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Hasan AAH, Belkum CV. Psychoeducational Interventions for People with Schizophrenia: Findings from the Systematic Reviews. Issues Ment Health Nurs 2019; 40:518-534. [PMID: 30689486 DOI: 10.1080/01612840.2018.1509405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Aims: This systematic review examines the effectiveness of the psycho-educational interventions (PEIs) targeted at people diagnosed with schizophrenia and their primary caregivers on improving knowledge level of schizophrenia and health-related outcomes.Methods: A total of 28 studies were reviewed from December 1999 to May 2015. The methods described by Centre for Reviews and Dissemination were used to guide this review.Results: The PEIs showed consistent improvement in the knowledge level of schizophrenia among participants for various follow-up intervals. In addition, PEIs were found to be superior to treatment as usual in influencing health-related outcomes.Conclusions: Implications of the findings for mental health care practice and education and recommendations are discussed.
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Affiliation(s)
- Abd Al-Hadi Hasan
- a Department of Nursing , Dr. Soliman Fakeeh College of Nursing and Medical Sciences , Jeddah , Saudi Arabia
| | - Corrien Van Belkum
- a Department of Nursing , Dr. Soliman Fakeeh College of Nursing and Medical Sciences , Jeddah , Saudi Arabia
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Ema Komala EP, Anna Keliat B, Yulia Wardani I. Acceptance and commitment therapy and family psycho education for clients with schizophrenia. ENFERMERIA CLINICA 2018. [DOI: 10.1016/s1130-8621(18)30044-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ali A, Carre A, Orri M, Urbach M, Barry C, Hassler C, Falissard B, Berthoz S, Nordon C. The real-life effectiveness of psychosocial therapies on social autonomy in schizophrenia patients: Results from a nationwide cohort study in France. Psychiatry Res 2017; 247:97-104. [PMID: 27886580 DOI: 10.1016/j.psychres.2016.10.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 10/20/2016] [Accepted: 10/23/2016] [Indexed: 12/15/2022]
Abstract
The objectives of the present study were to describe the prescribing patterns for psychosocial therapies in routine clinical practice and to assess the impact of psychoeducation on symptoms and social autonomy of patients with schizophrenia. We used data from the nationwide French ESPASS observational cohort study including 5967 patients with schizophrenia, which provided data on exposure to psychosocial therapies from 4961 (83%) participants. Patients who initiated psychosocial therapy within the first 3 months of study onset (n=143) were compared to patients not subject to psychosocial therapy throughout follow up (n=4268), using parametric tests. Symptom severity and social autonomy at 6 months from baseline were compared between patients undergoing psychoeducation (n=117) and patients not subject to psychosocial therapy, matched (1:1) on propensity scores. Patients who initiated psychosocial therapy were significantly younger, more severely ill and used less often antipsychotic drugs than patients in the reference group. At 6 months, patients who initiated psychoeducation and their matched referents did not differ significantly in terms of symptom severity, but their level of improvement in social autonomy was significantly greater (p=0.005). In routine clinical practice, psychoeducation in addition to antipsychotic drugs provides some benefit among schizophrenia patients, particularly in terms of social autonomy.
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Affiliation(s)
- Aminata Ali
- CESP, Paris-Sud University, Paris-Saclay University, INSERM, 16 avenue Paul Vaillant-Couturier, 94805 Villejuif, France
| | - Arnaud Carre
- CESP, Paris-Sud University, Paris-Saclay University, INSERM, 16 avenue Paul Vaillant-Couturier, 94805 Villejuif, France; Savoie Mont Blanc University, LIPP C2S EA 4145, Domaine Universitaire de Jacob, BP1104, 73000 Chambéry, France
| | - Massimiliano Orri
- CESP, Paris-Sud University, Paris-Saclay University, INSERM, 16 avenue Paul Vaillant-Couturier, 94805 Villejuif, France
| | - Mathieu Urbach
- Centre Expert Schizophrénie, Versailles Hospital Centre,177 rue de Versailles, 78157 Le Chesnay cedex, France
| | - Caroline Barry
- CESP, Paris-Sud University, Paris-Saclay University, INSERM, 16 avenue Paul Vaillant-Couturier, 94805 Villejuif, France
| | - Christine Hassler
- CESP, Paris-Sud University, Paris-Saclay University, INSERM, 16 avenue Paul Vaillant-Couturier, 94805 Villejuif, France
| | - Bruno Falissard
- CESP, Paris-Sud University, Paris-Saclay University, INSERM, 16 avenue Paul Vaillant-Couturier, 94805 Villejuif, France
| | - Sylvie Berthoz
- Institute for Cognitive and Integrative Neuroscience, 146 rue Léo Saignat, 33000 Bordeaux, France
| | - Clementine Nordon
- CESP, Paris-Sud University, Paris-Saclay University, INSERM, 16 avenue Paul Vaillant-Couturier, 94805 Villejuif, France; LASER Analytica, 10 place de Catalogne, 75014 Paris, France.
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Porcelli S, Bianchini O, De Girolamo G, Aguglia E, Crea L, Serretti A. Clinical factors related to schizophrenia relapse. Int J Psychiatry Clin Pract 2016; 20:54-69. [PMID: 27052109 DOI: 10.3109/13651501.2016.1149195] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Relapses represent one of the main problems of schizophrenia management. This article reviews the clinical factors associated with schizophrenia relapse. METHODS A research of the last 22 years of literature data was performed. Two-hundred nineteen studies have been included. RESULTS Three main groups of factors are related to relapse: factors associated with pharmacological treatment, add-on psychotherapeutic treatments and general risk factors. Overall, the absence of a maintenance therapy and treatment with first generation antipsychotics has been associated with higher risk of relapse. Further, psychotherapy add-on, particularly with cognitive behaviour therapy and psycho-education for both patients and relatives, has shown a good efficacy for reducing the relapse rate. Among general risk factors, some could be modified, such as the duration of untreated psychosis or the substance misuse, while others could not be modified as male gender or low pre-morbid level of functioning. CONCLUSION Several classes of risk factors have been proved to be relevant in the risk of relapse. Thus, a careful assessment of the risk factors here identified should be performed in daily clinical practice in order to individualise the relapse risk for each patient and to provide a targeted treatment in high-risk subjects.
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Affiliation(s)
- Stefano Porcelli
- a Department of Biomedical and NeuroMotor Sciences , University of Bologna , Bologna , Italy
| | - Oriana Bianchini
- a Department of Biomedical and NeuroMotor Sciences , University of Bologna , Bologna , Italy ;,b Institute of Psychiatry, University of Catania , Catania , Italy
| | | | - Eugenio Aguglia
- b Institute of Psychiatry, University of Catania , Catania , Italy
| | - Luciana Crea
- b Institute of Psychiatry, University of Catania , Catania , Italy
| | - Alessandro Serretti
- a Department of Biomedical and NeuroMotor Sciences , University of Bologna , Bologna , Italy
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Håkansson A, Johansson BA. Atypical course in severe catatonic schizophrenia in a cannabis-dependent male adolescent: a case report. J Med Case Rep 2015; 9:200. [PMID: 26388066 PMCID: PMC4576396 DOI: 10.1186/s13256-015-0678-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 08/18/2015] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Adolescents with psychoses usually have full recovery from their first psychotic episode, but the first relapse often arises within 2 years of the first episode. Cannabis-related psychoses are difficult to distinguish from schizophrenic psychoses. Here, we describe a particularly severe clinical case, with a first psychotic episode occurring after heavy cannabis smoking, an atypically long symptom-free duration, and a subsequent non-substance-related episode. CASE PRESENTATION A 17-year-old male adolescent of Middle-East origin presented with delusions and hallucinations after extensive cannabis smoking. His first psychotic episode, with paranoid delusions and hallucinations, progressed into severe catatonic symptoms. His symptoms were treated with electroconvulsive therapy and risperidone and he was transferred to a residential substance abuse treatment center. He remained drug-free and non-psychotic for 3.5 years. Given the temporal association with extensive cannabis use, and his full remission of symptoms lasting several years, a cannabis-induced psychosis-though atypically extended-could be suspected. However, after 3.5 years without psychiatric care, and in a drug-free state, our patient again presented with positive psychotic symptoms, possibly induced by a period of severe psychosocial stress. CONCLUSION We here discuss whether a primary schizophrenic episode possibly induced by cannabis can increase the risk of subsequent non-drug-related schizophrenic episodes.
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Affiliation(s)
- Anders Håkansson
- Department of Clinical Sciences Lund, Division of Psychiatry, Lund University, Malmö Addiction Centre, Södra Förstadsgatan 35, Malmö, S-205 02, Sweden.
| | - Björn Axel Johansson
- Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, Malmö, Sweden.
- Office for Healthcare 'Sund', Child & Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, Malmö, Sweden.
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Casas RN, Gonzales E, Aldana-Aragón E, Lara-Muñoz MDC, Kopelowicz A, Andrews L, López SR. Toward the early recognition of psychosis among Spanish-speaking adults on both sides of the U.S.-Mexico border. Psychol Serv 2015; 11:460-469. [PMID: 25383998 DOI: 10.1037/a0038017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Lack of knowledge about psychosis, a condition oftentimes associated with serious mental illness, may contribute to disparities in mental health service use. Psychoeducational interventions aimed at improving psychosis literacy have attracted significant attention recently, but few have focused on the growing numbers of ethnic and linguistic minorities in countries with large immigrant populations, such as the United States. This paper reports on 2 studies designed to evaluate the effectiveness of a DVD version of La CLAve, a psychoeducational program that aims to increase psychosis literacy among Spanish-speaking Latinos. Study 1 is a randomized control study to test directly the efficacy of a DVD version of La CLAve for Spanish speakers across a range of educational backgrounds. Fifty-seven medical students and 68 community residents from Mexico were randomly assigned to view either La CLAve or a psychoeducational program of similar length regarding caregiving. Study 2 employed a single-subjects design to evaluate the effectiveness of the DVD presentation when administered by a community mental health educator. Ninety-three Spanish-speakers from San Diego, California completed assessments both before and after receiving the DVD training. Results from these 2 studies indicate that the DVD version of La CLAve is capable of producing a range of psychosis literacy gains for Spanish-speakers in both the United States and Mexico, even when administered by a community worker. Thus, it has potential for widespread dissemination and use among underserved communities of Spanish-speaking Latinos and for minimizing disparities in mental health service use, particularly as it relates to insufficient knowledge of psychosis.
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Affiliation(s)
| | - Edlin Gonzales
- Department of Psychology, University of Southern California
| | | | | | - Alex Kopelowicz
- Department of Psychiatry & Behavioral Sciences, University of California, Los Angeles
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Ran MS, Chan CLW, Ng SM, Guo LT, Xiang MZ. The effectiveness of psychoeducational family intervention for patients with schizophrenia in a 14-year follow-up study in a Chinese rural area. Psychol Med 2015; 45:2197-2204. [PMID: 25686801 DOI: 10.1017/s0033291715000197] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND It is unclear if the impact of psychoeducational family intervention for patients with schizophrenia can be sustained over 10 years. In this study, we explored the 14-year effect of psychoeducational family intervention for patients with schizophrenia in a Chinese rural area. METHOD The data from a cluster randomized control trial (CRCT) study of psychoeducational family intervention in a 14-year follow-up was analyzed. All patients with schizophrenia (n = 326) who participated in the CRCT drawn from six townships in Xinjin County of Chengdu in 1994, of whom 238 (73.0%) who were still alive, and their informants were followed up in 2008. The Patients Follow-up Scale, the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning were used in the follow-up study. RESULTS There were no significant differences of marital status, mean scores of PANSS positive symptoms, negative symptoms, general mental health, and total scores among the psychoeducational family intervention, medication, and control groups in 2008. The psychoeducational family intervention group had a significantly higher rate of antipsychotic medication and a higher level of work ability than other two groups. The control group had a significantly higher rate of never-treated (26.0%) than psychoeducational family intervention group (6.5%). CONCLUSION Psychoeducational family intervention might be still effective in the 14-year follow-up, especially in patients' treatment adherence/compliance and social functioning. Psychoeducational family intervention might be more effective in places where family members frequently participated in patients' care and had a lower level of knowledge on mental illness. Family intervention should be considered when making mental health policy and planning mental health services.
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Affiliation(s)
- M S Ran
- Department of Social Work and Social Administration, Faculty of Social Sciences,University of Hong Kong,Hong Kong,China
| | - C L W Chan
- Department of Social Work and Social Administration, Faculty of Social Sciences,University of Hong Kong,Hong Kong,China
| | - S M Ng
- Department of Social Work and Social Administration, Faculty of Social Sciences,University of Hong Kong,Hong Kong,China
| | - L T Guo
- Department of Psychiatry,West China Hospital, Sichuan University,Chengdu,Sichuan,China
| | - M Z Xiang
- Department of Psychiatry,West China Hospital, Sichuan University,Chengdu,Sichuan,China
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Zendjidjian XY, Boyer L. Challenges in measuring outcomes for caregivers of people with mental health problems. DIALOGUES IN CLINICAL NEUROSCIENCE 2015. [PMID: 25152655 PMCID: PMC4140510 DOI: 10.31887/dcns.2014.16.2/xzendjidjian] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patient-reported outcomes (PROs) are increasingly important in health care and mental health research. Furthermore, caregivers become partners in care for patients with mental disorders, and health workers are more attentive to the expectations and needs of caregivers. A number of outcomes for caregivers are measured and used in daily practice in order to promote actions to improve health care systems and progress in research on the impact of mental disorders on their caregivers. This paper proposes an inventory of the different outcomes and different measurement tools used to assess the impact of disorders, raising a number of methodological and conceptual issues that limit the relevance of measurement tools and complicate their use. Finally, we propose some recommendations promoting the development of relevant outcome measures for caregivers and their integration into current systems of care.
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Affiliation(s)
- Xavier Y Zendjidjian
- Aix-Marseille University, EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, Marseille, France; Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - Laurent Boyer
- Aix-Marseille University, EA 3279-Public Health, Chronic Diseases and Quality of Life -Research Unit, Marseille, France
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Ozkan B, Erdem E, Demirel Ozsoy S, Zararsiz G. Effect of psychoeducation and telepsychiatric follow up given to the caregiver of the schizophrenic patient on family burden, depression and expression of emotion. Pak J Med Sci 2013; 29:1122-7. [PMID: 24353704 PMCID: PMC3858947 DOI: 10.12669/pjms.295.2613] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 11/01/2012] [Accepted: 07/08/2013] [Indexed: 11/17/2022] Open
Abstract
Objective: This randomized-controlled experimental study was conducted to determine the effects of psychoeducation in the inpatient clinic and regular telepsychiatric follow-up (via telephone) after discharge on emotional expression, depression and family burden of primary caregivers of the schizophrenic patients. Methods: This study was performed on 62 caregivers of the schizophrenic patients, assigned to experiment (n=32) and control (n=30) groups, from 1st July 2010 to 31st May 2011. The Scales for Expressed Emotion, the Beck Depression and the Zarit Family Burden were applied for the caregivers in experiment and control groups before education, after education and after 6-months telephone follow-up. Results: The mean scores of the caregivers in experiment group on family burden, emotional expression and depression were decreased after education and after telephone follow-up and difference was significant (p<0.001). Conclusions: Psychoeducation and telepsychiatric follow-up via telephone induced decrease in family burden, emotional expression and depressive symptoms for their caregivers and was a support for the family in the patient care.
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Affiliation(s)
- Birgul Ozkan
- Birgul Ozkan, PhD, Lecturer, Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Emine Erdem
- Emine Erdem, PhD, Assistant Professor, Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Saliha Demirel Ozsoy
- Dr. Saliha Demirel Ozsoy, Associate Professor, Department of Psychiatry, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Gokmen Zararsiz
- Gokmen Zararsiz, MSc, Research Assistant, Department of Biostatistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Cole M, Padmanabhan A. Breast cancer treatment of women with schizophrenia and bipolar disorder from Philadelphia, PA: lessons learned and suggestions for improvement. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:774-779. [PMID: 22806216 DOI: 10.1007/s13187-012-0391-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Treating cancer in patients with concurrent severe mental illness is complex and challenging for patients, families, and health care providers. Two such illnesses include schizophrenia and bipolar disorder. In this review, cases of women with breast cancer and severe mental illness from Philadelphia, PA illustrate the obstacles these women face in maintaining adequate cancer care. Barriers to receiving cancer treatment include understanding their disease, continuing medications and appointments, and experiencing complications of their psychiatric disorders. Learning from these cases is critical for health care providers and allows for innovation in treating and educating this difficult population. Increasing patient visit time, using social support services, and psychiatrist and psychiatrist-liaisons are necessary to improve care. In addition, family or caregivers should be included in discussions when possible. These techniques will assist in educating patients, improve insight into their disease and treatment, and allow them to benefit from cancer therapy.
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Affiliation(s)
- Marion Cole
- Division of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
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