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Brailovskaia J, von Brachel R, van Hall F, Teismann T, Hirschfeld G, Margraf J. A dual-factor model perspective on depressed inpatients: examining the dynamics of mental health and therapy outcomes. Front Psychiatry 2024; 14:1295032. [PMID: 38274438 PMCID: PMC10808683 DOI: 10.3389/fpsyt.2023.1295032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
Background The dual-factor model of mental health posits that mental health and mental illness constitute two distinct axes; accordingly the model identifies four mental health groups: (1) complete mental health, (2) troubled, (3) vulnerable, (4) symptomatic but content. Yet, only a few studies investigated effectiveness of therapy on both dimensions of mental health simultaneously. Against this background, the present study aimed to determine proportions and changes of group assignments in depressed inpatients undergoing therapy. Method N = 1,044 depressed inpatients (age in years: M = 53.36, SD = 9.81, range: 17-83) completed a pre- and a post-treatment survey including questionnaires on depression, anxiety, and positive mental health. A total of n = 328 persons completed the survey also at 6-month and 12-month follow-up assessments. Results In the classification that included depression symptoms and positive mental health, 49% of the participants were classified as troubled and 13.2% were classified as completely mentally healthy at the pre-treatment assessment. At the post-treatment, 9.5% were classified as troubled and 55.7% were classified as completely mentally healthy. In the classification that included anxiety symptoms and positive mental health, 21.9% of the participants were classified as troubled and 14.2% were classified as completely mentally healthy at the pre-treatment assessment. At the post-treatment, 3.7% were classified as troubled and 56.1% were classified as completely mentally healthy. About 10 to 20% of patients showed an improvement in depression/anxiety and positive mental health, whereas another 10 to 20% showed a reduction in depression/anxiety, but only a minor increase in positive mental health between pre- and post-treatment. Conclusion Findings are in line with past research inspired by the dual-factor model in showing that enhancing positive mental health and alleviating psychopathology do not always co-occur in treatment. It is therefore important to implement measures of both psychopathology and positive mental health in therapy outcome studies, and to promote interventions targeting both psychopathology and positive mental health.
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Affiliation(s)
- Julia Brailovskaia
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Bochum, Germany
- DZPG (German Center for Mental Health), Partner Site Bochum/Marburg, Bochum, Germany
| | - Ruth von Brachel
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Bochum, Germany
| | | | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Bochum, Germany
| | | | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Bochum, Germany
- DZPG (German Center for Mental Health), Partner Site Bochum/Marburg, Bochum, Germany
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Tolonen J, Jääskeläinen E, Kiviniemi L, Majuri T, Haapea M, Miettunen J, Moilanen K. Functioning, psychiatric symptoms and quality of life of individuals with severe mental disorders after psychiatric rehabilitation. Nord J Psychiatry 2024; 78:54-63. [PMID: 37815430 DOI: 10.1080/08039488.2023.2262448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 09/20/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE Psychiatric disorders may have a negative effect on individuals' living, forming intimate relationships, education, and employment. The aim of psychiatric rehabilitation is to promote recovery - finding ways to cope with mental disorders despite debilitating symptoms. This study aimed to explore the outcomes of accommodation, social inclusion, psychiatric symptoms, substance and service use, quality of life and subjective recovery of young adults with severe mental illness after psychiatric rehabilitation. MATERIALS AND METHODS The study population consisted of individuals who had been in residential psychiatric rehabilitation between the ages of 18-29 years. Data on outcomes were collected using a questionnaire after a flexible follow-up period (mean 29 months). The questionnaire was answered by 32 eligible persons. We analysed multiple outcomes and compared the proportion of persons living independently at the start, after psychiatric rehabilitation, and at the follow-up point. RESULTS At the start of the rehabilitation, 33%, at the end, 69%, and at follow-up, 78% lived independently. However, most had not reached competitive employment nor were studying. Cognitive symptoms were the most common psychiatric symptoms, followed by depressive symptoms. More than 80% of the sample felt that they had partly recovered from their severe mental illness. CONCLUSION According to the results of this study residential psychiatric rehabilitation may have positive effects on functioning and independent living at follow-up. Reaching competitive employment is difficult for persons with severe mental disorders and effective rehabilitation interventions need to be implemented. However, this study had limitations, and these results should be considered preliminary.
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Affiliation(s)
- Jonna Tolonen
- Humana Sähäkkä Ltd., Ylivieska, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | | | - Tuomas Majuri
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Marianne Haapea
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kristiina Moilanen
- Humana Sähäkkä Ltd., Ylivieska, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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Shemesh S, Feldman R, Zagoory-Sharon O, Tzur Bitan D, Grossman-Giron A, Chen D, Maoz H, Bloch Y. Oxytocin as a transdiagnostic biomarker of well-being in severe mental illness during the Covid-19 pandemic. J Psychiatr Res 2024; 169:355-363. [PMID: 38101184 DOI: 10.1016/j.jpsychires.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/04/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023]
Abstract
Individuals with severe mental illness (SMI) have been found to suffer a greater decline in psychological well-being compared to the general population in times of stress. The present study aimed to examine clinical and endocrine resilience factors of psychological well-being in SMI patients during the Covid-19 pandemic. METHODS After Covid-19 crisis outburst in Israel 112 participants, 69 outpatients, and 43 inpatients and day treatment patients were recruited. Outpatients signed an online informed consent and filled in questionnaires regarding their level of mental health symptoms (OQ-45), fear of Covid-19 (FCV), and psychological well-being (PWB). Inpatients answered the same questionnaires and in addition, went through a positive social interaction paradigm while providing three saliva samples to measure their s-IgA and oxytocin (OT) levels. RESULTS A strong negative correlation was found in the whole sample between reported mental health symptoms, fear of Covid-19, and well-being. Hierarchical regression did not find additional contribution of the fear of the pandemic in predicting well-being beyond the impact of symptomatology. For inpatients (N = 39) only, hierarchical regression found that oxytocin, but not s-IgA could explain 5% of the variance of well-being (R2 = 0.05) in individuals with SMI regardless of their mental health symptoms (R2 = 0.46) and their marital status (R2 = 0.21). CONCLUSIONS OT is suggested as a possible independent biological resilience factor of well-being in times of major stress among SMI patients. It is still unknown whether OT is a mediator that contributes to well-being or a biological marker that indicates the degree of beneficial social interactions.
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Affiliation(s)
| | | | | | - Dana Tzur Bitan
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | | | - Dror Chen
- Shalvata Mental Health Center, Hod- Hasharon, Israel; School of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Hagai Maoz
- Shalvata Mental Health Center, Hod- Hasharon, Israel; School of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Yuval Bloch
- School of Medicine, Tel Aviv University, Ramat Aviv, Israel.
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Miley K, Meyer-Kalos P, Ma S, Bond DJ, Kummerfeld E, Vinogradov S. Causal pathways to social and occupational functioning in the first episode of schizophrenia: uncovering unmet treatment needs. Psychol Med 2023; 53:2041-2049. [PMID: 37310333 PMCID: PMC10106305 DOI: 10.1017/s0033291721003780] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND We aimed to identify unmet treatment needs for improving social and occupational functioning in early schizophrenia using a data-driven causal discovery analysis. METHODS Demographic, clinical, and psychosocial measures were obtained for 276 participants from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) trial at baseline and 6-months, along with measures of social and occupational functioning from the Quality of Life Scale. The Greedy Fast Causal Inference algorithm was used to learn a partial ancestral graph modeling causal relationships across baseline variables and 6-month functioning. Effect sizes were estimated using a structural equation model. Results were validated in an independent dataset (N = 187). RESULTS In the data-generated model, greater baseline socio-affective capacity was a cause of greater baseline motivation [Effect size (ES) = 0.77], and motivation was a cause of greater baseline social and occupational functioning (ES = 1.5 and 0.96, respectively), which in turn were causes of their own 6-month outcomes. Six-month motivation was also identified as a cause of occupational functioning (ES = 0.92). Cognitive impairment and duration of untreated psychosis were not direct causes of functioning at either timepoint. The graph for the validation dataset was less determinate, but otherwise supported the findings. CONCLUSIONS In our data-generated model, baseline socio-affective capacity and motivation are the most direct causes of occupational and social functioning 6 months after entering treatment in early schizophrenia. These findings indicate that socio-affective abilities and motivation are specific high-impact treatment needs that must be addressed in order to promote optimal social and occupational recovery.
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Affiliation(s)
- Kathleen Miley
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Piper Meyer-Kalos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Sisi Ma
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - David J. Bond
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Erich Kummerfeld
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
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Li H, Glecia A. Impact of Social Isolation and Digital Divide on Mental Health and Wellbeing in Patients with Mental Health Disorders during COVID-19: A Multiple Case Study. Issues Ment Health Nurs 2023; 44:313-320. [PMID: 36989507 DOI: 10.1080/01612840.2023.2189957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
The positive relationship between social connections and mental health and wellbeing has been widely documented. During the initial stage of the pandemic, COVID-19 associated restrictions had given rise to social isolation that had a negative effect on individuals' mental health and wellbeing, particularly among patients with preexisting mental health disorders. To abridge physical distance, digital technology had become a primary method of communication and social engagement. However, not everyone had access to internet and devices required to connect online due to the digital divide, especially among marginalized populations. The purpose of this multiple case study was to explore experiences of social isolation and the digital divide among patients with mental health disorders, and its impact on their mental health and wellbeing. Our findings revealed that social isolation was the major contributing factor to the intensification of mental health symptoms, while the digital divide (e.g., financial constraints and low proficiency in digital technology) was recognized as a barrier to making social connections via digital technologies. Nurses should engage with communities and policymakers in developing strategies to address the social determinants of health disparities during the current pandemic, other disruptive pandemics and beyond.
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Affiliation(s)
- Hua Li
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Alana Glecia
- Department of Sociology, University of Saskatchewan, Saskatoon, SK, Canada
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Olive L, Dober M, Mazza C, Turner A, Mohebbi M, Berk M, Telford R. Surf therapy for improving child and adolescent mental health: A pilot randomised control trial. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 65:102349. [PMID: 37665831 DOI: 10.1016/j.psychsport.2022.102349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 09/06/2023]
Abstract
The aim of this pilot randomised control trial (RCT) was to test, 1) feasibility and acceptability of a surf therapy program to improve symptoms of mental ill-health among children and adolescents, and 2) the design and procedures of an evaluative study. This pilot RCT compared a 6-week mentor-supported surf therapy program with a wait list control group, in Australian children and adolescents aged 8-18yrs (M age = 11.28, SD = 2.34; 15 females), who were help seeking for issues relating to their mental health. Exclusion criteria included if an individual was actively suicidal or experiencing a psychotic episode or being unavailable for program dates. The primary outcome was the feasibility and acceptability of the intervention and study design assessed via 11 pre-defined criteria. A secondary outcome was to investigate the effectiveness signal of the intervention on child indicators of depression and anxiety, assessed via the Revised Children's Anxiety and Depression Scale-Short Form and the Strengths and Difficulties Questionnaire. Random allocation was computer generated and while it was not possible to blind participants, researchers collecting assessments were blinded to group allocation. Thirty-six youth were randomised (intervention = 18; wait list controls = 18), representing an 84% participation rate among eligible youth. Of the 11 a priori feasibility and acceptability criteria, 4 of 5 relating to the intervention, and 4 of 6 addressing the study design were fully met, with the unmet factors guiding program revision. At the completion of the intervention, children and adolescents receiving the intervention reported reductions in symptoms of depression (ES = 0.57), anxiety (ES = 0.43), emotional problems, (ES = 0.79), peer problems (ES = 0.56), hyperactivity/inattention (ES = 0.28), and overall difficulties (ES = 0.64). These reductions were not sustained 6-weeks after completion of the intervention. Surf therapy is an acceptable and feasible intervention for addressing symptoms of mental ill-health among children and adolescents. Preliminary evidence suggests that surf therapy improves symptoms of mental ill-health in the short-term but that these improvements were not sustained after the intervention is ceased.
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Affiliation(s)
- Lisa Olive
- School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia; IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre of Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Madeleine Dober
- School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia; IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Catherine Mazza
- School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia; IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Alyna Turner
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia; School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Mohammadreza Mohebbi
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia; Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre of Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia; Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Rohan Telford
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia; Research Institute of Sport and Exercise, University of Canberra, Bruce, ACT, Australia
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Nagendra A, Weiss DM, Merritt C, Cather C, Sosoo EE, Mueser KT, Penn DL. Clinical and psychosocial outcomes of Black Americans in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:77-89. [PMID: 35932309 DOI: 10.1007/s00127-022-02297-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 05/05/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE In the US, Black people diagnosed with schizophrenia experience worse psychosocial and clinical outcomes than their White counterparts. While racism-related factors contribute to these disparities, an additional understudied explanation may be that psychosocial treatments for psychotic disorders are less effective for Black than White individuals. The purpose of this study is to examine the extent to which best treatment practices for first-episode psychosis (FEP) are effective for Black and White participants. METHODS We conducted a secondary data analysis of the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP), a two-year multisite trial that compared a coordinated specialty care intervention for FEP (NAVIGATE) to community care as usual (CC) in 34 sites across the US. Specifically, we compared interviewer-rated quality of life and symptoms, as well as self-reported mental health and stigma, between 139 Non-Latinx Black and 172 Non-Latinx White participants with FEP in NAVIGATE and CC. RESULTS We found few differences between Black and White participants over two-year outcomes, either overall or in terms of benefit from NAVIGATE. Across both treatment conditions, Black participants improved less than White participants on positive symptoms, an effect driven primarily by suspiciousness/persecution. In NAVIGATE, self-reported mental health stigma decreased for both Black and White participants, while in CC stigma decreased for White participants but increased for Black participants. This effect was driven primarily by experienced stigma rather than self-stigma. CONCLUSION NAVIGATE benefits both Black and White individuals diagnosed with FEP. Mental health stigma and positive symptoms may be particularly important aspects of treatment for Black individuals diagnosed with FEP.
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Affiliation(s)
- Arundati Nagendra
- Center of Excellence in Psychosocial and Systemic Research, Massachusetts General Hospital, Boston, MA, USA.
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - David M Weiss
- Center for Psychiatric Research, Maine Medical Center Research Institute, Portland, ME, USA
| | - Carrington Merritt
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Corinne Cather
- Center of Excellence in Psychosocial and Systemic Research, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Effua E Sosoo
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation, Departments of Occupational Therapy and Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - David L Penn
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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Pelizza L, Quattrone E, Leuci E, Paulillo G, Azzali S, Pupo S, Pellegrini P. Anxious-depressive symptoms after a first episode of schizophrenia: Response to treatment and psychopathological considerations from the 2-year "Parma Early Psychosis" program. Psychiatry Res 2022; 317:114887. [PMID: 36219900 DOI: 10.1016/j.psychres.2022.114887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/01/2022] [Accepted: 10/04/2022] [Indexed: 01/05/2023]
Abstract
Depression is common in schizophrenia and is correlated with suicide risk and poor long-term outcomes. However, the presence of depressive symptoms is often underestimated in both research and treatment, particularly at the illness onset. The goals of this study were: (a) to longitudinally observe anxious-depressive symptom levels in patients with First Episode Schizophrenia (FES) during a 24 months of follow-up period, and (b) to examine their associations with other psychopathology and the intervention patients received in an "Early Intervention in Psychosis" (EIP) program during the follow-up period. The Global Assessment of Functioning (GAF) and the Positive And Negative Syndrome Scale (PANSS) were completed by 159 FES patients both at baseline and across the follow-up. Data were analyzed by linear regression analysis and Spearman's coefficients. Anxious-depressive symptoms had significant longitudinal associations with GAF deterioration and PANSS "Positive Symptoms", "Negative Symptoms" and "Disorganization" subscores. During the follow-up period, FES participants significantly improved the level of anxious-depressive symptoms. This was significantly associated with the number of case management and individual psychotherapy meetings the patient engaged in, as well as with lower antipsychotic doses prescribed during the follow-up period. In conclusion, anxious-depressive symptoms are prominent in FES and at the initial entry into EIP programs. Anxious-depressive symptom severity tends to diminish overtime, especially with the provision of specialized EIP treatments. However, since we did not have a control population studied in parallel, we cannot say whether these results are specific to the protocols of EIP programs or just to the intensity of engagement in care.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, Parma 43100, Italy; Department of Biomedical and Neuromotor Sciences, Università degli Studi di Bologna, Via Zamboni n. 33, Bologna, Italy.
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, Parma 43100, Italy
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, Parma 43100, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, Parma 43100, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, Reggio, Emilia 43100, Italy
| | - Simona Pupo
- Division of Pain Medicine, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci n.14, Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, Parma 43100, Italy
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van Dierendonck D, Lam H. Interventions to enhance eudaemonic psychological well-being: A meta-analytic review with Ryff's Scales of Psychological Well-being. Appl Psychol Health Well Being 2022; 15:594-610. [PMID: 36073601 DOI: 10.1111/aphw.12398] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/23/2022] [Indexed: 11/30/2022]
Abstract
This meta-analysis enhances our insight into the effectiveness of interventions aimed at improving eudaemonic well-being. The focal outcome of these interventions is Ryff's Scales of Psychological Well-being. We summarized experimental studies and concluded whether a specific intervention approach improves individual positive functioning by assessing the six dimensions of psychological well-being and the composite score of well-being. Our study confirmed that eudaemonic well-being can be improved. The strongest influence is seen in integral programs that link directly to Ryff's conceptual model. Breaking down to dimensional scores, existing interventions had the strongest influence on Environmental Mastery, Personal Growth, and Self-Acceptance. The weakest influence was on Autonomy and Positive Relations with Others. Overall, our result is an important contribution to the well-being literature in that it shows, more convincing than previous meta-analyses due to its exclusive and comprehensive focus on Ryff's model, that psychological eudaemonic well-being can be enhanced by targeted intervention programs.
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Affiliation(s)
| | - Hodar Lam
- University of Amsterdam, Amsterdam, The Netherlands
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“It cannot be boring!”: Developing a measure of function for young adults accessing integrated youth services. J Patient Rep Outcomes 2022; 6:92. [PMID: 36057736 PMCID: PMC9440742 DOI: 10.1186/s41687-022-00491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background In Canada, the prevalence of mental health challenges is highest in young people aged 12–24. Mental health challenges frequently cause marked functional impairment. Despite this, we are unaware of any existing conceptualization and/or measures of function that has been developed from the perspective of young people. The objective of this paper is to develop a conceptual and measurement model, including a preliminary set of items, for an outcome measure of function for young adults accessing mental health services. Methods We conducted this study in three phases. In phase 1, we conducted three focus groups to conceptualize function as a construct from the perspective of young adults. In phase 2, we co-designed a set of items with youth (n = 4) to capture the construct. In phase 3, we invited young people (n = 12) accessing mental health services to complete workbooks and participate in one of two focus groups to evaluate whether items were clear, captured function comprehensively, and were relevant. We transcribed and compiled all data to eliminate, refine and generate new items. Results In phase 1, a conceptual model of function was developed with three main themes: basic needs, roles and responsibilities, and social connections. In phase 2, 97 candidate items were developed, and in phase 3, a candidate pool of 50 items resulted for psychometric testing. Conclusion This youth-centred conceptualization of function and preliminary item bank has the potential to advance person-centred care, outcomes, and experiences for youth seeking mental health services. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00491-6.
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Tay JL, Goh YSS, Sim K, Klainin-Yobas P. Impact of the HOPE Intervention on Mental Health Literacy, Psychological Well-Being and Stress Levels amongst University Undergraduates: A Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159772. [PMID: 35955126 PMCID: PMC9368620 DOI: 10.3390/ijerph19159772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 05/04/2023]
Abstract
Mental health literacy (MHL) promotes mental health among youths. We aimed to evaluate the effectiveness of the newly developed HOPE intervention in improving depression literacy, anxiety literacy, psychological well-being, and reducing personal stigma and stress levels amongst young adults at a university in Singapore. After two pilot studies, we conducted a randomised controlled trial (RCT) and recruited 174 participants aged 18-24 years old through social media platforms. The HOPE intervention group received four online sessions over two weeks and the control group received online inspirational quotes. Study outcomes were measured with self-reported questionnaires and they were assessed at baseline, post-intervention, and two-month follow-up (ClinicalTrials.gov: NCT04266119). Compared with the control arm, the intervention group was associated with increased depression and anxiety literacy levels at post-intervention and two-month follow-up. In addition, personal stigma for depression was reduced at the post-intervention juncture. However, there were no statistically significant changes in the ratings of psychological well-being and stress levels between the two groups. Longitudinal studies with larger sample sizes are warranted to replicate and extend the extant findings.
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Affiliation(s)
- Jing Ling Tay
- West Region, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore
- Correspondence:
| | - Yong Shian Shawn Goh
- Alice Lee Centre for Nursing Studies, Yoo Loo Lin School of Medicine, 2 National University of Singapore Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore
| | - Kang Sim
- West Region, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, 11 Mandalay Road, Level 18, Singapore 308232, Singapore
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yoo Loo Lin School of Medicine, 2 National University of Singapore Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore
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12
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Chu MHW, Lau B, Leung J, Chan SC, Tang B, Lau C, Newby C, Chiu R, Lo WTL, Schrank B, Slade M. Positive psychotherapy for psychosis in Hong Kong: A randomized controlled trial. Schizophr Res 2022; 240:175-183. [PMID: 35030447 DOI: 10.1016/j.schres.2021.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/21/2021] [Accepted: 12/25/2021] [Indexed: 10/19/2022]
Abstract
Recovery-oriented practice has been advocated in mental health services in Hong Kong since 2009. Well-being has become an important area of focus for mental health services. Positive Psychotherapy for Psychosis (PPP) is a well-being-focused intervention for use in psychosis, with preliminary evidence from a randomized controlled trial in the United Kingdom of impact on well-being and symptomatology. The aim of this study was to test the effectiveness of PPP on the well-being of people with psychosis in Hong Kong. The study was a randomized controlled trial with two-arm parallel groups. Both groups received treatments as usual, and in addition the intervention group received a 13-session intervention based on a Cantonese Chinese translation of the PPP manual. Intention-to-treat analysis was used. The trial was registered (ANZCTR: ACTRN12620000464965). A total of 154 participants (78 intervention, 76 control) were recruited. As compared to control group, intervention group participants showed significant changes over time on the primary outcome of well-being assessed using the Chinese Short Warwick-Edinburgh Mental Well-being Scale (p = 0.001) and on secondary outcomes of hope (Agency subscale: p = 0.029) and self-efficacy (p = 0.001). Positive Psychotherapy for Psychosis was found to be an effective treatment in improving the well-being and other mental health outcomes for people with psychosis. It can be recommended for use in mental health services to promote recovery.
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Affiliation(s)
- Menza Hon-Wai Chu
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China.
| | - Bien Lau
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Joey Leung
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Sheung Chun Chan
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Betty Tang
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Charles Lau
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | | | - Rose Chiu
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - William Tak-Lam Lo
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong, People's Republic of China
| | - Beate Schrank
- Karl Landsteiner University of Health Sciences, Department of Psychiatry, Krems, Austria
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, United Kingdom
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13
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Gleeson JFM, Eleftheriadis D, Santesteban-Echarri O, Koval P, Bastian B, Penn DL, Lim MH, Ryan RM, Alvarez-Jimenez M. Positive and meaningful lives: Systematic review and meta-analysis of eudaimonic well-being in first-episode psychosis. Early Interv Psychiatry 2021; 15:1072-1091. [PMID: 33037789 DOI: 10.1111/eip.13049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/13/2020] [Accepted: 09/26/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND First-episode psychosis typically has its onset during adolescence. Prolonged deficits in social functioning are common in FEP and yet often variance in functioning remains unexplained. Developmental psychology frameworks may be useful for understanding these deficits. Eudaimonic well-being (EWB), or positive self-development, is a developmental psychology construct that has been shown to predict mental health outcomes across multiple populations but has not been systematically reviewed in FEP. AIM Our aim was to systematically review the evidence for: the predictors of EWB, the effectiveness of EWB interventions and to examine the quality of this research in FEP. METHODS Selected studies measured either composite or components of EWB. A systematic search produced 2876 abstracts and 122 articles were identified for full screening which produced 17 final papers with 2459 participants. RESULTS Studies comprised six RCTs, eight prospective follow-up studies and three case-controlled studies. Self-esteem and self-efficacy were the most commonly measured components. A meta-analysis of RCTs revealed no statistically significant effect of interventions on self-esteem. The extant research indicates that character strengths may be associated with higher EWB. Self-esteem may be lower in FEP compared with age matched controls but not different from ultra-high risk patients. Self-esteem appears to be associated with poorer insight and improved therapeutic alliance. Significant problems with both external and internal validity of reviewed studies were apparent. CONCLUSIONS The hypotheses that lowered EWB is a risk factor for both onset of FEP and for poorer functional outcomes warrant further investigation. There is currently no evidence for effective interventions for EWB in FEP.
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Affiliation(s)
- John F M Gleeson
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Dina Eleftheriadis
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia.,Orygen, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Olga Santesteban-Echarri
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Peter Koval
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Brock Bastian
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - David L Penn
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia.,Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michelle H Lim
- Centre for Mental Health & Iverson Health Research Innovation Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Richard M Ryan
- Department of Psychology, University of Rochester, Rochester, New York, USA.,Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Mario Alvarez-Jimenez
- Orygen, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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14
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Albin K, Albin C, Jeffries CD, Perkins DO. Clinician Recognition of First Episode Psychosis. J Adolesc Health 2021; 69:457-464. [PMID: 33846053 DOI: 10.1016/j.jadohealth.2020.12.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 10/21/2022]
Abstract
PURPOSE Psychotic disorders develop during mid-adolescence through early adulthood, with the initial few months a "critical period" offering the greatest promise for recovery. However, the duration of untreated psychosis is typically over a year. This study aimed to identify aspects of care episodes contributing to delays in diagnosis of a first psychotic episode. METHODS Study subjects included 161 adolescents and young adults referred to a first episode psychosis treatment program. We captured the various ways that people who experience a severe mental illness engage in treatment using standardized interviews with patients and informants (e.g., family member) and medical record review. RESULTS A psychotic disorder diagnosis was not given for 38% of subjects at their initial episode of care. Time to first care episode was virtually the same for subjects that did and did not receive a psychosis diagnosis; 50% within 1 month and 84% within 6 months. Compared to initial care episodes with a psychosis diagnosis, those without a psychosis diagnosis less often involved emergency services (80% vs. 38%, respectively; p value = 1 × 10-7) and more often outpatient primary care (6% vs. 18%; p value = .032) and mental health (32% vs. 49%; p value = .045) services. However, dangerousness indicators were similar (29% vs. 28%; p value = 1). Dangerousness indicators increased to 54% (p value = .002) by the time of eventual diagnosis for those requiring multiple care episodes. CONCLUSIONS Clinicians were important contributors to delays in diagnosis and treatment of psychosis. Interventions targeting outpatient health care providers may be fruitful in reducing the duration of untreated psychosis.
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Affiliation(s)
- Kathryn Albin
- Texas College of Osteopathic Medicine Student, Fort Worth, Texas
| | - Cameron Albin
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Clark D Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, North Carolina
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina.
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15
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Özdemir AA, Kavak Budak F. The Effects of Mindfulness-Based Stress Reduction Training on Hope, Psychological Well-Being, and Functional Recovery in Patients with Schizophrenia. Clin Nurs Res 2021; 31:183-193. [PMID: 34382427 DOI: 10.1177/10547738211039069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study tested the effects of mindfulness-based stress reduction (MBSR) training on multiple outcomes in patients with schizophrenia. We compared MBSR, psychoeducation, and control groups in a randomized controlled research design. Outcome measures assessed hope, psychological wellbeing, and functional recovery over three time points in 137 participants. The results of this study indicate that MBSR training was more effective in terms of increasing the level of hope, psychological well-being, and functional recovery of schizophrenia patients when compared with psychoeducation and control patients.
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16
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Ludwig KA, Browne JW, Nagendra A, Gleeson JF, D'Alfonso S, Penn DL, Alvarez-Jimenez M. Horyzons USA: A moderated online social intervention for first episode psychosis. Early Interv Psychiatry 2021; 15:335-343. [PMID: 32067415 DOI: 10.1111/eip.12947] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 01/31/2020] [Indexed: 12/13/2022]
Abstract
AIM We evaluated the feasibility and acceptability of Horyzons, an online social media platform designed to facilitate relationship development among, and introduce therapeutic content to, first-episode psychosis (FEP) clients. We also evaluated whether participation in the platform was related to reduced loneliness, improved social integration and increased psychological well-being. METHODS Twenty-six participants diagnosed with a schizophrenia spectrum disorder were provided access to the moderated Horyzons platform for 12 weeks. During the intervention period, participants were encouraged to access therapeutic content and social components embedded within the site. Participants were recruited from three first-episode coordinated specialty care clinics in North Carolina and assessed at four time points: baseline, mid-treatment, post-treatment and 1-month follow-up. RESULTS Findings indicated that Horyzons was both feasible and very well tolerated, with a 92.3% retention rate and 79.2% of participants actively engaged in the platform. The most commonly identified personal strengths selected by Horyzons users were creativity (61.5%), curiosity (42.3%) and courage (38.5%). Feedback from participants indicated Horyzons could be improved by the development of a smartphone application, expanding the size of the Horyzons community and facilitating private messages between users. Preliminary results with engaged participants showed the greatest improvements in psychosis-related symptoms, followed by self-reported experience of negative emotions, depressive symptoms and loneliness. CONCLUSIONS This open trial found that Horyzons is both feasible and acceptable to FEP persons early in the course of illness living in the United States.
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Affiliation(s)
- Kelsey A Ludwig
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Julia W Browne
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Arun Nagendra
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John F Gleeson
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon D'Alfonso
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - David L Penn
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
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17
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Valiente C, Espinosa R, Contreras A, Trucharte A, Caballero R, Peinado V. The feasibility and acceptability study of a positive psychology group intervention for people with severe psychiatric conditions. JOURNAL OF POSITIVE PSYCHOLOGY 2021. [DOI: 10.1080/17439760.2021.1871940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Carmen Valiente
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Regina Espinosa
- Department of Psychology, School of Education and Health, Camilo José Cela University, Madrid, Spain
| | - Alba Contreras
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Almudena Trucharte
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Rocío Caballero
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Vanesa Peinado
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
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18
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Association of Follow-Up After an Emergency Department Visit for Mental Illness with Utilization Based Outcomes. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:718-728. [PMID: 33438094 DOI: 10.1007/s10488-020-01106-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
Follow-up within 30 days of an emergency department (ED) visit for mental illness is a new and widely-used quality measure. However, no empirical evidence validates associations between follow-up and subsequent utilization based outcomes. Using Massachusetts all payer claims data, we identified insured individuals with an ED visit for mental illness. Multivariate regression analysis estimated associations between follow-up within 30 days after an ED visit for mental illness with costs, hospitalizations, and additional ED visits in 180 days following the index visit. 63,814 index ED visits were included (56.5% female, mean [SD] age 38.0 [12.1] years, 48% Medicaid covered). 31% of index ED principal diagnoses were for major depressive disorder, 3% schizophrenia, 5% bipolar disorder, 34% anxiety disorder, 0.6% post-traumatic stress disorder, 8% other psychoses, and 19% other mental illness diagnoses. Only 33% of patients had a follow-up visit for mental illness within 30 days. Adjusted regression analyses show timely follow-up is associated with increased costs in the 180 days after (average marginal effect = $1622; 95% confidence interval [CI] 1459, 1786), an increased probability of inpatient hospitalization (2.7 percentage points; 95% CI 0.021, 0.032), and a small reduction in the probability of at least one additional ED visit (- 1.7 percentage points; 95% CI - 0.026 to 0.009). Overall follow-up rates are low; follow-up within 30 days of an ED visit for mental illness is associated with increased costs and increased probability of hospitalization in the follow-up period. It is not known whether increased rates of utilization improve patient outcomes, potentially by receiving appropriate more intensive care.
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19
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Leendertse JCP, Wierdsma AI, van den Berg D, Ruissen AM, Slade M, Castelein S, Mulder CL. Personal Recovery in People With a Psychotic Disorder: A Systematic Review and Meta-Analysis of Associated Factors. Front Psychiatry 2021; 12:622628. [PMID: 33708145 PMCID: PMC7940758 DOI: 10.3389/fpsyt.2021.622628] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/13/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Personal recovery (PR) is a subjective, multidimensional concept, and quantitative research using PR as an outcome is rapidly increasing. This systematic review is intended to support the design of interventions that contribute to PR in psychotic disorders, by providing an overview of associated factors and their weighted importance to PR: clinical factors, social factors, and socio-demographic characteristics are included, and factors related to the concept of PR (organized into CHIME dimensions). Methods: A systematic literature search was conducted from inception to March 2020. Quantitative studies that had used a validated questionnaire assessing the concept of PR were included. Mean effect sizes for the relationship between PR-scale total scores and related factors were calculated using meta-analyses. Sources of heterogeneity were examined using meta-regression tests. Results: Forty-six studies, that used (a total of) eight PR measures, showed that in clinical factors, affective symptoms had a medium negative association with PR-scale total scores (r = -0.44, 95%CI -0.50 to -0.37), while positive, negative and general symptoms had small negative correlations. No association was found with neuro-cognition. Social factors (support, work and housing, and functioning) showed small positive correlations. Gender and age differences had barely been researched. Large associations were found for PR-scale total scores with the CHIME dimensions hope (r = 0.56, 95%CI 0.48-0.63), meaning in life (r = 0.48, 95%CI 0.38-0.58) and empowerment (r = 0.53, 95%CI 0.42-0.63); while medium associations were found with connectedness (r = 0.34, 95%CI 0.43-0.65) and identity (r = 0.43, 95%CI 0.35-0.50). Levels of heterogeneity were high, sources included: the variety of PR measures, variations in sample characteristics, publication bias, variations in outcome measures, and cultural differences. Discussion: Most interventions in mental healthcare aim to reduce symptoms and improve functioning. With regard to stimulating PR, these interventions may benefit from also focusing on enhancing hope, empowerment, and meaning in life. The strength of these findings is limited by the challenges of comparing separate CHIME dimensions with questionnaires assessing the concept of PR, and by the high levels of heterogeneity observed. Future research should focus on the interaction between elements of PR and clinical and social factors over time.
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Affiliation(s)
- J C P Leendertse
- Emergis Institute for Mental Healthcare, Kloetinge, Netherlands.,Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - A I Wierdsma
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - D van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Research and Innovation, Parnassia Psychiatric Institute, The Hague, Netherlands
| | - A M Ruissen
- Emergis Institute for Mental Healthcare, Kloetinge, Netherlands.,Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands.,Department of Psychiatry, Haaglanden Medical Centre, The Hague, Netherlands
| | - M Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - S Castelein
- Lentis Research, Lentis Psychiatric Institute, Groningen, Netherlands.,Faculty of Behavioural and Social Sciences, Clinical Psychology, University of Groningen, Groningen, Netherlands
| | - C L Mulder
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands.,Research and Innovation, Parnassia Psychiatric Institute, The Hague, Netherlands
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20
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Ruini C, Cesetti G. Spotlight on eudaimonia and depression. A systematic review of the literature over the past 5 years. Psychol Res Behav Manag 2019; 12:767-792. [PMID: 31507332 PMCID: PMC6720155 DOI: 10.2147/prbm.s178255] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 08/07/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND AIM Recent investigations pointed out to the important role of well-being in influencing physical and mental health, with robust findings for the dimension of depression. The aim of this systematic review is to provide an updated summary of articles focused on eudaimonia and depression, including psychosocial interventions that addressed both issues. METHOD The literature search was performed by entering the keywords: "eudaimonia" OR "eudaimonic well-being (EWB)" and "depression" and by limiting to "journal article" and to the English language. To be included in this, review articles had to present at least one EWB measure and one depression measure, and had to investigate young and adult populations, including populations with mental health disorders. Articles were excluded if they were published before 2014. RESULTS Thirty-four articles were included, with a total of 81,987 participants. About the majority of participants were recruited in two twin studies, followed by college students, and by adults belonging to the general and clinical populations. Sixteen different instruments assessed eudaimonia, being Ryff's psychological well-being scale the most frequently used. The most used instrument for assessing depression was the Depression Anxiety Stress Scale, followed by Center for Epidemiological Studies Depression Scale. The studies confirmed the robust, inverse correlation between eudaimonia and depression, which was only partially explained by genetic common factors and which was mediated by other factors, as self-compassion, personality traits, and defense mechanisms. Various interventions were found to be effective both in promoting eudaimonia and in addressing depression, ranging from cognitive-behavioral therapy, acceptance and commitment therapy, mindfulness, to positive psychotherapy. CONCLUSION Clinicians, counselors, and practitioners can select different strategies to promote EWB and to address depression. The findings also suggest the need for a larger consensus on the definition of eudaimonia and on the specific measure(s) to evaluate it in different populations and in different life stages.
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Affiliation(s)
- Chiara Ruini
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giulia Cesetti
- Department of Psychology, University of Bologna, Bologna, Italy
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21
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Chen EYH. Early intervention for psychosis: current issues and emerging perspectives. Int Rev Psychiatry 2019; 31:411-412. [PMID: 31647381 DOI: 10.1080/09540261.2019.1667597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Eric Y H Chen
- Department of Psychiatry, University of Hong Kong , Hong Kong SAR , PR China
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22
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Prat G, Ribot A, Recoder S, Muñoz F. Psychometric properties of the Spanish version of the Engagement in Meaningful Activities Survey in people with serious mental illness. Br J Occup Ther 2019. [DOI: 10.1177/0308022619856557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Gemma Prat
- Grup SaMIS, Divisió de Salut Mental, Fundació Althaia, Manresa (Barcelona), Spain
| | - Arantxa Ribot
- Leisure-Community Intervention, Federació Salut Mental Catalunya, Barcelona, Spain
| | - Sílvia Recoder
- Departament de Ciències Bàsiques, Àrea de Psicologia, Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain
| | - Francisco Muñoz
- Leisure-Community Intervention, Federació Salut Mental Catalunya, Barcelona, Spain
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23
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Impact of comprehensive treatment for first episode psychosis on substance use outcomes: A randomized controlled trial. Psychiatry Res 2018; 268:303-311. [PMID: 30086471 DOI: 10.1016/j.psychres.2018.06.055] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/21/2018] [Accepted: 06/21/2018] [Indexed: 12/20/2022]
Abstract
Lifetime co-occurring substance use disorders are common at the time of presentation for treatment of a first episode of primary psychosis and persistent substance use disorder (SUD) leads to poorer outcomes. We assessed whether the NAVIGATE program, a coordinated specialty care service that includes optional substance abuse content reduced substance use compared to usual care in 404 individuals in the Recovery After Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study. Participants were randomized to two years of NAVIGATE (n = 223) or usual care (n = 181) and assessed monthly for substance use. At baseline, over one-half (51.7%) of the participants met criteria for a lifetime SUD, including over one-third with alcohol use disorder (36.4%) and with cannabis use disorder (34.7%). Contrary to our hypothesis, there was no treatment group by time interaction effect on days of self-reported substance use over the two-year follow-up. Participant exposure to the substance abuse component of the NAVIGATE program was low, suggesting that modifications to the program and training method for clinicians may be needed. Further research is needed to determine the most effective strategies for addressing substance use disorders in persons recovering from a first episode of psychosis.
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24
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Abstract
PURPOSE OF REVIEW Schizophrenia has a heterogeneous range of end states, from severe cases requiring repeated hospitalization to cases in which a single illness episode is followed by complete remission. The purpose of the present review is to examine recent literature on recovery in schizophrenia, focusing on the predictive factors and on the possibility to achieve it. RECENT FINDINGS Roughly half of schizophrenia patients recovered or significantly improved over the long term, suggesting that functional remission is possible. Several factors predict the course of schizophrenia, including demographic, clinical, and treatment characteristics, as well as socioeconomic variables. Antipsychotics are a fundamental element of schizophrenia treatment, although the available antipsychotics have significant limitations. In this context, psychosocial interventions are supported by substantial evidence of efficacy in many outcome measures and rehabilitation interventions should be considered as an evidence-based practice and need to become a part of the standard treatment of schizophrenia. SUMMARY As recovery is a multidimensional concept, some authors suggested that at least two areas should be taken into account: clinical remission and social functioning. Functional outcome should be a priority target for therapeutic interventions in schizophrenia and in this perspective measuring treatment response, remission and functional recovery is essential. Only an integrated and multifaceted approach involving pharmacotherapy, psychosocial interventions, and attention to environmental circumstances can improve outcome in schizophrenia.
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