre-, post-, and follow-up; the majority of participants had SMD and were distributed in both conditions. The DASS-21 was obtained for its evaluation. The results of the Mann-Whitney U test for independent samples indicated a significant reduction in the levels of stress and depression in the mindfulness intervention group compared to the control group in which no significant changes were observed, providing evidence on the effect of this practice in prison contexts.
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12
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Chen MH, Hsu JW, Huang KL, Tsai SJ, Tu PC, Bai YM. Inflammatory cytokines in and cognitive function of adolescents with first-episode schizophrenia, bipolar disorder, or major depressive disorder. CNS Spectr 2023; 28:70-7. [PMID: 34664544 DOI: 10.1017/S1092852921000857] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Few studies have explored the complex relationship of pro- and anti-inflammatory cytokines with cognitive function in adolescents with first-episode schizophrenia, bipolar disorder, or major depressive disorder. METHODS In total, 26, 35, and 29 adolescents with first-episode schizophrenia, bipolar disorder, and major depressive disorder, respectively, and 22 age- and sex-matched controls were included in the current study. Cytokines, namely interleukin (IL)-2, IL-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP), were assessed. The Wisconsin Card Sorting Test (WCST) and the working memory task were administered to assess cognitive function. RESULTS Using generalized linear models with adjustment for demographic data and clinical symptoms, patients with bipolar disorder were found to exhibit the highest levels of CRP (P = .023), IL-6 (P = .022), and TNF-α (P = .011), and had the lowest IL-2 levels (P = .034) among the four groups. According to the results of the WCST and working memory task, adolescents with schizophrenia exhibited the lowest performance in cognitive function. In addition, among the assessed cytokines, only CRP levels (P = .027) were negatively associated with WCST scores. DISCUSSION Dysregulated pro- and anti-inflammatory cytokines and impaired cognitive functioning were observed in first-episode adolescent-onset schizophrenia, bipolar disorder, and major depressive disorder. The altered cytokine profiles may play important roles in the pathophysiology of schizophrenia, bipolar disorder, and major depressive disorder.
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13
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Domínguez Vázquez I, Nuño Gómez L, Freixa Fontanals N, Hidalgo Arjona C, Cervera G, Corominas Díaz A, Balcells-Oliveró M. Multifamily therapy in the community mental health network: A pragmatic randomized and controlled study. J Marital Fam Ther 2023; 49:205-221. [PMID: 36273430 DOI: 10.1111/jmft.12617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 09/24/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Multifamily therapy (MFT) is a psychotherapeutic group intervention for patients with severe mental disorders (SMDs) and their families. The present study is a multicenter, randomized, and controlled trial that analyzes the benefit of MFT during outpatient treatment. The recruited patients were randomly assigned to the experimental group (n = 26), which received 24 MFT sessions in addition to their treatment as usual (TAU), or to the control group (n = 29), which received only TAU (individual and family sessions). Six months after the inclusion in the MFT, the experimental group showed a significant decrease in number of visits to the psychiatric emergency services, number of psychiatric admissions, and the days of admission. The need for hospital care 6 months after recruitment was also lower in the experimental group compared to the control group. These results suggest that the implementation of MFT during outpatient treatment facilitates community management of people diagnosed with mental health problems.
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Affiliation(s)
| | - Laura Nuño Gómez
- Addictions Unit, Clinical Institute of Neuroscience (ICN), Hospital Clinic, Barcelona, Spain
| | - Neus Freixa Fontanals
- Addictions Unit, Clinical Institute of Neuroscience (ICN), Hospital Clinic, Barcelona, Spain
| | | | - Gemma Cervera
- Mental Health and Addictions Service, Fundació Sanitària Mollet, Barcelona, Spain
| | | | - Mercè Balcells-Oliveró
- Addictions Unit, Clinical Institute of Neuroscience (ICN), Hospital Clinic, Barcelona, Spain
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14
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Garrote-Cámara ME, Gea-Caballero V, Sufrate-Sorzano T, Rubinat-Arnaldo E, Santos-Sánchez JÁ, Cobos-Rincón A, Santolalla-Arnedo I, Juárez-Vela R. Clinical and Sociodemographic Profile of Psychomotor Agitation in Mental Health Hospitalisation: A Multicentre Study. Int J Environ Res Public Health 2022; 19:15972. [PMID: 36498042 PMCID: PMC9735933 DOI: 10.3390/ijerph192315972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Psychomotor agitation is characterised by an increase in psychomotor activity, restlessness and irritability. People with psychomotor agitation respond by over-reacting to both intrinsic and extrinsic stimuli, experiencing stress and/or altered cognition. The objective of this study is to assess the clinical and sociodemographic profile of psychomotor agitation in patients with severe mental disorders. The study was carried out in Spain by means of multicentre cross-sectional convenience sampling involving 140 patients who had been admitted to psychiatric hospital units and had experienced an episode of psychomotor agitation between 2018 and 2021.Corrigan's Agitated Behaviour Scale was used to assess psychomotor agitation. The results show that the predominant characteristic in psychomotor agitation is aggressiveness, which is also the most reported factor in patients with severe mental disorder. Patients who also have anxiety develop psychomotor agitation symptoms of moderate/severe intensity. The clinical and sociodemographic profile found in our study is consistent with other studies on the prevalence of psychomotor agitation.
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Affiliation(s)
- María Elena Garrote-Cámara
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Vicente Gea-Caballero
- Research Group on Community Health and Care, Faculty of Health Science, Valencia International University, 46002 Valencia, Spain
| | - Teresa Sufrate-Sorzano
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Esther Rubinat-Arnaldo
- Society, Health, Education and Culture Study Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 25003 Lleida, Spain
| | | | - Ana Cobos-Rincón
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Iván Santolalla-Arnedo
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Raúl Juárez-Vela
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
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15
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Tuncer GZ, Çetinkaya Duman Z. Emotional eating experiences of individuals with severe mental disorders: A qualitative study. Perspect Psychiatr Care 2022; 58:2723-2732. [PMID: 35561007 DOI: 10.1111/ppc.13113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/25/2022] [Accepted: 05/05/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The aim of this study is to understand the emotional eating experiences of individuals with severe mental disorders. DESIGN AND METHODS The study used a descriptive qualitative design. Data were collected from 19 individuals who displayed emotional eating behavior and a severe mental disorder. FINDINGS The main themes of this study are "Triggers," "Emotional Eating Process," and "Feelings after Emotional Eating." Participants stated that negative emotions and certain initiating factors were the triggers of their emotional eating; they also experienced feelings of regret and guilt after emotional eating. PRACTICE IMPLICATIONS It was concluded that programs for regulating the eating behaviors of individuals with severe mental disorders should be organized and that psychosocial interventions to prevent emotional eating among these individuals should be integrated into the programs' contents.
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Affiliation(s)
- Gülsüm Zekiye Tuncer
- Psychiatric Nursing PhD Program, Dokuz Eylül University The Institute Of Health Sciences, Izmir, Turkey
| | - Zekiye Çetinkaya Duman
- Department of Psychiatric Nursing, Dokuz Eylül University Faculty of Nursing, Izmir, Turkey
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16
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Abstract
OBJECTIVES People with severe mental illnesses (SMI: schizophrenia, depressive disorder, bipolar disorder) have a high risk of being infected by viruses and suffer a more severe infection illness course than the general population. The aim of this literature review was to elucidate rates as well as immunogenicity and side effects of vaccinations in SMI. METHODS All studies in the English or German language, which investigated either prevalence rates or effects of vaccinations in the target groups, were systematically searched in the databank PubMed by three independent authors using the PRISMA guidelines and discussed in more detail. RESULTS The search found 24 studies reporting epidemiological data and 16 investigating immunogenicity of vaccinations. The results on prevalence rates, antibody production, inflammation response and side effects were inconsistent. About interactions with psychotropic medication, only two studies on clozapine were found. CONCLUSIONS Only a few trials with heterogeneous samples have investigated prevalence and effects of vaccinations in SMI. Sex, age and other factors such as somatic comorbidities and special vaccination programmes have not been considered continuously and may influence rates as well. As individuals with SMI might be at special risk, further research on the willingness to be vaccinated as well as efficacy of vaccinations is needed.
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Affiliation(s)
- Nina Bonkat
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
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17
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Sánchez-Ortí JV, Balanzá-Martínez V, Correa-Ghisays P, Selva-Vera G, Vila-Francés J, Magdalena-Benedito R, San-Martin C, Victor VM, Escribano-Lopez I, Hernández-Mijares A, Vivas-Lalinde J, Crespo-Facorro B, Tabarés-Seisdedos R. Specific metabolic syndrome components predict cognition and social functioning in people with type 2 diabetes mellitus and severe mental disorders. Acta Psychiatr Scand 2022; 146:215-226. [PMID: 35359023 DOI: 10.1111/acps.13433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Obesity and metabolic diseases such as metabolic syndrome (MetS) are more prevalent in people with type 2 diabetes mellitus (T2DM), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ). MetS components might be associated with neurocognitive and functional impairments in these individuals. The predictive and discriminatory validity of MetS and its components regarding those outcomes were assessed from prospective and transdiagnostic perspectives. METHODS Metabolic syndrome components and neurocognitive and social functioning were assessed in 165 subjects, including 30 with SZ, 42 with BD, 35 with MDD, 30 with T2DM, and 28 healthy controls (HCs). A posteriori, individuals were classified into two groups. The MetS group consisted of those who met at least three of the following criteria: abdominal obesity (AO), elevated triglycerides (TG), reduced high-density lipoprotein cholesterol (HDL), elevated blood pressure (BP), and elevated fasting glucose (FPG); the remaining participants comprised the No-MetS group. Mixed one-way analysis of covariance and linear and binary logistic regression analyses were performed. RESULTS Cognitive impairment was significantly greater in the MetS group (n = 82) than in the No-MetS group (n = 83), with small effect sizes (p < 0.05; η²p = 0.02 - 0.03). In both groups, the most robust associations between MetS components and neurocognitive and social functioning were observed with TG and FPG (p < 0.05). There was also evidence for a significant relationship between cognition and BP in the MetS group (p < 0.05). The combination of TG, FPG, elevated systolic BP and HDL best classified individuals with greater cognitive impairment (p < 0.001), and TG was the most accurate (p < 0.0001). CONCLUSIONS Specific MetS components are significantly associated with cognitive impairment across somatic and psychiatric disorders. Our findings provide further evidence on the summative effect of MetS components to predict cognition and social functioning and allow the identification of individuals with worse outcomes. Transdiagnostic, lifestyle-based therapeutic interventions targeted at that group hold the potential to improve health outcomes.
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Affiliation(s)
- Joan Vicent Sánchez-Ortí
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Vicent Balanzá-Martínez
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain.,Mental Health Unit of Catarroja, Valencia, Spain
| | - Patricia Correa-Ghisays
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Faculty of Psychology, University of Valencia, Valencia, Spain.,Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vila-Francés
- IDAL - Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | | | - Constanza San-Martin
- TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Víctor M Victor
- Service of Endocrinology and Nutrition, University Hospital Dr. Peset, Valencia, Spain.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain.,Department of Physiology, University of Valencia, Valencia, Spain
| | - Irene Escribano-Lopez
- Service of Endocrinology and Nutrition, University Hospital Dr. Peset, Valencia, Spain
| | | | | | - Benedicto Crespo-Facorro
- TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Department of Psychiatry, Faculty of Medicine, University of Sevilla, HU Virgen del Rocío IBIS, Sevilla, Spain
| | - Rafael Tabarés-Seisdedos
- INCLIVA - Biomedical Research Institute, Valencia, Spain.,TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Valencia, Spain.,Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
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18
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Ferry F, Rosato M, Leavey G. Mind the gap: an administrative data analysis of dental treatment outcomes and severe mental illness. J Ment Health 2022:1-7. [PMID: 35535920 DOI: 10.1080/09638237.2022.2069722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Oral health of people with severe mental illness (SMI) remains an important public health issue, despite evidence pointing suboptimal dental health outcomes in this population. AIMS We test the hypotheses that individuals with SMI have lower contact with dental services and higher levels of fillings and extractions. We also examine effect modification by age-group. METHODS We used linked administrative data from general practitioner (GP), hospital and dental records to examine dental service use and treatments (extractions, fillings, crowns and x-rays) among the Northern Ireland hospital population between January 2015 and November 2019 (N = 798,564). RESULTS After adjusting for available socio-demographic characteristics, analysis indicated lower levels of dental service use (OR = 0.80, 95% CI = 0.77, 0.84), including lower likelihood of fillings (OR = 0.81, 0.77, 0.84) and x-rays (OR = 0.77, 0.74, 0.81), but higher levels of extractions (OR = 1.23, 1.18, 1.29) among patients with SMI. We also found effect modification by age-group, with older individuals with SMI less likely to have each of the four dental treatments. CONCLUSIONS We suggest that in the general area of physical healthcare for people with SMI, oral healthcare is neglected. There is a need for improved understanding of the barriers to routine care and treatment, and development of psychoeducational interventions.
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Affiliation(s)
- Finola Ferry
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Belfast, Northern Ireland
| | - Michael Rosato
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Belfast, Northern Ireland
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Northern Ireland
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Belfast, Northern Ireland
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19
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Maddineshat M, Cheraghi F, Ghaleiha A, Khalafbeigi M, Sadeghian E. Facilitators and Barriers of Return to Work in Working People with Serious Mental Illness: A Qualitative Study. Indian J Psychol Med 2022; 44:120-128. [PMID: 35655975 PMCID: PMC9120982 DOI: 10.1177/02537176221074730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Among working people with serious mental illness (WPSMI), return to work (RTW) is controlled by several factors. Identifying these factors can help prevent long-term sick leave absence and work disability. We aimed to identify facilitators and barriers of RTW in WPSMI admitted to a psychiatric hospital and clinic affiliated with the Hamadan University of Medical Sciences, Iran. METHODS This qualitative study was conducted in 2020 on 27 participants with SMI and their families, supervisors, coworkers, managers, and mental health professionals (MHPs). The participants were selected through purposive sampling and subjected to semi-structured interviews. Forty interviews were conducted and analyzed using conventional content analysis. RESULTS Nine hundred initial codes were extracted and categorized into 34 subcategories and eight categories. Categories that emerged as facilitators of RTW include emotional availability, information availability and use, practical assistance of others, employment facilitation by the society, and supervisor's flexibility. Categories identified as barriers are imposed effects of mental illness, poor self-concept, and social obstacles. CONCLUSION WPSMI experience some facilitators and barriers in RTW. Therefore, MHPs and politicians are recommended to consider these factors in vocational rehabilitation plans.
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Affiliation(s)
- Maryam Maddineshat
- Dept. of Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Cheraghi
- Dept. of Pediatric, School of Nursing and Midwifery, Chronic Disease (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Ghaleiha
- Dept. of Psychiatry, Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mitra Khalafbeigi
- Dept. of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Efat Sadeghian
- Dept. of Pediatric, School of Nursing and Midwifery, Chronic Disease (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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20
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Kallio M, Korkeila J, Malmberg M, Gunn J, Rautava P, Korhonen P, Kytö V. Impaired long-term outcomes of patients with schizophrenia spectrum disorder after coronary artery bypass surgery: nationwide case-control study. BJPsych Open 2022; 8:e48. [PMID: 35144708 PMCID: PMC8867870 DOI: 10.1192/bjo.2022.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Patients with schizophrenia spectrum disorder have increased risk of coronary artery disease. AIMS To investigate long-term outcomes of patients with schizophrenia spectrum disorder and coronary artery disease after coronary artery bypass grafting surgery (CABG). METHOD Data from patients with schizophrenia spectrum disorder (n = 126) were retrospectively compared with propensity-matched (1:20) control patients without schizophrenia spectrum disorder (n = 2520) in a multicentre study in Finland. All patients were treated with CABG. The median follow-up was 7.1 years. The primary outcome was all-cause mortality. RESULTS Patients with diagnosed schizophrenia spectrum disorder had an elevated risk of 10-year mortality after CABG, compared with control patients (42.7 v. 30.3%; hazard ratio 1.56; 95% CI 1.13-2.17; P = 0.008). Schizophrenia spectrum diagnosis was associated with a higher risk of major adverse cardiovascular events during follow-up (49.9 v. 32.6%, subdistribution hazard ratio 1.59; 95% CI 1.18-2.15; P = 0.003). Myocardial infarction (subdistribution hazard ratio 1.86; P = 0.003) and cardiovascular mortality (subdistribution hazard ratio 1.65; P = 0.017) were more frequent in patients with versus those without schizophrenia spectrum disorder, but there was no difference for stroke. Psychiatric ward admission, antipsychotic medication, antidepressant use and benzodiazepine use before CABG were not associated with outcome differences. After CABG, patients with schizophrenia spectrum disorder received statin therapy less often and had lower doses; the use of other cardiovascular medications was similar between schizophrenia spectrum and control groups. CONCLUSIONS Patients with schizophrenia spectrum disorder have higher long-term risks of death and major adverse cardiovascular events after CABG. The results underline the vulnerability of these patients and highlight the importance of intensive secondary prevention and risk factor optimisation.
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Affiliation(s)
- Mika Kallio
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland
| | - Jyrki Korkeila
- Department of Psychiatry, University of Turku and Turku University Hospital, Finland; and Department of Psychiatry, Hospital District of Satakunta, Finland
| | - Markus Malmberg
- Heart Center, Turku University Hospital and University of Turku, Finland
| | - Jarmo Gunn
- Heart Center, Turku University Hospital and University of Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku, Finland; and Turku Clinical Research Centre, Turku University Hospital, Finland
| | - Päivi Korhonen
- Turku Clinical Research Centre, Turku University Hospital, Finland; and Department of General Practice, University of Turku and Turku University Hospital, Finland
| | - Ville Kytö
- Heart Center, Turku University Hospital and University of Turku, Finland; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland; Center for Population Health Research, Turku University Hospital and University of Turku, Finland; Administrative Center, Hospital District of Southwest Finland, Finland; and Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
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21
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Hortal-Mas R, Moreno-Poyato AR, Granel-Giménez N, Roviralta-Vilella M, Watson-Badia C, Gómez-Ibáñez R, Aguayo-González MP, Giménez-Díez D, Bernabeu-Tamayo MD, Leyva-Moral JM. Sexuality in people living with a serious mental illness: A meta-synthesis of qualitative evidence. J Psychiatr Ment Health Nurs 2022; 29:130-146. [PMID: 33047434 DOI: 10.1111/jpm.12700] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 01/31/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT A serious mental illness influences sexual life and people affected have worries about their sexual health. People living with a serious mental illness can and want to participate in interventions related to sexual health. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE People who suffer a serious mental illness are interested in maintaining an active sex life. People who suffer a serious mental illness experience rejection when they open up and they lose intimate relationships or possibilities of meeting other people because of ignorance and prejudices surrounding mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE Mental health services must respond to this need, that is including sexual needs assessment among routine standard practices or training nurses on sexual education to allow them to advise patients and their families and friends. Health systems should promote awareness programmes and reduce the stigma surrounding mental health and sexuality. ABSTRACT INTRODUCTION: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality. AIM To explain how people with a serious mental illness perceive and experience their sexuality. METHOD A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. RESULTS Four categories were identified: "Pathologized sexuality," which explains how the disorder and treatment affect sexuality; "Not my sexuality anymore," which describes feelings emerging from the perceived limitations and the role of self-acceptance; "Learning to manage intimate relationships," which explains the desire to establish intimate personal relationships and define their meaning; and "Reconstructing my sexuality," which elucidates the influence of the environment on sexuality. DISCUSSION Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma. IMPLICATIONS FOR PRACTICE Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.
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Affiliation(s)
- Roger Hortal-Mas
- Psychiatric Rehabilitation Area, Hermanas Hospitalarias - Hospital Sagrat Cor, Martorell, Catalonia, Spain
| | - Antonio Rafael Moreno-Poyato
- Department of Public Health, Mental Health and Perinatal Nursing, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Hospital del Mar Institute for Medical Research (IMIM), Barcelona, Catalonia, Spain
| | - Nina Granel-Giménez
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Maria Roviralta-Vilella
- Institut de Neuropisquiatria i Addiccions, Parc de Salut Mar de Barcelona, Barcelona, Catalonia, Spain
| | - Carolina Watson-Badia
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Knowledge Management Department, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Rebeca Gómez-Ibáñez
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Mariela Patricia Aguayo-González
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - David Giménez-Díez
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Partial Home Care Unit, CPB Serveis de Salut Mental, Barcelona, Catalonia, Spain
| | - Maria Dolores Bernabeu-Tamayo
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Juan Manuel Leyva-Moral
- Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Centre for Health Sciences Research, Universidad María Auxiliadora, Lima, Peru.,Evidence-Based Health Care South America: A Joanna Briggs Institute Affiliated Group, Universidad Norbert Wiener, Lima, Peru
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22
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Mauritz M, Goossens P, Jongedijk R, Vermeulen H, van Gaal B. Investigating the Efficacy and Experiences With Narrative Exposure Therapy in Severe Mentally Ill Patients With Comorbid Post-traumatic Stress Disorder Receiving Flexible Assertive Community Treatment: A Mixed Methods Study. Front Psychiatry 2022; 13:804491. [PMID: 35573345 PMCID: PMC9095974 DOI: 10.3389/fpsyt.2022.804491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with severe mental illness with repeated interpersonal trauma and post-traumatic stress disorder (PTSD) have a negative illness progression. Traumas are often not treated because of their vulnerability. Narrative exposure therapy (NET) is an effective trauma therapy. It is unknown whether NET is effective and tolerable in these patients receiving community mental healthcare. OBJECTIVES The objectives of this study are (1) to gain insights into patients' experiences before, during, and after NET concerning changes in PTSD, dissociative and severe mental ill symptoms, care needs (CAN), quality of life, and global functioning; (2) to identify factors that influence diagnostic changes after NET as compared to patients' experiences. These insights will help to decide whether NET should be incorporated in usual care for these patients. DESIGN A mixed methods convergent design consists of a grounded theory approach with thematic analysis followed by a merged analysis, comparing quantitative, and qualitative data for each participant and by means of a joint matrix. PARTICIPANTS Adult psychiatric outpatients (age, 21-65) with post-traumatic stress disorder (PTSD) related to repeated interpersonal trauma were indicted for the study. METHODS Baseline demographics and clinical characteristics were assessed. Qualitative data were collected 3 months after NET using individual semi-structured in-depth interviews. The merged analysis compared quantitative and qualitative results for each participant. RESULTS Twenty-three outpatients (female, 82%) with a mean age of 49.9 years (SD 9.8) participated in the study. Participants experienced NET as intensive, and most of them tolerated it well. Afterward, eighteen participants perceived less symptoms. Mixed analysis showed substantial congruency between quantitative scores and participants' perceptions of PTSD, dissociative symptoms, and CAN (Cohen's kappa > 0.4). Remission of PTSD was associated with sufficient experienced support. CONCLUSION Outpatients with severe mental illness underwent intensive NET, and most of them tolerate it well. This therapy is clearly efficacious in this group. CLINICAL TRIAL REGISTRATION [www.ClinicalTrials.gov], identifier [NL5608 (NTR5714)].
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Affiliation(s)
- Maria Mauritz
- GGNet Center for Mental Health Care, Warnsveld, Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands
| | - Peter Goossens
- Dimence Group, Center for Mental Health Care, SCBS Bipolar Disorders, Deventer, Netherlands.,Department of Public Health, Faculty of Medicine and Health Sciences, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Ruud Jongedijk
- ARQ Centrum'45, Oegstgeest, Netherlands.,ARQ National Psychotrauma Centre, Diemen, Netherlands
| | - Hester Vermeulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands.,School of Health Studies, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Betsie van Gaal
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands.,School of Health Studies, HAN University of Applied Sciences, Nijmegen, Netherlands
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23
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Salime S, Clesse C, Jeffredo A, Batt M. Process of Deinstitutionalization of Aging Individuals With Severe and Disabling Mental Disorders: A Review. Front Psychiatry 2022; 13:813338. [PMID: 35401263 PMCID: PMC8987193 DOI: 10.3389/fpsyt.2022.813338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND For more than 60 years, psychiatric services has gradually gone from an asylum model to a community model. This change has led to the emergence of a deinstitutionalization movement. This movement seems to have left behind long-term hospitalized aging individuals with severe and disabling mental disorders. The objective of this article is to conduct a review on the challenges and issues associated with the process of deinstitutionalization among hospitalized aging individuals with severe and disabling mental disorders. METHODS Using PRISMA statement, the research methodology was carried out in English and French in 16 databases with a combination of 3 lists of keywords. The selection process was then followed by a thematic analysis which aimed at categorizing by theme and classifying the writings selected. RESULTS A total of 83 articles published between 1978 and 2019 were selected and organized into six categories: (a) a forgotten population in research and health policies, (b) an economic presentation of the deinstitutionalization process, (c) an improvement in quality of life and global functioning for deinstitutionalized patients (d) from stigmatization to the rejection of elderly psychiatric inpatients from deinstutionalization process, (e) a difficult community-based care offer and a difficult epistemological identification, (f) from the lack of community services to the phenomenon of transinstitutionalization. The current state of scientific research, institutional policies and clinical practices associated with the deinstitutionalization process of SVPTSIH are then commented. CONCLUSIONS Recommendations are proposed to researchers and professionals concerned with the support of long-term hospitalized aging individuals with severe and disabling mental disorders.
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Affiliation(s)
- Samira Salime
- INTERPSY Laboratory, University of Lorraine, Nancy, France.,Hope 54 Association, Nancy, France
| | - Christophe Clesse
- INTERPSY Laboratory, University of Lorraine, Nancy, France.,Center for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine Dentistry, Queen Mary University of London, London, United Kingdom.,Psychiatric Hospital of Jury-les-Metz, Metz, France
| | | | - Martine Batt
- INTERPSY Laboratory, University of Lorraine, Nancy, France
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24
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Lamberti JS. Commentary: Reimagining Community Mental Health Care Services: Case Study of a Need Based Biopsychosocial Response Initiated During Pandemic. Front Psychiatry 2022; 13:859884. [PMID: 35711593 PMCID: PMC9196903 DOI: 10.3389/fpsyt.2022.859884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- J Steven Lamberti
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
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25
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Kowalinski E, Ziltener T, Staub S, Moeller J, Trachsel M, Schneeberger AR, Franke I, Lang UE, Huber CG. Physician assisted-dying in mentally and somatically ill individuals in Switzerland: Protocol for survey-based study. Front Psychiatry 2022; 13:987791. [PMID: 36386979 PMCID: PMC9651943 DOI: 10.3389/fpsyt.2022.987791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Article 115 of the Swiss Penal Code (StGB) permits physician-assisted dying (PAD), provided it is not performed for "selfish reasons," and thus, occupies a special role in international comparison. However, the Swiss federal law does not regulate who exactly is entitled to access PAD, and there is no universal agreement in the concerned professional societies. Additional uncertainty arises when assessing the wish for PAD of a mentally ill person compared to a somatically ill person. OBJECTIVES This study aims to contribute to the discussion of PAD among the mentally ill and to provide insight into the current situation in Switzerland. METHODS This is a monocentric prospective observational survey-based study. We will conduct an exploratory online/telephone survey about PAD in somatic vs. mental illness in Switzerland. The survey sample will comprise 10,000 Swiss residents of the general population from all three language regions (German, Italian, and French) as well as 10,000 medical professionals working in the seven states ("cantons") of Basel-Stadt, Basel-Landschaft, Aargau, Lucerne, Graubünden, Ticino, and Vaud. Opinions on PAD in mentally and somatically ill patients will be assessed using 48 different case vignettes. Each participant will be randomly assigned a somatic terminal, a somatic non-terminal, and a mental non-terminal case vignette. Furthermore, the attitude toward the ethical guidelines of the Swiss Medical Association of 2004, 2018, and 2022, as well as the stigmatization of mentally ill people will be assessed. DISCUSSION Physician-assisted dying in mentally ill persons is a highly relevant yet controversial topic. On the one hand, mentally ill persons must not be discriminated against in their desire for PAD compared to somatically ill persons while at the same time, their vulnerability must be considered. On the other hand, treating physicians must be protected in their ethical integrity and need security when judging PAD requests. Despite its relevance, data on PAD in the mentally ill is sparse. To regulate PAD for the mentally ill, it is therefore important for Switzerland-but also internationally-to gain more insight into the ongoing debate. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT05492461.
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Affiliation(s)
- Eva Kowalinski
- Department of Adult Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Tiziana Ziltener
- Department of Adult Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Sarah Staub
- Department of Adult Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Julian Moeller
- Department of Adult Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Manuel Trachsel
- Department of Adult Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Clinical Ethics Unit, University Hospital Basel (USB), Basel, Switzerland.,Biomedical Ethics, Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
| | - Andres R Schneeberger
- Behavioral and Mental Health Care, University of San Diego, San Diego, CA, United States.,Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, United States.,Department of Adult Psychiatry, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Departments of Adult and Forensic Psychiatry, Psychiatric Services Grisons (PDGR), Chur, Switzerland
| | - Irina Franke
- Departments of Adult and Forensic Psychiatry, Psychiatric Services Grisons (PDGR), Chur, Switzerland.,Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Undine E Lang
- Department of Adult Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Christian G Huber
- Department of Adult Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
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26
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Jin L, Chen Y, Zhu J, Huang Q, Li B, Xu Y, Xi R, Lu W. The Willingness of Community Psychiatric Management Physicians to Preferentially Recommend Long-Acting Injections in Beijing. Front Public Health 2021; 9:779563. [PMID: 34869192 PMCID: PMC8639574 DOI: 10.3389/fpubh.2021.779563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Severe mental disorders (SMD) impose a heavy burden on individuals, society, and the country. Under the background of deinstitutionalization, more and more patients return to the community, and the community psychiatric management physicians (CPMP) play an essential role in this process. Long-acting injection (LAI) is an important way to improve compliance and reduce re-hospitalization. Some districts in Beijing have implemented the policy of free LAI. This article aims to find out the willingness of CPMP to preferentially recommend LAI and provide suggestions for follow-up promotion. Methods: All CPMP in 16 districts of Beijing were surveyed. A self-made electronic questionnaire was used to investigate the willingness to recommend LAI in priority. Descriptive statistics, Chi-square test, and logistic regression were used to analyze the data. Results: The willingness of CPMP to preferentially recommend LAI is up to 80%. Participants aged 40–49, female, with higher self-evaluation of psychiatric management knowledge, managing patients who have used LAI in the past, and working in communities with the free LAI policy have higher willingness to recommend LAI in priority. Conclusion: CPMP in Beijing have a positive attitude toward LAI, and most of them have the willingness to recommend LAI to the patients in priority. The recommendation willingness is the basis of prescription decision-making. Therefore, the coverage of free LAI policy should be further expanded in the future to improve the recommendation willingness and thus improve the injection rate of LAI.
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Affiliation(s)
- Lefan Jin
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| | - Yun Chen
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Junli Zhu
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| | - Qingzhi Huang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Bin Li
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Ying Xu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Rui Xi
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Policy Research Office, Beijing Institute of Mental Health, Beijing, China
| | - Wei Lu
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
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27
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Molloy R, Brand G, Munro I, Pope N. Seeing the complete picture: A systematic review of mental health consumer and health professional experiences of diagnostic overshadowing. J Clin Nurs 2021; 32:1662-1673. [PMID: 34873769 DOI: 10.1111/jocn.16151] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/20/2021] [Accepted: 11/16/2021] [Indexed: 12/16/2022]
Abstract
AIM To systematically identify, explore and synthesise qualitative data related to mental health consumer and health professional experiences of diagnostic overshadowing. BACKGROUND Mental health consumers experience significantly high rates of physical illness, poorer health outcomes and are more likely to die prematurely of physical illnesses than the general population. Diagnostic overshadowing is a complex and life-threatening phenomenon that occurs when physical symptoms reported by mental health consumers are misattributed to mental disorders by health professionals. This typically occurs in general healthcare settings. METHODS Drawing on JBI methodology for systematic reviews, four scholarly databases and grey literature was searched, followed by eligibility screening and quality assessment using JBI QARI frameworks, resulting in six studies for inclusion. Findings were synthesised using meta-aggregation. The PRISMA checklist was adhered to throughout this process. FINDINGS Five synthesised findings emerged. Three from the health professional experience: working in ill-suited healthcare systems, missing the complete diagnostic picture, and misunderstanding the lived experience of mental illness. Two from the mental health consumer experience: not knowing if the cause is physical or mental, and surviving and ill-suited health care system. CONCLUSIONS Diagnostic overshadowing is a multidimensional experience of interconnecting factors including systematic healthcare system issues, health professionals limited mental health knowledge and skills, stigmatic attitudes and mental health consumers miscommunicating their physical healthcare needs. Further research is needed to make diagnostic overshadowing visible and mitigate against this phenomenon that deprives mental health consumers of equitable access to quality healthcare. RELEVANCE TO CLINICAL PRACTICE Those who govern healthcare systems have an obligation to recognise and address the unique needs of mental health consumers who seek help for physical illnesses to ensure they receive quality and safe care. Forming collaborative partnerships with mental health consumers in the development of knowledge translation initiatives targeting healthcare policy, practice and education are urgently required.
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Affiliation(s)
- Renee Molloy
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Gabrielle Brand
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Ian Munro
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Nicole Pope
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia.,The Western Australian Group for Evidence Informed Healthcare Practice: A JBI Centre of Excellence, Perth, Western Australia, Australia
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28
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Nilsson NH, Bendix M, Öhlund L, Widerström M, Werneke U, Maripuu M. Increased Risks of Death and Hospitalization in Influenza/Pneumonia and Sepsis for Individuals Affected by Psychotic Disorders, Bipolar Disorders, and Single Manic Episodes: A Retrospective Cross-Sectional Study. J Clin Med 2021; 10:jcm10194411. [PMID: 34640430 PMCID: PMC8509221 DOI: 10.3390/jcm10194411] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/28/2021] [Accepted: 09/18/2021] [Indexed: 11/21/2022] Open
Abstract
Individuals with severe mental disorders (SMDs) such as psychotic disorders, bipolar disorders, and single manic episodes have increased mortality associated with COVID-19 infection. We set up a population-based study to examine whether individuals with SMD also had a higher risk of hospitalization and death from other infectious conditions. Anonymized and summarized data from multiple Swedish patient registers covering the entire Swedish population were supplied by the Swedish National Board of Health and Welfare. The frequencies of hospitalizations and deaths associated with influenza/pneumonia and sepsis in individuals with SMD were compared with the rest of the population during 2018–2019. Possible contributing comorbidities were also examined, of which diabetes, cardiovascular disease, chronic lung disease, and hypertension were chosen. A total of 7,780,727 individuals were included in the study; 97,034 (1.2%) cases with SMD and 7,683,693 (98.8%) controls. Individuals with SMD had increased risk of death associated with influenza/pneumonia (OR = 2.06, 95% CI [1.87–2.27]) and sepsis (OR = 1.61, 95% CI [1.38–1.89]). They also had an increased risk of hospitalization associated with influenza/pneumonia (OR = 2.12, 95% CI [2.03–2.20]) and sepsis (OR = 1.89, 95% CI [1.75–2.03]). Our results identify a need for further evaluation of whether these individuals should be included in prioritized risk groups for vaccination against infectious diseases other than COVID-19.
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Affiliation(s)
- Niklas Harry Nilsson
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (N.H.N.); (M.B.)
| | - Marie Bendix
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (N.H.N.); (M.B.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 11364 Stockholm, Sweden
| | - Louise Öhlund
- Division of Psychiatry, Sunderby Research Unit, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (L.Ö.); (U.W.)
| | - Micael Widerström
- Department of Clinical Microbiology, Umeå University, 90185 Umeå, Sweden;
| | - Ursula Werneke
- Division of Psychiatry, Sunderby Research Unit, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (L.Ö.); (U.W.)
| | - Martin Maripuu
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, 90736 Umeå, Sweden; (N.H.N.); (M.B.)
- Correspondence:
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29
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Engh JA, Ueland T, Agartz I, Andreou D, Aukrust P, Boye B, Bøen E, Drange OK, Elvsåshagen T, Hope S, Høegh MC, Joa I, Johnsen E, Kroken RA, Lagerberg TV, Lekva T, Malt UF, Melle I, Morken G, Nærland T, Steen VM, Wedervang-Resell K, Weibell MA, Westlye LT, Djurovic S, Steen NE, Andreassen OA. Plasma Levels of the Cytokines B Cell-Activating Factor (BAFF) and A Proliferation-Inducing Ligand (APRIL) in Schizophrenia, Bipolar, and Major Depressive Disorder: A Cross Sectional, Multisite Study. Schizophr Bull 2021; 48:37-46. [PMID: 34499169 PMCID: PMC8781325 DOI: 10.1093/schbul/sbab106] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Immune dysfunction has been implicated in the pathogenesis of schizophrenia and other nonaffective psychosis (SCZ), bipolar spectrum disorder (BIP) and major depressive disorder (MDD). The cytokines B cell-activating factor (BAFF) and A proliferation-inducing ligand (APRIL) belong to the tumor necrosis factor (TNF) super family and are essential in orchestrating immune responses. Abnormal levels of BAFF and APRIL have been found in autoimmune diseases with CNS affection. METHODS We investigated if plasma levels of BAFF and APRIL differed between patients with SCZ, BIP, and MDD with psychotic symptoms (n = 2009) and healthy control subjects (HC, n = 1212), and tested for associations with psychotic symptom load, controlling for sociodemographic status, antipsychotic and other psychotropic medication, smoking, body-mass-index, and high sensitivity CRP. RESULTS Plasma APRIL level was significantly lower across all patient groups compared to HC (P < .001; Cohen's d = 0.33), and in SCZ compared to HC (P < .001; d = 0.28) and in BIP compared to HC (P < .001; d = 0.37). Lower plasma APRIL was associated with higher psychotic symptom load with nominal significance (P = .017), but not with any other clinical characteristics. Plasma BAFF was not significantly different across patient groups vs HC, but significantly higher in BIP compared to HC (P = .040; d = 0.12) and SCZ (P = .027; d = 0.10). CONCLUSIONS These results show aberrant levels of BAFF and APRIL and association with psychotic symptoms in patients with SCZ and BIP. This suggest that dysregulation of the TNF system, mediated by BAFF and APRIL, is involved in the pathophysiology of psychotic disorders.
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Affiliation(s)
- John Abel Engh
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Vestfold Hospital Trust, Division of Mental health and Addiction, Tønsberg, Norway,To whom correspondence should be addressed; Norwegian Centre for Mental Disorders Research, NORMENT, Oslo, Norway; tel: 023-02-73-50 (022-11-78-43 dir), fax: 023-02-73-33,
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway,K.G. Jebsen Thrombosis Research and Expertise Center, University of Troms, Tromsø, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research, NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Dimitrios Andreou
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Birgitte Boye
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway,Psychosomatic and Consultation-liason Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erlend Bøen
- Psychosomatic and Consultation-liason Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole Kristian Drange
- Department of Mental Health, Norwegian University of Science and Technology, NTNU, Trondheim, Norway,Department of Østmarka, Division of Mental Health, St. Olavs University Hospital, Trondheim, Norway,Department of Psychiatry, St Olav University Hospital, Trondheim, Norway
| | - Torbjørn Elvsåshagen
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Sigrun Hope
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Department of Neuro Habilitation, Oslo University Hospital Ullevål, Oslo, Norway
| | - Margrethe Collier Høegh
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Inge Joa
- TIPS, Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway,Network for Medical Sciences, Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway,University of Bergen, Bergen, Norway,Norwegian Centre for Mental Disorders Research, NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Rune Andreas Kroken
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway,University of Bergen, Bergen, Norway,Norwegian Centre for Mental Disorders Research, NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Trine Vik Lagerberg
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Tove Lekva
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | | | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology, NTNU, Trondheim, Norway,Department of Psychiatry, St Olav University Hospital, Trondheim, Norway
| | - Terje Nærland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,K.G. Jebsen Center for Neurodevelopmental Disorders, Oslo, Norway,Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
| | - Vidar Martin Steen
- University of Bergen, Bergen, Norway,Norwegian Centre for Mental Disorders Research, NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway,Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Kirsten Wedervang-Resell
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Melissa Auten Weibell
- TIPS, Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway,Network for Medical Sciences, Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Lars Tjelta Westlye
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - Srdjan Djurovic
- Norwegian Centre for Mental Disorders Research, NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway,Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Nils Eiel Steen
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole Andreas Andreassen
- Norwegian Centre for Mental Disorders Research, NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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30
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Sánchez-Guarnido AJ, Hidalgo N, Arenas de la Cruz J, Esteban I, Mondón S, Herruzo C. Analysis of the Consequences of the COVID-19 Pandemic on People with Severe Mental Disorders. Int J Environ Res Public Health 2021; 18:8549. [PMID: 34444298 PMCID: PMC8393683 DOI: 10.3390/ijerph18168549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 01/01/2023]
Abstract
For people with severe mental disorders (SMDs) the COVID-19 pandemic may pose a number of risks. These include the loss of needed care, a higher probability of infection, and the worsening of their mental health. To analyze the pandemic's impact on care received, relapses, loss of employment, and adherence to preventive guidelines in SMD sufferers, a multicenter retrospective cohort study was carried out comparing 185 patients diagnosed with SMD and 85 with common disorders. The results showed that during lockdown, there was a significant reduction in face-to-face psychotherapeutic, nursing, and occupational therapy interventions. In the same period, telematic interventions were introduced which, although subsequently reduced, now continue to be used to a greater extent than before the pandemic. Employment decreased significantly (13% vs. 9.2%; χ2 = 126.228 p < 0.001). The percentage of people with SMD following preventive guidelines was significantly lower for both hand washing (56.2% vs. 75.3%; χ2 = 9.360, p = 0.002) and social distancing (47% vs. 63.5; χ2 = 6.423 p = 0.011). In conclusion, the COVID-19 pandemic has led to a reduction in the interventions that are needed for the recovery of people with SMDs, together with a significant loss of employment and an increased risk of contagion due to less adherence to preventive guidelines. In the future, appropriate attention to these people's needs must be guaranteed.
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Affiliation(s)
| | - Nuria Hidalgo
- Hospital Santa Ana, 18600 Motril, Spain; (A.J.S.-G.); (N.H.); (I.E.)
| | | | | | - Silvia Mondón
- Hospital Clínic de Barcelona, 08036 Barcelona, Spain;
| | - Carlos Herruzo
- Department of Psychology, Universidad de Córdoba, 14071 Córdoba, Spain
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Zhu J, Huang Q, Lu W, Chen Y, Li B, Xu Y, Xi R, Li D. Do Community Free-Medication Service Policy Improve Patient Medication Adherence? A Cross-Sectional Study of Patients With Severe Mental Disorders in Beijing Community. Front Public Health 2021; 9:714374. [PMID: 34381755 PMCID: PMC8351906 DOI: 10.3389/fpubh.2021.714374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Nowadays, mental health problems have become a major concern affecting economic and social development, with severe mental health disorders being the top priority. In 2013, Beijing began to implement the Community Free-Medication Service policy (CFMS). This article aims to evaluate the effect of the policy on medication adherence. Methods: In this study, multi-stage sampling was used to select representative patients as samples. Some of the baseline data were obtained by consulting the archives, and information about patient medication adherence measured by Brooks Medication Adherence Scale was obtained through face-to-face interviews. Logistic regression was used to examine the impact of the policy. Results: Policy participation had a significant positive impact on medication adherence (OR = 1.557). The effect of policy participation on medication adherence in the Medication-only mode and Subsidy-only mode were highly significant, but it was not significant in the Mixed mode. Conclusion: This study found that the CFMS in Beijing as an intervention is effective in improving the medication adherence of community patients. However, the impact of the policy is not consistent among service modes. Reinforcement magnitude and frequency should be considered when designing reinforcement interventions.
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Affiliation(s)
- Junli Zhu
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| | - Qingzhi Huang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Wei Lu
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| | - Yun Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Bin Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Ying Xu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Rui Xi
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Dan Li
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
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32
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Chen WY, Huang SJ, Chang CK, Pan CH, Su SS, Yang TW, Kuo CJ. Excess mortality and risk factors for mortality among patients with severe mental disorders receiving home care case management. Nord J Psychiatry 2021; 75:109-117. [PMID: 32749171 DOI: 10.1080/08039488.2020.1799431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM Home care case management (CM) is the main intervention for patients with severe mental disorders (SMDs) requiring outreach care. This study investigated the long-term mortality outcome and associated risk factors in patients who received home care CM. METHODS This nationwide study enrolled patients who received home care CM (n = 10,255) between 1 January 1999 and 31 December 2010. Each patient was followed up from the baseline (when patients underwent home case CM for the first time during the study period) to the censor (i.e. mortality or the end of the study). We calculated the standardized mortality ratio (SMR) and presented by age and diagnosis. Multivariate regression was performed to assess independent risk factors for mortality. RESULTS Among 10,255 patients who received home care CM, 1409 died during the study period; the overall SMR was 3.13. Specifically, patients with organic mental disorder had the highest SMR (4.98), followed by those with schizophrenia (3.89), major depression (2.98), and bipolar disorder (1.97). In the multivariate analysis, patients with organic mental disorder or dementia had the highest risk, whereas the mortality risk in patients with schizophrenia was comparable to that in patients with bipolar disorder or major depression. Deceased patients had a significantly higher proportion of acute or chronic physical illnesses, including cancer, chronic hepatic disease, pneumonia, diabetes mellitus, cardiovascular disease, and asthma. CONCLUSION This study presented the gap of mortality in patients with SMDs receiving home care CM in Taiwan. We highlight the need for effective strategies to improve medical care for this specified population.
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Affiliation(s)
- Wen-Yin Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taipei, Taiwan
| | - Sheng-Jean Huang
- Taipei City Hospital, Taipei, Taiwan.,Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chin-Kuo Chang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taipei, Taiwan.,University of Taipei, Taipei, Taiwan.,Department of Psychological Medicine, King's College London (Institute of Psychiatry, Psychology and Neuroscience), UK.,Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Sheng-Shiang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Tien-Wei Yang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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33
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Maripuu M, Bendix M, Öhlund L, Widerström M, Werneke U. Death Associated With Coronavirus (COVID-19) Infection in Individuals With Severe Mental Disorders in Sweden During the Early Months of the Outbreak-An Exploratory Cross-Sectional Analysis of a Population-Based Register Study. Front Psychiatry 2021; 11:609579. [PMID: 33488430 PMCID: PMC7819873 DOI: 10.3389/fpsyt.2020.609579] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/07/2020] [Indexed: 01/04/2023] Open
Abstract
Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD. Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymized tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four comorbidities, namely diabetes, cardiovascular disease, hypertension, chronic lung disease. Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4,945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were 4-fold for the age groups between 60 and 79 years and 1.5-fold for cardiovascular diseases. Individuals with SMD without any of the risk factors under study had 3-fold odds of COVID-19 associated death. Conclusion: Our preliminary results identify individuals with SMD as a further group at increased risk of COVID-19 associated death. In regard to comorbidities, future studies should explore the potential confounding or mediation role in the relationship between SMD and COVID-19 associated deaths.
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Affiliation(s)
- Martin Maripuu
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Marie Bendix
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
- Department of Clinical Neuroscience, Center for Psychiatry Research & Stockholm Health Care Services, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden
| | - Louise Öhlund
- Division of Psychiatry, Sunderby Research Unit, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | | | - Ursula Werneke
- Division of Psychiatry, Sunderby Research Unit, Department of Clinical Sciences, Umeå University, Umeå, Sweden
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Raballo A, Schultze-Lutter F, Armando M. Editorial: Children, Adolescents and Families With Severe Mental Illness: Toward a Comprehensive Early Identification of Risk. Front Psychiatry 2021; 12:812229. [PMID: 34992558 PMCID: PMC8724427 DOI: 10.3389/fpsyt.2021.812229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/03/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Andrea Raballo
- Section of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy.,Center for Translational, Phenomenological and Developmental Psychopathology (CTPDP), Perugia University Hospital, Perugia, Italy
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marco Armando
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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35
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Vera San Juan N, Gronholm PC, Heslin M, Lawrence V, Bain M, Okuma A, Evans-Lacko S. Recovery From Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives. Front Psychiatry 2021; 12:712026. [PMID: 34539464 PMCID: PMC8440827 DOI: 10.3389/fpsyt.2021.712026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/14/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction: The recovery approach aims to have users' perspectives at the heart of service development and research; it is a holistic perspective that considers social needs, personal growth and inclusion. In the last decade recovery-oriented research and practice has increased greatly, however, a comprehensive model of recovery considering exclusively the perspectives of people with lived experience has not been devised. Aims: This review aimed to develop a framework and contextualize service users' and informal caregivers' understanding of recovery from severe mental health problems. Methods: We systematically searched 6 databases including key terms related to knowledge, experience and narratives AND mental health AND personal recovery. The search was supplemented with reference sourcing through gray literature, reference tracking and expert consultation. Data analysis consisted of a qualitative meta-synthesis using constant comparative methods. Results: Sixty-two studies were analyzed. A pattern emerged regarding the recovery paradigms that the studies used to frame their findings. The resulting recovery framework included the domains Social recovery; Prosperity (Legal, political, and economic recovery); Individual Recovery; and Clinical Recovery Experience (SPICE). Service users' definitions of recovery tended to prioritize social aspects, particularly being accepted and connecting with others, while caregivers focused instead on clinical definitions of recovery such as symptom remission. Both groups emphasized individual aspects such as becoming self-sufficient and achieving personal goals, which was strongly linked with having economic means for independence. Conclusions: The recovery model provided by this review offers a template for further research in the field and a guide for policy and practice. Predominant definitions of recovery currently reflect understandings of mental health which focus on an individual perspective, while this review found an important emphasis on socio-political aspects. At the same time, only a small number of studies took place in low-income countries, focused on minoritized populations, or included caregivers' perspectives. These are important gaps in the literature that require further attention. Systematic Review Registration: The review protocol was registered on PROSPERO (CRD42017076450); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=76450.
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Affiliation(s)
- Norha Vera San Juan
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Petra C Gronholm
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Margaret Heslin
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Vanessa Lawrence
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matthew Bain
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Ayako Okuma
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
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36
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Sari A, Çetinkaya Duman Z. Strategies used by families to cope with chronic mental illnesses: Psychometric properties of the family crisis oriented personal evaluation scale. Perspect Psychiatr Care 2020; 56:462-473. [PMID: 31793008 DOI: 10.1111/ppc.12457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 11/16/2019] [Accepted: 11/25/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study was aimed at investigating the psychometric properties of the Family Crisis Oriented Personal Evaluation Scale (F-COPES) for Turkish society, which assesses the coping skills of caregivers of individuals with chronic mental illnesses. DESIGN AND METHODS The study was conducted with 153 family caregivers of patients with a chronic mental illness admitted to the inpatient and outpatient units of two university hospitals and İzmir Schizophrenia Solidarity Association. For the language validity, the translation-back translation method was performed, for the content validity, expert opinions were obtained, for the construct validity, exploratory and confirmatory factor analysis was performed. For the reliability analysis, Cronbach α reliability coefficient was calculated and the test-retest reliability analysis was performed. FINDINGS The content validity index of the scale was 0.96. The Cronbach's α reliability coefficient for the overall scale was .80. Factor loadings of the subscales ranged between 0.56 and 0.69 for the Acquiring Social Support subscale, between 0.43 and 0.74 for the Reframing subscale, between 0.53 and 0.74 for the Seeking Spiritual Support subscale. The model fit indexes were as follows: χ2 = 176.369, df = 116, χ2 /df = 1.52, RMSEA = 0.059, CFI = 0.90, IFI = 0.91, GFI = 0.88. PRACTICE IMPLICATIONS The results of the present study show that the levels of psychometric properties of F-COPES in Turkish society are acceptable. It is thought that it would be useful to use the F-COPES in the assessment of coping behaviors of individuals who give care to patients with a chronic mental illness and that it can be used as measurement tool in studies to be conducted with caregivers of patients with a chronic mental illness to assess their coping skills.
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Affiliation(s)
- Ayşe Sari
- Department of Psychiatric Nursing, Faculty of Nursing, Graduate School of Health Sciences, Dokuz Eylül University, İzmir, Turkey
| | - Zekiye Çetinkaya Duman
- Department of Psychiatric Nursing, Faculty of Nursing, Dokuz Eylül University, İzmir, Turkey
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Perez-Cruzado D, Vera-Garcia E, Mayoral-Cleries F, Luciano JV, Cuesta-Vargas A. Adaptation and validation of a scale of self-efficacy and social support for physical activity in Spanish patients with severe mental disorders. Brain Behav 2020; 10:e01510. [PMID: 31880097 PMCID: PMC7010581 DOI: 10.1002/brb3.1510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND People with severe mental disorders (SMDs) suffer problems of obesity, a sedentary life, and poor physical condition, mainly due to low levels of physical activity. Self-efficacy (SE) and social support (SS) are important components that influence participation in physical activity. METHODS This study adapted a scale to assess SE and SS in promoting physical activity in Spanish people with SMDs, as well as provide preliminary evidence of its validity. One hundred Spanish patients (23% female) with SMDs, between 26 and 61 years old, completed the SE/SS assessment for SMD (SE/SS-ASMD). RESULTS The instrument seemed to capture a four-factor structure in people with SMDs. Due to the lack of a gold standard, the scale was related to other instruments with which it might be expected to show a correlation, such as those for physical activity and its quality; however, the levels of correlation found were low (≈0.3). The Internal consistency (Cronbach's α) for the SE-ASMD, SS-ASMD staff, SS-ASMD peers, and SS-ASMD family scales were 0.76, 0.76, 0.80, and 0.80, respectively. CONCLUSIONS The psychometric analysis of the SE/SS-ASMD supported its suitability as a new tool for researchers in the area of physical activity among people with SMDs.
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Affiliation(s)
- David Perez-Cruzado
- Department of Physiotherapy, Grupo de Investigacion de Clinimetria, IBIMA, Primary Care Prevention and Health Promotion Research Network, RedIAPP, University of Malaga, Malaga, Spain.,Departmen of Occupational Therapy, Catolic University of Murcia, Murcia, Spain
| | - Elisa Vera-Garcia
- Department of Physiotherapy, Grupo de Investigacion de Clinimetria, IBIMA, Primary Care Prevention and Health Promotion Research Network, RedIAPP, University of Malaga, Malaga, Spain.,Grupo de Investigación de Salud Mental, IBIMA, Hospital Regional de Málaga, Malaga, Spain
| | - Fermin Mayoral-Cleries
- Grupo de Investigación de Salud Mental, IBIMA, Hospital Regional de Málaga, Malaga, Spain
| | - Juan Vicente Luciano
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, Grupo de Investigacion de Clinimetria, IBIMA, Primary Care Prevention and Health Promotion Research Network, RedIAPP, University of Malaga, Malaga, Spain.,School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, Qld, Australia
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38
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Foguet-Boreu Q, Guàrdia Sancho A, Santos Lopez JM, Roura Poch P, Palmarola Ginesta J, Puig-Ribera AM, Muñoz Pradós J. Association between cognitive impairment and cardiovascular burden in patients with severe mental disorder. Cogn Neuropsychiatry 2020; 25:1-13. [PMID: 31599190 DOI: 10.1080/13546805.2019.1676709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Cognitive impairment is related to an increase in cardiovascular risk (CVR) in the general population. However, in severe mental disorder (SMD), the evidence is less consistent. Few studies have evaluated the relationship between cognition and vascular burden in SMD. This study determines the relationship between cognition and vascular burden in patients with SMD.Methods: Sixty SMD patients (61% men, mean age: 46) attending a psychosocial rehabilitation centre were included. We evaluated sociodemographic, clinical, laboratory, quality of life and functionality characteristics. And we analysed the association between cognitive performance and vascular burden.Results: SMD diagnoses were: 41.7% schizophrenia, 20.0% bipolar, 5.0% schizoaffective, 21.7% depressive and 11.7% other. Cognitive impairment was present in 55% of the cases. The average vascular burden was 3.2. Patients with cognitive impairment have a significantly higher vascular burden than patients without cognitive impairment (p < 0.05). The speed of processing had a moderate correlation with vascular burden (r = -0.457, p = 0.001).Conclusions: Patients with cognitive impairment had a significantly higher vascular burden than patients without cognitive impairment. There are two practical clinical implications: CVR should be evaluated in all SMD patients; and psychoeducation programmes for CVR should be performed and adapted to the cognitive deficits.
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Affiliation(s)
- Quintí Foguet-Boreu
- Department of Psychiatry, Vic University Hospital, Vic, Spain.,Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Anna Guàrdia Sancho
- Sport and Physical Activity Research Group, Centre for Health and Social Care Research, Department of Physical Activity and Sports Sciences, University of Vic - Central University of Catalonia, Vic, Spain.,Osonament - Osona Psychopedagogical Medical Center, Vic, Spain
| | | | - Pere Roura Poch
- Department of Psychiatry, Vic University Hospital, Vic, Spain.,School of Medicine, University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
| | | | - Anna Maria Puig-Ribera
- Sport and Physical Activity Research Group, Centre for Health and Social Care Research, Department of Physical Activity and Sports Sciences, University of Vic - Central University of Catalonia, Vic, Spain
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Sowunmi OA, Amoo G, Onifade PO, Ogunwale A, Babalola E. Psychoactive substance use among outpatients with severe mental illness: A comparative study. S Afr J Psychiatr 2019; 25:1111. [PMID: 31616577 PMCID: PMC6779966 DOI: 10.4102/sajpsychiatry.v25i0.1111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 03/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background Despite several studies on the prevalence and pattern of substance use in Nigeria, there is little information on substance use in patients diagnosed with serious mental illness (SMI) such as schizophrenia and bipolar affective disorder (BD). Aim The aim of the study was to compare the pattern of psychoactive substance use among outpatients with BD and schizophrenia. Setting The study was conducted in a neuropsychiatric hospital in Nigeria. Methods Seventy five consecutive patients with a MINI-PLUS diagnosis of BD were compared with an equal number of patients obtained by systematic random sampling with a MINI-PLUS diagnosis of schizophrenia. Results The respondents with schizophrenia were aged 18–59 years (37.2 ± 9.99) and were predominantly young adult (49, 65.3%), men (46, 61.3%), who were never married (38, 50.7%). Overall, lifetime drug use prevalence was 52%, while for current use, overall prevalence was 21.3%. Participants with BD were aged 18–63 years (36.7 ± 10.29) and were predominantly young adult (53, 70.7%), women (44, 58.7%), who were married (32, 42.7%), with tertiary education (31, 41.3%). Overall, lifetime drug use prevalence was 46.7%, while current overall prevalence was 17.3%. These rates (lifetime and current) for both diagnostic groups are higher than what was reported by the World Health Organization in the global status report of 2014 (0% – 16%). The statistically significant difference between the two diagnostic groups was related to their sociodemographic and clinical variables and psychoactive substance use. Conclusion Psychoactive substance use remains a burden in the care of patients diagnosed with schizophrenia and BD. Future policies should incorporate routine screening for substance use at the outpatient department with a view to stemming the tide of this menace.
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40
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Tirfessa K, Lund C, Medhin G, Hailemichael Y, Fekadu A, Hanlon C. Food insecurity among people with severe mental disorder in a rural Ethiopian setting: a comparative, population-based study. Epidemiol Psychiatr Sci 2019; 28:397-407. [PMID: 29143723 PMCID: PMC6998966 DOI: 10.1017/s2045796017000701] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 10/13/2017] [Indexed: 11/06/2022] Open
Abstract
AIM In low-income African countries, ensuring food security for all segments of the population is a high priority. Mental illness is associated consistently with poverty, but there is little evidence regarding the association with food insecurity. The aim of this study was to compare the levels of food insecurity in people with severe mental disorders (SMD) with the general population in a rural African setting with a high burden of food insecurity. METHOD Households of 292 community-ascertained people with a specialist-confirmed diagnosis of SMD (including schizophrenia and bipolar disorder) were compared with 284 households without a person with SMD in a rural district in south Ethiopia. At the time of the study, no mental health services were available within the district. Food insecurity was measured using a validated version of the Household Food Insecurity Access Scale. Disability was measured using the World Health Organisation Disability Assessment Schedule 2.0. RESULT Severe household food insecurity was reported by 32.5% of people with SMD and 15.9% of respondents from comparison households: adjusted odds ratio 2.82 (95% confidence interval 1.62 to 4.91). Higher annual income was associated independently with lower odds of severe food insecurity. When total disability scores were added into the model, the association between SMD and food insecurity became non-significant, indicating a possible mediating role of disability. CONCLUSION Efforts to alleviate food insecurity need to target people with SMD as a vulnerable group. Addressing the disabling effects of SMD would also be expected to reduce food insecurity. Access to mental health care integrated into primary care is being expanded in this district as part of the Programme for Improving Mental health carE (PRIME). The impact of treatment on disability and food insecurity will be evaluated.
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Affiliation(s)
- K. Tirfessa
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- College of Education and Behavioral Studies, Kotebe Metropolitan University, Addis Ababa, Ethiopia
| | - C. Lund
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, Republic of South Africa
- Health Service and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G. Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Y. Hailemichael
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - A. Fekadu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C. Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Health Service and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Sampogna G, Luciano M, Del Vecchio V, Pocai B, Palummo C, Fico G, Giallonardo V, De Rosa C, Fiorillo A. Perceived Coercion Among Patients Admitted in Psychiatric Wards: Italian Results of the EUNOMIA Study. Front Psychiatry 2019; 10:316. [PMID: 31164841 PMCID: PMC6536685 DOI: 10.3389/fpsyt.2019.00316] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/24/2019] [Indexed: 11/18/2022] Open
Abstract
The decision to use coercive measures (restraint, seclusion and forced medication) in psychiatric practice is controversial in mental health care. The EUNOMIA study was funded by the European Commission and carried out in 11 countries in order to develop European recommendations for good clinical practice on the use of coercive measures. The aim of the study is to identify sociodemographic and clinical predictors of the levels of perceived coercion in a sample of Italian patients with severe mental disorders at hospital admission. A total of 294 patients were recruited in five Italian psychiatric hospitals and screened with the MacArthur Perceived Coercion Scale to explore the levels of perceived coercion. Patients were assessed three times: within the first seven days after admission as well as after 1 and 3 months. At each time point, data on changes of perceived coercion, assessed by the Cantril Ladder of Perceived Coercion Scale, information on coercive measures received during hospitalization and the levels of satisfaction with the received treatments were collected. According to the multivariable regression model, being compulsorily admitted (OR: 2.5; 95% CI: 1.3-3.3, p < .000), being male (OR: 0.7; 95% CI: 0.9-1.4; p < .01), being older (OR: 0.03; 95% CI: 0.01-0.06) and less satisfied with received treatments (OR: -0.2; 95% CI: -0.3 to -0.1; p < .05) are all associated with higher levels of perceived coercion, even after controlling for the use of any coercive measure during hospitalization. Satisfaction with received treatment predicts the levels of perceived coercion and this should represent an important challenge for mental health professionals.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Benedetta Pocai
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Carmela Palummo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Giovanna Fico
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Vincenzo Giallonardo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Corrado De Rosa
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Napoli, Italy
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Ebrahimi H, Seyedfatemi N, Namdar Areshtanab H, Ranjbar F, Thornicroft G, Whitehead B, Rahmani F. Barriers to Family Caregivers' Coping With Patients With Severe Mental Illness in Iran. Qual Health Res 2018; 28:987-1001. [PMID: 29478404 DOI: 10.1177/1049732318758644] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The broad spectrum of problems caused by caring for a patient with mental illness imposes a high burden on family caregivers. This can affect how they cope with their mentally ill family members. Identifying caregivers' experiences of barriers to coping is necessary to develop a program to help them overcome these challenges. This qualitative content analysis study explored barriers impeding family caregivers' ability to cope with their relatives diagnosed with severe mental illness (defined here as schizophrenia, schizoaffective disorders, and bipolar affective disorders). Sixteen family caregivers were recruited using purposive sampling and interviewed using a semi-structured in-depth interview method. Data were analyzed by a conventional content analytic approach. Findings consisted of four major categories: the patient's isolation from everyday life, incomplete recovery, lack of support by the mental health care system, and stigmatization. Findings highlight the necessity of providing support for caregivers by the mental health care delivery service system.
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Affiliation(s)
- Hossein Ebrahimi
- 1 Department of Psychiatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naeimeh Seyedfatemi
- 2 Nursing Care Research Center. Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Namdar Areshtanab
- 1 Department of Psychiatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Ranjbar
- 3 Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Farnaz Rahmani
- 1 Department of Psychiatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Rössler W, Kawohl W, Nordt C, Haker H, Rüsch N, Hengartner MP. "Placement Budgets" for Supported Employment-Impact on Quality of Life in a Multicenter Randomized Controlled Trial. Front Psychiatry 2018; 9:462. [PMID: 30319467 PMCID: PMC6168924 DOI: 10.3389/fpsyt.2018.00462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/06/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Employment is an important aspect of psychiatric rehabilitation. The objective of this analysis was to explore how quality of life (QoL) may affect the outcome of supported employment and vice versa. Methods: A total of 116 participants with severe mental disorders were randomly assigned to either 25, 40, or 55 h placement budgets, which comprises job coaches' time resources to support a client in finding a job. The intervention followed the individual placement and support model and lasted up to 36 months. Primary outcome was employment in the first labor market for at least 3 months. QoL was assessed 7 times over the entire 36-months observation period using the WHO QoL Bref, which comprises the dimensions physical health, psychological, social relationships, and environment. Results: The three placement budgets did not differentially relate to QoL, but QoL environment showed a significant increase over time across all three groups. Baseline QoL environment weakly predicted subsequent obtainment of employment (F = 4.08, df = 1, p = 0.046, Cohen's d = 0.39). Controlling for baseline QoL, those participants who obtained a job, as compared to those who did not, showed persistent increases in QoL physical health (b = 0.39, p = 0.002, Cohen's d = 0.50) and QoL psychological (b = 0.40, p < 0.001, Cohen's d = 0.47). Conclusion: Obtaining employment in the first labor market improves patients' QoL. Supported employment is a valuable intervention that may benefit patients with severe mental disorder.
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Affiliation(s)
- Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.,Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany.,Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Wolfram Kawohl
- Department for Psychiatry and Psychotherapy, Psychiatric Services Aargau, Brugg, Switzerland
| | - Carlos Nordt
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Helene Haker
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Nicolas Rüsch
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Günzburg, Germany
| | - Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
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Samuelsen SS, Moljord IEO, Eriksen L. Re-establishing and preserving hope of recovery through user participation in patients with a severe mental disorder: the self-referral-to-inpatient-treatment project. Nurs Open 2016; 3:222-226. [PMID: 27708833 PMCID: PMC5050546 DOI: 10.1002/nop2.59] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 04/25/2016] [Indexed: 11/07/2022] Open
Abstract
AIMS The treatment of patients with a severe mental disorder is generally not good enough. The aim of this article was to illustrate some alternative approaches for better understanding and treatment for the individual, besides seeing and interpreting the symptoms. METHODS The context of understanding is regulation of emotions whit a person-based approach. The self-referral-to-inpatient-treatment project is presented and discussed as a possible method of intervention to improve patient involvement. DESIGN Theoretical approach. RESULTS Involvement in genuine decisions, where the individual is in control and feels emotionally robust, is important. The experience of regaining authority through being self-empowered with sufficient environmental support is essential for re-establishing and preserving hope of recovery.
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Affiliation(s)
- Silje S Samuelsen
- St Olavs University Hospital Nidaros Community Mental Health Center Trondheim Norway
| | | | - Lasse Eriksen
- St Olavs University Hospital Nidaros Community Mental Health Center Trondheim Norway; Norwegian University of Science and Technology Faculty of Medicine Institute of Neuroscience Trondheim Norway
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Farholm A, Sørensen M. Motivation for physical activity and exercise in severe mental illness: A systematic review of cross-sectional studies. Int J Ment Health Nurs 2016; 25:116-26. [PMID: 26833453 DOI: 10.1111/inm.12217] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 12/03/2015] [Accepted: 12/09/2015] [Indexed: 01/24/2023]
Abstract
Individuals with severe mental illness (SMI) are less physically active than the general population. One important barrier contributing to this inactivity is lack of motivation. The aim of this paper is to systematically review all cross-sectional literature on motivation for physical activity among people with SMI and to use the results as basis for guidance on how mental health nurses can facilitate motivation for physical activity. Systematic searches of seven databases were conducted from database inception to February 2015. Studies were eligible if they included participants with SMI and reported data on motivation for physical activity. In total, 21 articles were included and over half them were published in 2011 or later. The present results indicate preliminary evidence of how the motivational processes do not differ between individuals with SMI and the general population, and that they are independent of diagnosis, medication, age, gender, and body mass index. Results from the current systematic review can give some tentative guidance on how to facilitate motivation for physical activity within mental health-care. However, there is still a great need for developing and examining practical strategies that can enhance adoption and adherence of physical activity among people with SMI.
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Fekadu A, Hanlon C, Gebre-Eyesus E, Agedew M, Solomon H, Teferra S, Gebre-Eyesus T, Baheretibeb Y, Medhin G, Shibre T, Workneh A, Tegegn T, Ketema A, Timms P, Thornicroft G, Prince M. Burden of mental disorders and unmet needs among street homeless people in Addis Ababa, Ethiopia. BMC Med 2014; 12:138. [PMID: 25139042 PMCID: PMC4147171 DOI: 10.1186/s12916-014-0138-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 07/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of mental disorders among homeless people is likely to be substantial in low income countries because of underdeveloped social welfare and health systems. As a first step towards advocacy and provision of care, we conducted a study to determine the burden of psychotic disorders and associated unmet needs, as well as the prevalence of mental distress, suicidality, and alcohol use disorder among homeless people in Addis Ababa, the capital of Ethiopia. METHODS A cross-sectional survey was conducted among street homeless adults. Trained community nurses screened for potential psychosis and administered standardized measures of mental distress, alcohol use disorder and suicidality. Psychiatric nurses then carried out confirmatory diagnostic interviews of psychosis and administered a locally adapted version of the Camberwell Assessment of Needs Short Appraisal Schedule. RESULTS We assessed 217 street homeless adults, about 90% of whom had experienced some form of mental or alcohol use disorder: 41.0% had psychosis, 60.0% had hazardous or dependent alcohol use, and 14.8% reported attempting suicide in the previous month. Homeless people with psychosis had extensive unmet needs with 80% to 100% reporting unmet needs across 26 domains. Nearly 30% had physical disability (visual and sensory impairment and impaired mobility). Only 10.0% of those with psychosis had ever received treatment for their illness. Most had lived on the streets for over 2 years, and alcohol use disorder was positively associated with chronicity of homelessness. CONCLUSION Psychoses and other mental and behavioural disorders affect most people who are street homeless in Addis Ababa. Any programme to improve the condition of homeless people should include treatment for mental and alcohol use disorders. The findings have significant implications for advocacy and intervention programmes, particularly in similar low income settings.
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Affiliation(s)
- Abebaw Fekadu
- />Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
- />King’s College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders, London, UK
- />Health Services and Population Research Department, King’s College London, Institute of Psychiatry, London, UK
- />Amanuel Specialized Mental Hospital, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- />Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
- />Health Services and Population Research Department, King’s College London, Institute of Psychiatry, London, UK
| | | | - Melkamu Agedew
- />Amanuel Specialized Mental Hospital, Addis Ababa, Ethiopia
| | - Haddis Solomon
- />Amanuel Specialized Mental Hospital, Addis Ababa, Ethiopia
| | - Solomon Teferra
- />Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Tsehaysina Gebre-Eyesus
- />Department of Internal Medicine, St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Yonas Baheretibeb
- />Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Girmay Medhin
- />Addis Ababa University, Aklilu Lemma Institute of Pathobiology, Addis Ababa, Ethiopia
| | - Teshome Shibre
- />Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
- />University of Toronto, Ontario Shores Center for Mental Health Sciences, Toronto, Canada
| | - Abraham Workneh
- />Addis Ababa University, Ethiopian Institute of Architecture, Building Construction and City Development, Addis Ababa, Ethiopia
| | - Teketel Tegegn
- />Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | | | - Philip Timms
- />South London and Maudsley NHS Foundation Trust, London, UK
| | - Graham Thornicroft
- />Health Services and Population Research Department, King’s College London, Institute of Psychiatry, London, UK
| | - Martin Prince
- />Health Services and Population Research Department, King’s College London, Institute of Psychiatry, London, UK
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