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Conneely M, Roe D, Hasson-Ohayon I, Pijnenborg GHM, van der Meer L, Speyer H. Antipsychotics and Identity: The Adverse Effect No One is Talking About. Community Ment Health J 2024:10.1007/s10597-024-01255-w. [PMID: 38427277 DOI: 10.1007/s10597-024-01255-w] [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: 12/12/2023] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
People who take antipsychotics, and people who are prescribed antipsychotics without taking them, experience effects which are not frequently discussed: effects on their identity and sense of self. Qualitative research indicates the relationship between taking APs and identity is multilayered, and changeable. Taking APs can restore people to their earlier, pre-symptom sense of self. Being prescribed and taking APs can also, on the other hand, be experienced as damaging, erasing and dulling people's sense of who they are. This complexity deserves exploration in clinical practice, which we believe is currently not done routinely. More work is needed to understand whether, and how, the relationship between identity and APs is being addressed. We outline the importance of having discussions in a clinical space around identity, and a sense of agency, on the grounds that true recovery-oriented care, which enacts shared decision-making principles, demands it. Further, we argue that it will allow for better therapeutic alliance and trust to be forged between clinician and client, ultimately leading to better care.
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Affiliation(s)
- M Conneely
- Division of Psychiatry, University College London, Maple House, W1T 7BN, London, UK.
| | - D Roe
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - I Hasson-Ohayon
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - G H M Pijnenborg
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
| | - L van der Meer
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
| | - H Speyer
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Molenaar JM, van der Meer L, Bertens LCM, de Vries EF, Waelput AJM, Knight M, Steegers EAP, Kiefte-de Jong JC, Struijs JN. Defining vulnerability subgroups among pregnant women using pre-pregnancy information: a latent class analysis. Eur J Public Health 2023; 33:25-34. [PMID: 36515418 PMCID: PMC10263266 DOI: 10.1093/eurpub/ckac170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Early detection of vulnerability during or before pregnancy can contribute to optimizing the first 1000 days, a crucial period for children's development and health. We aimed to identify classes of vulnerability among pregnant women in the Netherlands using pre-pregnancy data on a wide range of social risk and protective factors, and validate these classes against the risk of adverse outcomes. METHODS We conducted a latent class analysis based on 42 variables derived from nationwide observational data sources and self-reported data. Variables included individual, socioeconomic, lifestyle, psychosocial and household characteristics, self-reported health, healthcare utilization, life-events and living conditions. We compared classes in relation to adverse outcomes using logistic regression analyses. RESULTS In the study population of 4172 women, we identified five latent classes. The largest 'healthy and socioeconomically stable'-class [n = 2040 (48.9%)] mostly shared protective factors, such as paid work and positively perceived health. The classes 'high care utilization' [n = 485 (11.6%)], 'socioeconomic vulnerability' [n = 395 (9.5%)] and 'psychosocial vulnerability' [n = 1005 (24.0%)] were characterized by risk factors limited to one specific domain and protective factors in others. Women classified into the 'multidimensional vulnerability'-class [n = 250 (6.0%)] shared multiple risk factors in different domains (psychosocial, medical and socioeconomic risk factors). Multidimensional vulnerability was associated with adverse outcomes, such as premature birth and caesarean section. CONCLUSIONS Co-existence of multiple risk factors in various domains is associated with adverse outcomes for mother and child. Early detection of vulnerability and strategies to improve parental health and well-being might benefit from focussing on different domains and combining medical and social care and support.
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Affiliation(s)
- J M Molenaar
- Department of Quality of Care and Health Economics, National Institute for Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services, Bilthoven, the Netherlands
- Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Centre, the Hague, the Netherlands
| | - L van der Meer
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - L C M Bertens
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - E F de Vries
- Department of Quality of Care and Health Economics, National Institute for Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services, Bilthoven, the Netherlands
- Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Centre, the Hague, the Netherlands
| | - A J M Waelput
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - M Knight
- Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Centre, the Hague, the Netherlands
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - E A P Steegers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - J C Kiefte-de Jong
- Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Centre, the Hague, the Netherlands
| | - J N Struijs
- Department of Quality of Care and Health Economics, National Institute for Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Services, Bilthoven, the Netherlands
- Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Centre, the Hague, the Netherlands
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Veling W, Sizoo B, van Buuren J, van den Berg C, Sewbalak W, Pijnenborg GHM, Boonstra N, Castelein S, van der Meer L. [Are conspiracy theorists psychotic? A comparison between conspiracy theories and paranoid delusions]. Tijdschr Psychiatr 2021; 63:775-781. [PMID: 34851516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Conspiracy theories are popular during the COVID-19 pandemic. Conspiratorial thinking is characterised by the strong conviction that a certain situation that one sees as unjust is the result of a deliberate conspiracy of a group of people with bad intentions. Conspiratorial thinking appears to have many similarities with paranoid delusions. AIM To explore the nature, consequences, and social-psychological dimensions of conspiratorial thinking, and describe similarities and differences with paranoid delusions. METHOD Critically assessing relevant literature about conspiratorial thinking and paranoid delusions. RESULTS Conspiratorial thinking meets epistemic, existential, and social needs. It provides clarity in uncertain times and connection with an in-group of like-minded people. Both conspiratorial thinking and paranoid delusions involve an unjust, persistent, and sometimes bizarre conviction. Unlike conspiracy theorists, people with a paranoid delusion are almost always the only target of the presumed conspiracy, and they usually stand alone in their conviction. Furthermore, conspiracy theories are not based as much on unusual experiences of their inner self, reality, or interpersonal contacts. CONCLUSIONS Conspirational thinking is common in uncertain circumstances. It gives grip, certainty, moral superiority and social support. Extreme conspirational thinking seems to fit current psychiatric definitions of paranoid delusions, but there are also important differences. To make a distinction with regard to conspiratorial thinking, deepening of conventional definitions of delusions is required. Instead of the strong focus on the erroneous content of delusions, more attention should be given to the underlying idiosyncratic, changed way of experiencing reality.
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Quee PJ, van der Meer L, Krabbendam L, de Haan L, Cahn W, Wiersma D, van Beveren N, Pijnenborg GHM, Mulder CL, Bruggeman R, Aleman A. Insight change in psychosis: relationship with neurocognition, social cognition, clinical symptoms and phase of illness. Acta Psychiatr Scand 2014; 129:126-33. [PMID: 23600752 DOI: 10.1111/acps.12138] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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] [Accepted: 03/22/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Impaired insight is an important and prevalent symptom of psychosis. It remains unclear whether cognitive disturbances hamper improvements in insight. We investigated the neurocognitive, social cognitive, and clinical correlates of changes in insight. METHOD One hundred and fifty-four patients with a psychotic disorder were assessed at baseline (T0 ) and after three years (T3 ) with the Birchwood Insight Scale, the Positive And Negative Syndrome Scale, measures of neurocognition and social cognition. Linear regression analyses were conducted to examine to what extend neurocognition, social cognition, clinical symptoms and phase of illness could uniquely predict insight change. Subsequently, changes in these factors were related to insight change. RESULTS Better neurocognitive performance and fewer clinical symptoms at baseline explained insight improvements. The additional effect of clinical symptoms over and above the contribution of neurocognition was significant. Together, these factors explained 10% of the variance. Social cognition and phase of illness could not predict insight change. Changes in clinical symptoms, but not changes in neurocognitive performance were associated with insight change. CONCLUSION Neurocognitive abilities may predict, in part, the development of insight in psychosis.
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Affiliation(s)
- P J Quee
- Department of Psychiatry & Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Rehabilitation, Lentis Center for Mental Health, Zuidlaren, the Netherlands
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van der Meer L, Vervoort I. O04 Parents and children in families with Huntington's disease: dutch professional's experiences. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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van der Meer L, van Duijn E, Tibben A. D05 Childhood experiences of persons at risk for Huntington's disease. J Neurol Neurosurg Psychiatry 2010. [DOI: 10.1136/jnnp.2010.222612.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Vibrational excitations of low frequency collective modes are essential for functionally important conformational transitions in proteins. Here we report the first direct measurement on the lifetime of vibrational excitations of the collective modes at 87 pm (115 cm(-1)) in bacteriorhodopsin, a transmembrane protein. The data show that these modes have extremely long lifetime of vibrational excitations, over 500 picoseconds, accommodating 1500vibrations. We suggest that there is a connection between this relativelyslow anharmonic relaxation rate of approximately 10 g sec(-1) and thesimilar observed rate of conformational transitions in proteins, which require require multi-level vibrational excitations and energy exchanges with othervibrational modes and collisional motions of solvent molecules.
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Affiliation(s)
- A Xie
- Department of Physics, Oklahoma State University, Stillwater, OK 74078 USA
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van den Brink WA, Zwienenberg M, Zandee SM, van der Meer L, Maas AI, Avezaat CJ. The prognostic importance of the volume of traumatic epidural and subdural haematomas revisited. Acta Neurochir (Wien) 1999; 141:509-14. [PMID: 10392207 DOI: 10.1007/s007010050332] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The size of a traumatic intracranial haematoma at the moment of diagnosis can be impressive. Haematoma thickness is an inaccurate estimator of haematoma volume, and association with patient outcome is controversial. In this study computerized volumetry of offline digitized CT scans was used to relate haematoma volume with both patient characteristics on admission and at the six months outcome. This retrospective study covered the time period 1981/1990. Ninety eight patients operated upon for an epidural haematoma and 91 patients operated upon for an acute subdural haematoma were analyzed. The relative importance of clinical data, CT scan parameters, and calculated haematoma volumes was determined by multivariate analysis. Volume of the haematoma did not correlate with preoperative neurological condition or the six months outcome in either group, and consequently is not of additional prognostic value.
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MESH Headings
- Acute Disease
- Adult
- Blood Volume
- Craniocerebral Trauma/complications
- Craniocerebral Trauma/surgery
- Female
- Hematoma, Epidural, Cranial/diagnostic imaging
- Hematoma, Epidural, Cranial/etiology
- Hematoma, Epidural, Cranial/physiopathology
- Hematoma, Epidural, Cranial/surgery
- Hematoma, Subdural/diagnostic imaging
- Hematoma, Subdural/etiology
- Hematoma, Subdural/physiopathology
- Hematoma, Subdural/surgery
- Humans
- Male
- Mathematical Computing
- Middle Aged
- Prognosis
- Retrospective Studies
- Statistics, Nonparametric
- Tomography, X-Ray Computed
- Treatment Outcome
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Affiliation(s)
- W A van den Brink
- Department of Neurosurgery, University Hospital Rotterdam, The Netherlands
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Joubert P, van der Meer L. A specific cardiac glycoside for cardiac failure and another for atrial fibrillation? S Afr Med J 1979; 56:1040-2. [PMID: 550438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Ouabain produces a greater degree of prolongation of the P-R interval than digitoxin in rats when dosages which produce similar inotropic responses are used. When digitoxin is administered after pretreatment with propranolol, it produces prolongation of the P-R interval comparable to that produced by ouabain. Indications in the literature that these findings may apply to human beings suggest that in some situations atrial fibrillation may be better controlled with a hydrophilic digitalis preparation (e.g. ouabain), whereas cardiac failure with a tendency to atrioventricular block may be better controlled with a lipophilic preparation (e.g. digitoxin).
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