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Yamaguchi S, Ojio Y, Koike J, Matsunaga A, Ogawa M, Kikuchi A, Kawashima T, Tachimori H, Bernick P, Kimura H, Inagaki A, Watanabe H, Kishi Y, Yoshida K, Hirooka T, Oishi S, Matsuda Y, Fujii C. Associations between readmission and patient-reported measures in acute psychiatric inpatients: a multicenter prospective longitudinal study. Soc Psychiatry Psychiatr Epidemiol 2025; 60:79-93. [PMID: 39102067 DOI: 10.1007/s00127-024-02710-5] [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: 02/20/2024] [Accepted: 06/24/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE This study examined whether patient-reported measures (PRMs) addressing quality of life, personal agency, functional impairment, and treatment satisfaction at hospital discharge were associated with future readmission during a 12-month follow-up period. The study also examined whether readmission influenced changes in the same measures. METHODS A multicenter prospective cohort study was conducted at 21 psychiatric hospitals in Japan. Participants completed the EuroQol-five-dimensions-five-level (EQ-5D), the Five-item Subjective Personal Agency Scale, and the Sheehan Disability Scale (SDS) at the time of index admission (T1), discharge from index admission (T2), and 6 months (T3) and 12 months (T4) after discharge. Inpatient treatment satisfaction was assessed at T2. Readmission and variables potentially associated with hospitalization and PRMs were evaluated using mixed-effects logistic regression models and mixed models for repeated measures. RESULTS A total of 491 participants were followed for 12 months (attrition rate: 19.4%), and 480 were included in the EQ-5D analysis. The most common diagnoses were schizophrenia (59%), depression (14%), and bipolar disorder (13%). No patient-reported measures were significantly associated with readmission over the follow-up period. Interaction of readmission and time did not significantly affect changes in EQ-5D. Readmission did significantly influence SDS score changes between T2 and T3 (B = 1.78, 95% CI = 0.30-3.25, p = 0.018) and between T3 and T4 (B = 1.43, 95% CI = 0.14-2.72, p = 0.029). The same influence of readmission on SDS score changes was not observed in the model which adjusted for all potential covariates. CONCLUSION Readmission was potentially associated with changes in self-reported functional impairment. Findings highlight the potential role of intensive post-discharge services in preventing readmission, rather than relying on time-of-discharge PRMs in order to predict readmission risk. TRIAL REGISTRATION This study was registered in UMIN Clinical Trials Registry (UMIN000034220).
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Affiliation(s)
- Sosei Yamaguchi
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553, Japan.
| | - Yasutaka Ojio
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553, Japan
| | - Junko Koike
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553, Japan
| | - Asami Matsunaga
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553, Japan
- Department of Mental Health and Psychiatric Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makoto Ogawa
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553, Japan
| | - Akiko Kikuchi
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553, Japan
- Faculty of Human Sciences, Musashino University, Tokyo, Japan
| | - Takahiro Kawashima
- Department of Information Medicine, National Center of Neurology and Psychiatry, National Institute of Neuroscience, Tokyo, Japan
| | - Hisateru Tachimori
- Department of Information Medicine, National Center of Neurology and Psychiatry, National Institute of Neuroscience, Tokyo, Japan
- Endowed Course for Health System Innovation, Keio University School of Medicine, Tokyo, Japan
| | - Peter Bernick
- Student Accessibility Office, Nagasaki University, Nagasaki, Japan
| | - Hiroshi Kimura
- Department of Psychiatry, Gakuji-Kai Kimura Hospital, Chiba, Japan
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chaba, Japan
| | - Ataru Inagaki
- College of Education, Psychology and Human Studies, Aoyama Gakuin University, Tokyo, Japan
| | - Hiroyuki Watanabe
- Department of Psychiatry, Gakuji-Kai Kimura Hospital, Chiba, Japan
- Division of Medical Treatment and Rehabilitation, Center of Forensic Mental Health, Chiba University, Chiba, Japan
| | - Yoshiki Kishi
- Department of Psychiatry, Okayama Psychiatric Medical Center, Okayama, Japan
| | - Koji Yoshida
- Department of Human Care and Support, Toyo University, Tokyo, Japan
| | - Takaaki Hirooka
- Department of Psychiatry, Kitasato University School of Medicine, Sagamihara, Japan
| | - Satoru Oishi
- Department of Psychiatry, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yasuhiro Matsuda
- Osaka Psychiatric Medical Center, Osaka, Japan
- Department of Psychiatry, Nara Medical University School of Medicine, Nara, Japan
| | - Chiyo Fujii
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553, Japan
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Pavlichenko A, Petrova N, Stolyarov A. The Modern Concept of Schizoaffective Disorder: A Narrative Review. CONSORTIUM PSYCHIATRICUM 2024; 5:42-55. [PMID: 39526012 PMCID: PMC11542913 DOI: 10.17816/cp15513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 09/03/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Schizoaffective disorder (SAD) is one of the most complex and controversial diagnoses in clinical psychiatry. Despite the significant changes that have occurred in the conceptualization of SAD in modern classifications and the publications of recent years, many unresolved issues remain regarding the disease, from the point of view of clinical psychiatry and basic neuroscience. AIM The purpose of this paper is to summarize published data on the concept of SAD, its clinical characteristics, cognitive profile, potential biomarkers, as well as the place of the disease in the following modern international classifications: the International Classification of Diseases (ICD) 9th, 10th and 11th revisions, and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). METHODS We undertook a review of the scientific studies in the relevant bibliographic systems and databases (eLIBRARY, PubMed) of the past 15 years. The descriptive analysis method was used to summarize the collected information. A total of 70 publications were selected for review, including different versions of international classifications of diseases (ICD and DSM-5). RESULTS There has been some improvement in the inter-rater reliability of SAD criteria in modern classifications, but this has not yet led to a clearer understanding among mental health specialists, while the various subtypes of SAD identified so far fail to account for the heterogeneity in the clinical presentation of the disorder. The dimensional approach to diagnosing SAD, according to which the intensity of psychotic and affective symptoms can fluctuate over time and they can influence one another, more accurately reflects the disease's ability to embody different forms. Basic research does not support the identification of a distinct cognitive, neuroimaging, or immunological SAD endophenotype that differs qualitatively from schizophrenia and affective psychoses. CONCLUSION The conceptualization of SAD remains incomplete, and new approaches rooted in neuroscience are needed to better understand the coexistence of affective and psychotic symptoms.
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Nkire N, Kinsella A, Russell V, Waddington JL. Duration of the psychosis prodrome and its relationship to duration of untreated psychosis across all 12 DSM-IV psychotic diagnoses: Evidence for a trans-diagnostic process associated with resilience. Eur Neuropsychopharmacol 2024; 80:5-13. [PMID: 38128335 DOI: 10.1016/j.euroneuro.2023.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 12/04/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
While duration of the psychosis prodrome (DPP) attracts attention in relation to the developmental trajectory of psychotic illness and service models, fundamental issues endure in the context of dimensional-spectrum models of psychosis. Among 205 epidemiologically representative subjects in the Cavan-Monaghan First Episode Psychosis Study, DPP was systematically quantified and compared, for the first time, across all 12 DSM-IV psychotic diagnoses. DPP was also compared with duration of untreated psychosis (DUP) and each was then analysed in relation to premorbid features across three age ranges: <12, 12-15 and 16-18 years. For each diagnosis, medians for both DPP and DUP were shorter than means, indicating common right-skewed distributions. Rank orders for both DPP and DUP were longest for schizophrenia, intermediate for other schizophrenia-spectrum psychoses, psychotic depression and psychotic disorder not otherwise specified, and shortest for brief psychotic disorder, bipolar disorder and substance-induced psychotic disorder, though with overlapping right-skewed distributions. DPP was longer than DUP for all diagnoses except substance-induced psychotic disorder. Across functional psychotic diagnoses, longer DPP was predicted by higher premorbid intelligence and better premorbid adjustment during age 16-18 years. These findings indicate that, trans-diagnostically, DPP and DUP share right-skewed continuities, in accordance with a dimensional-spectrum model of psychotic illness, and may reflect a unitary process that has been dichotomized at a subjective threshold along its trajectory. Better premorbid functioning during age 16-18 years appears to confer resilience by delaying progression to overt psychotic symptoms and may constitute a particular target period for psychosocial interventions.
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Affiliation(s)
- Nnamdi Nkire
- Drumalee Primary Care Centre, Cavan-Monaghan Mental Health Service, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anthony Kinsella
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Vincent Russell
- Drumalee Primary Care Centre, Cavan-Monaghan Mental Health Service, Cavan, Ireland; Department of Psychiatry, RCSI University of Medicine and Health Sciences, Beaumont Hospital, Dublin, Ireland
| | - John L Waddington
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psychiatric-Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China.
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Waddington JL. From operational diagnostic to dimensional-continuum concepts of psychotic and non-psychotic illness: Embracing catatonia across psychopathology and intrinsic movement disorder in neural network dysfunction. Schizophr Res 2024; 263:99-108. [PMID: 36244867 DOI: 10.1016/j.schres.2022.10.001] [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: 08/19/2022] [Revised: 10/01/2022] [Accepted: 10/02/2022] [Indexed: 03/04/2023]
Abstract
Psychiatry is currently negotiating several challenges that are typified by (but are not unique to) schizophrenia: do periodic refinements in operational diagnostic algorithms (a) resolve intricacies and subtleties within and between psychotic and non-psychotic disorders that are authentic and impactful, or (b) constitute arbitrary and porous boundaries that should be complemented, or even replaced, by dimensional-continuum concepts of abnormality and dysfunction. Critically, these issues relate not only to apparent boundaries between diagnoses but also to those between 'health' and 'illness'. This article considers catatonia within evolving dimensional-continuum approaches to the description of impairment and dysfunction among psychotic and non-psychotic disorders. It begins by considering the definition and assessment of catatonia vis-à-vis other disorders, followed by its long-standing conjunction with schizophrenia, relationship with antipsychotic drug treatment, transdiagnostic perspectives and relationships, and pathobiological processes. These appear to involve dysfunction across elements in overlapping neural networks that result in a confluence of psychopathology and intrinsic hypo- and hyperkinetic motor dysfunction. It has been argued that while current diagnostic approaches can have utility in defining groups of cases that are closely related, contemporary evidence indicates categorical diagnoses to be arbitrary divisions of what is essentially a continuous landscape. Psychotic and non-psychotic diagnoses, including catatonia, may reflect arbitrary areas around points of intersection between orthogonal dimensions of psychopathology and intrinsic movement disorder in a poly-dimensional space that characterises this continuous landscape of mental health and dysfunction.
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Affiliation(s)
- John L Waddington
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Jiangsu Key Laboratory of Translational Research & Therapy for Neuropsychiatric Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China.
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Branjerdporn G, Gillespie KM, Dymond A, Reyes NJD, Robertson J, Almeida-Crasto A, Bethi S. Development of an Interprofessional Psychosocial Interventions Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085495. [PMID: 37107777 PMCID: PMC10138946 DOI: 10.3390/ijerph20085495] [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: 01/19/2023] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 05/11/2023]
Abstract
To meet the increasingly complex needs of mental health consumers, it is essential for multidisciplinary clinicians to have capabilities across a range of psychosocial interventions. Despite this, there is scant evidence investigating the existing levels of knowledge and skills of specialties within multidisciplinary mental health teams. The purpose of this paper was to describe the self-reported capabilities of mental health clinicians, and to provide a rationale for the Psychosocial Interventions Framework Assessment (PIFA), which aims to enhance the access to, and quality of, evidence-informed practice for consumers of mental health services (MHSs) by strengthening workforce capabilities and leadership for psychosocial therapies. Using the Delphi method, the team developed a 75-item survey based on the 10-point Mental Health Recovery Star (MHRS). Participants completed a self-administered survey indicating their perceived capabilities in the PIFA items. The findings revealed lower-than-expected average scores between 'novice' and 'proficient', highlighting the need for further development of specific training and education modules for individual teams. This is the first framework of its nature to use the Recovery StarTM to determine the psychosocial areas and domains for the assessment of practitioners' strengths and needs for skill development.
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Affiliation(s)
- Grace Branjerdporn
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Gold Coast 4215, Australia
- Correspondence:
| | - Kerri Marie Gillespie
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Gold Coast 4215, Australia
- School of Clinical Sciences, Queensland University of Technology, Kelvin Grove 4059, Australia
| | - Alex Dymond
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Gold Coast 4215, Australia
| | - Neil Josen Delos Reyes
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Gold Coast 4215, Australia
| | - Julia Robertson
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Gold Coast 4215, Australia
| | - Alice Almeida-Crasto
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Gold Coast 4215, Australia
| | - Shailendhra Bethi
- Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Gold Coast 4215, Australia
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Szyszko vel Chorazy K, Efkemann SA, Schneider U, Juckel G. Multi-dimensional recording of long-term treatment of patients with schizophrenic disorders compared to patients with major depression measured with the ASSESS battery. Heliyon 2022; 8:e11924. [DOI: 10.1016/j.heliyon.2022.e11924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/28/2022] [Accepted: 11/19/2022] [Indexed: 11/30/2022] Open
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Nkire N, Kingston T, Kinsella A, Russell V, Waddington JL. Mixed-effects models reveal prediction of long-term outcome by duration of untreated psychosis (DUP) and illness (DUI) varies with quantile gradation but is invariant with time across 7 years in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS). Schizophr Res 2022; 248:124-130. [PMID: 36037645 DOI: 10.1016/j.schres.2022.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/01/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022]
Abstract
While associations between duration of untreated psychosis (DUP) and outcome have been widely reported, how long these relationships endure following initiation of treatment and how such associations are distributed across the range of DUP values encountered remain unclear. This study investigates prospectively (i) whether prediction of outcome by DUP and by duration of untreated illness (DUI) diminishes, remains stable or increases in the long term after initiating treatment, and (ii) whether these relationships for differing indices of outcome vary across gradations of DUP-DUI values. Sixty-two subjects were evaluated prospectively for DUP, DUI, premorbid features, psychopathology and quality of life at both first episode psychosis (FEP) and at 7-year follow-up; functionality and service engagement were assessed at follow-up. Data were analysed using mixed-effects models for DUP and DUI quantiles. Prediction by longer DUP and DUI of greater psychopathology, particularly negative symptoms, and lower quality of life remained stable between FEP and follow-up; longer DUP and DUI also predicted lower functionality and service engagement at follow-up. While most associations were confined to the longest DUP-DUI quartile, those between DUP-DUI and negative symptoms and quality of life were distributed in a graded manner across DUP-DUI quartiles. Material confounding with premorbid features, including lead-time bias, was not supported. These findings suggest that benefits of reducing DUP-DUI may endure for at least a decade beyond FEP and that even modest reductions in DUP-DUI may confer particular advantage in the more debilitating and intransigent domain of impairment.
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Affiliation(s)
- Nnamdi Nkire
- Cavan-Monaghan Mental Health Service, Drumalee Primary Care Centre, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Tara Kingston
- Cavan-Monaghan Mental Health Service, Drumalee Primary Care Centre, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anthony Kinsella
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Vincent Russell
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Beaumont Hospital, Dublin, Ireland
| | - John L Waddington
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric-Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China.
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Chakrabarti S, Singh N. Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review. World J Psychiatry 2022; 12:1204-1232. [PMID: 36186500 PMCID: PMC9521535 DOI: 10.5498/wjp.v12.i9.1204] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/02/2022] [Accepted: 08/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder (BD) and can have an adverse effect on its course, outcome, and treatment. However, despite a considerable amount of research, the impact of psychotic symptoms on BD remains unclear, and there are very few systematic reviews on the subject.
AIM To examine the extent of psychotic symptoms in BD and their impact on several aspects of the illness.
METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. An electronic literature search of six English-language databases and a manual search was undertaken to identify published articles on psychotic symptoms in BD from January 1940 to December 2021. Combinations of the relevant Medical Subject Headings terms were used to search for these studies. Articles were selected after a screening phase, followed by a review of the full texts of the articles. Assessment of the methodological quality of the studies and the risk of bias was conducted using standard tools.
RESULTS This systematic review included 339 studies of patients with BD. Lifetime psychosis was found in more than a half to two-thirds of the patients, while current psychosis was found in a little less than half of them. Delusions were more common than hallucinations in all phases of BD. About a third of the patients reported first-rank symptoms or mood-incongruent psychotic symptoms, particularly during manic episodes. Psychotic symptoms were more frequent in bipolar type I compared to bipolar type II disorder and in mania or mixed episodes compared to bipolar depression. Although psychotic symptoms were not more severe in BD, the severity of the illness in psychotic BD was consistently greater. Psychosis was usually associated with poor insight and a higher frequency of agitation, anxiety, and hostility but not with psychiatric comorbidity. Psychosis was consistently linked with increased rates and the duration of hospitalizations, switching among patients with depression, and poorer outcomes with mood-incongruent symptoms. In contrast, psychosis was less likely to be accompanied by a rapid-cycling course, longer illness duration, and heightened suicidal risk. There was no significant impact of psychosis on the other parameters of course and outcome.
CONCLUSION Though psychotic symptoms are very common in BD, they are not always associated with an adverse impact on BD and its course and outcome.
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Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, UT, India
| | - Navdeep Singh
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, UT, India
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Waddington JL, Nkire N, Russell V. Schizophrenia vis-à-vis dimensional-spectrum concepts of psychotic illness: Has an answer been 'hiding in plain sight'? Schizophr Res 2022; 242:144-146. [PMID: 34799221 DOI: 10.1016/j.schres.2021.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 12/22/2022]
Affiliation(s)
- John L Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China.
| | - Nnamdi Nkire
- Edmonton Mental Health Clinic, Edmonton, Alberta, Canada; Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Vincent Russell
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
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Higgins A, Downes C, Murphy R, Barry J, Monahan M, Doyle L, Gibbons P. Factors Influencing Attendees' Engagement with Group Psychoeducation: A Multi-stakeholder Perspective. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022; 49:539-551. [PMID: 34989933 PMCID: PMC9233715 DOI: 10.1007/s10488-021-01182-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 12/05/2022]
Abstract
Few studies have explored the problem of engagement in relation to group psychoeducation from a multi-site and multi-stakeholder perspective. The aim of the study was to explore the factors influencing service user and family engagement with group psychoeducation programmes. The study design was qualitative descriptive. Data were collected through individual and focus group interviews with key stakeholders (n = 75) involved with the programme within 14 mental health sites in the Republic of Ireland. Enablers and barriers to engagement were identified at participant, provider, programme and organization level. Motivated participants and engaged clinicians, peer co-facilitation and support, and skilled and responsive facilitators were some of the factors which enhanced engagement. Barriers to engagement included readiness among participants, concerns related to stigma and confidentiality, desire to distance oneself from mental health services, a lack of support for programme participation within families, group discomfort, the time and length of the programme, issues with transport, visibility of the programme, and structural supports for clinicians. Findings from the study illustrate the multifaceted nature of engagement as well as provide a greater understanding of the multifactorial influences on engagement. Strategies to enhance engagement should therefore reflect a multipronged approach. At the outset of programme implementation, organizations should address their readiness to engage, conduct local needs assessments to anticipate individuals’ needs and plan accordingly in order to maximize engagement, and bolster facilitators’ engagement skills through the provision of training and mentoring opportunities.
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Affiliation(s)
- Agnes Higgins
- School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland.
| | - Carmel Downes
- School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland
| | - Rebecca Murphy
- Department of Psychology, National University of Ireland, Maynooth, Kildare, Ireland
| | - Jennifer Barry
- School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland
| | - Mark Monahan
- School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland
| | - Louise Doyle
- School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland
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Thonon B, Levaux MN, van Aubel E, Larøi F. A Group Intervention for Motivational Deficits: Preliminary Investigation of a Blended Care Approach Using Ambulatory Assessment. Behav Modif 2021; 46:1167-1197. [PMID: 34583549 DOI: 10.1177/01454455211047605] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Motivational deficits are an important predictor of functional outcomes in individuals with a serious mental illness such as schizophrenia and mood spectrum disorders. The aim of the present study was to explore the feasibility, acceptability, and preliminary efficacy of a group version of "Switch," an intervention that targets motivational deficits, enriched with an ecological momentary intervention (EMI) approach (i.e., prompts on the participants' smartphone to encourage the use of trained strategies in their daily life). Eight participants with schizophrenia, schizoaffective, or major depressive disorder entered the study. The intervention took place twice a week for 2 months. Assessment measures included traditional evaluations of motivational negative symptoms, apathy, quality of life and daily functioning, in addition to ambulatory assessment methods strategies, including the experience sampling method (ESM) to assess motivation and related processes, and actigraphy (daily step-count) to assess participants' activity level. Four participants were considered as non-completers (followed less than 2/3 of the program) and four were considered as completers. Only completers presented a decrease in amotivation/apathy and an improvement in functional outcomes after the intervention and at follow-up. Furthermore, mixed-effects ESM models showed significant interaction effects on multiple processes related to motivation, indicating improvements only in completers: heightened motivation, increased engagement in meaningful and effortful activities, better mood, higher levels of confidence, increased frequency of projection into the future (pleasure anticipation), and of positive reminiscence. This preliminary investigation provides evidence that Switch may be an effective intervention, with specific effects on motivation and associated processes.
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Cruyt E, De Vriendt P, De Letter M, Vlerick P, Calders P, De Pauw R, Oostra K, Rodriguez-Bailón M, Szmalec A, Merchán-Baeza JA, Fernández-Solano AJ, Vidaña-Moya L, Van de Velde D. Meaningful activities during COVID-19 lockdown and association with mental health in Belgian adults. BMC Public Health 2021; 21:622. [PMID: 33785029 PMCID: PMC8009071 DOI: 10.1186/s12889-021-10673-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/22/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The spread of COVID-19 has affected people's daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people's mental health. AIM To identify correlates of adults' mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular. METHODS A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates. RESULTS Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = -.33). Loss of meaningful activities was strongly related to mental health (β = -.36) and explained 9% incremental variance (R2 change = .092, p < .001) above control variables. CONCLUSIONS The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults' mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics.
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Affiliation(s)
- Ellen Cruyt
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | - Patricia De Vriendt
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
- Department of Occupational Therapy, Artevelde University College, Ghent, Belgium
- Mental Health Research group, Frailty in Ageing Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Miet De Letter
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | - Peter Vlerick
- Faculty of Psychology and Educational Sciences, Department of Work, Organization and Society, Ghent University, Ghent, Belgium
| | - Patrick Calders
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | - Robby De Pauw
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | - Kristine Oostra
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium
| | | | - Arnaud Szmalec
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Jose Antonio Merchán-Baeza
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, University of Vic-Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain
| | - Ana Judit Fernández-Solano
- Department of Occupational Therapy. School of Health Sciences, Catholic University of Murcia, Murcia, Spain
| | - Laura Vidaña-Moya
- Research Group GrEUIT, Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona, Terrassa, Spain
| | - Dominique Van de Velde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Corneel Heymanslaan 10, B3, entrance 46, 9000, Ghent, Belgium.
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13
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Izakova L, Breznoscakova D. Differences in Treatment of Schizoaffective Disorder and Schizophrenia in Real Clinical Practice in Slovakia. Health (London) 2021. [DOI: 10.4236/health.2021.131007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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The network and dimensionality structure of affective psychoses: an exploratory graph analysis approach. J Affect Disord 2020; 277:182-191. [PMID: 32829194 DOI: 10.1016/j.jad.2020.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/27/2020] [Accepted: 08/08/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The dimensional symptom structure of classes of affective psychoses, and more specifically the relationships between affective and mood symptoms, has been poorly researched. Here, we examined these questions from a network analysis perspective. METHODS Using Exploratory Graph Analysis (EGA) and network centrality parameters, we examined the dimensionality and network structure of 28 mood and psychotic symptoms in subjects diagnosed with schizoaffective disorder (n=124), psychotic bipolar disorder (n=345) or psychotic depression (n=245), such as in the global sample of affective psychoses. RESULTS EGA identified four dimensions in subjects with schizoaffective or bipolar disorders (depression, mania, positive and negative) and three dimensions in subjects with psychotic depression (depression, psychosis and activation). The item composition of dimensions and the most central symptoms varied substantially across diagnoses. The most central (i.e., interconnected) symptoms in schizoaffective disorder, psychotic bipolar disorder and psychotic depression were hallucinations, delusions and depressive mood, respectively. Classes of affective psychoses significantly differed in terms of network structure but not in network global strength. LIMITATIONS The cross-sectional nature of this study precludes conclusions about the causal dynamics between affective and psychotic symptoms. CONCLUSION EGA is a powerful tool for examining the dimensionality and network structure of symptoms in affective psychoses showing that both the interconnectivity pattern between affective and psychotic symptoms and the most central symptoms vary across classes of affective psychoses. The findings outline the value of specific diagnoses in explaining the relationships between mood and affective symptoms.
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15
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Development and Feasibility Exploration of a Combined Compensatory and Restorative Approach to Addressing Cognitive Challenges in Early Intervention Psychosis. COGNITIVE AND BEHAVIORAL PRACTICE 2020. [DOI: 10.1016/j.cbpra.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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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: 0.7] [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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17
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Yamaguchi S, Ojio Y, Koike J, Matsunaga A, Ogawa M, Tachimori H, Kikuchi A, Kimura H, Inagaki A, Watanabe H, Kishi Y, Yoshida K, Hirooka T, Oishi S, Matsuda Y, Fujii C. Associations between readmission and patient-reported measures in acute psychiatric inpatients: a study protocol for a multicenter prospective longitudinal study (the ePOP-J study). Int J Ment Health Syst 2019; 13:40. [PMID: 31182972 PMCID: PMC6555753 DOI: 10.1186/s13033-019-0298-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 05/28/2019] [Indexed: 02/06/2023] Open
Abstract
Background Several previous observational studies have reported the risk factors associated with readmission in people with mental illness. While patient-reported experiences and outcomes have become increasingly important in healthcare, only a few studies have examined these parameters in terms of their direct association with readmission in an acute psychiatric setting. This project will investigate multiple factors associated with readmission and community living in acute psychiatric patients in Japan. This study will primarily investigate whether patient-reported experiences at discharge, particularly quality of life (QoL), are associated with future readmission and whether readmission after the index hospitalization is associated with changes in patient-reported outcomes during the study period. Here, we describe the rationale and methods of this study. Methods This multicenter prospective cohort study is being conducted in 21 participating Japanese hospitals, with a target sample of approximately 600 participants admitted to the acute psychiatric ward. The study has four planned assessment points: time of index admission (T1), time of discharge (from the index admission) (T2), 6 months after discharge from the index admission (T3), and 12 months after discharge from the index admission (T4). Participants will complete self-reported measures including a QoL scale, a subjective disability scale, and an empowerment- and self-agency-related scale at each assessment point; additionally, service satisfaction, subjective view of need for services, and subjective relationships with family members will be assessed at T2 and T3. We will assess the participants’ hospitalization during the study period and evaluate several potential individual- and service-level factors associated with readmission and patient-reported experiences and outcomes. Multivariate analyses will be conducted to identify potential associations between readmission and patient-reported experiences and outcomes. Discussion The present study may produce evidence on how patient-reported experiences at discharge influence readmission and on the influence of readmission on the course of patient-reported outcomes from admission to community living after discharge. The study may contribute to improving care for both patients’ subjective views of their own health conditions and their community lives in an acute psychiatric setting. Trial registration University Hospital Medical Information Network—Clinical Trials Registry (UMIN-CTR) UMIN000034220. Registered on September 20, 2018. Electronic supplementary material The online version of this article (10.1186/s13033-019-0298-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sosei Yamaguchi
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Yasutaka Ojio
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Junko Koike
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Asami Matsunaga
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Makoto Ogawa
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Hisateru Tachimori
- 2Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan.,3The Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-ku, Tokyo, 162-8655 Japan
| | - Akiko Kikuchi
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Hiroshi Kimura
- 4Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan.,Department of Psychiatry, Gakuji-kai, Kimura Hospital, 6-19 Higashi-honcho, Chuo-ku, Chiba, 260-8670 Japan
| | - Ataru Inagaki
- 6College of Education, Psychology and Human Studies, Aoyama Gakuin University, 4-4-25 Shibuya, Shibuya-ku, Tokyo, 150-8366 Japan
| | - Hiroyuki Watanabe
- Department of Psychiatry, Gakuji-kai, Kimura Hospital, 6-19 Higashi-honcho, Chuo-ku, Chiba, 260-8670 Japan.,7Division of Medical Treatment and Rehabilitation, Center of Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Yoshiki Kishi
- 8Department of Psychiatry, Okayama Psychiatric Medical Center, 3-16 Shikata-Honmachi, Kita-ku, Okayama, Japan
| | - Koji Yoshida
- 9Department of Human Care and Support, Toyo University, 48-1 Oka, Asaka, 351-8510 Japan
| | - Takaaki Hirooka
- 10Department of Psychiatry, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami, Sagamihara, 252-0374 Japan
| | - Satoru Oishi
- 10Department of Psychiatry, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami, Sagamihara, 252-0374 Japan
| | - Yasuhiro Matsuda
- 11Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo, Kashihara, 634-8521 Japan
| | - Chiyo Fujii
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
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18
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The Cavan-Monaghan First Episode Psychosis Study (CAMFEPS): arbitrary diagnostic boundaries across the gene–environment interface and within evolving models of care. Ir J Psychol Med 2019; 36:293-303. [DOI: 10.1017/ipm.2019.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
As research into psychotic illness evolves along established lines, insights are emerging that deviate from those lines and challenge more fundamentally our understanding. On the background of a new generation of studies on first-episode psychosis, investigations across the gene–environment interface and the intersection with ‘normal’ human mentation heighten these concerns. Using findings from the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS) as an exemplar, we here review the complexity of these challenges from the perspective of this real-world setting. They range from trans-diagnostic epidemiology and clinical characterisation, through molecular genetics, social milieu, developmental pathobiology and functional outcome across arbitrary diagnostic boundaries, to the evidence base for early intervention and more radical conceptualisations and structures for provision of mental health care.
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19
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Zhen XC, Waddington J. Emerging and evolving concepts in the pathobiology and treatment of psychosis. CNS Neurosci Ther 2018; 24:583-585. [PMID: 29898285 DOI: 10.1111/cns.12974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Xue-Chu Zhen
- Jiangsu Key Laboratory of Neuropsychiatric Diseases, College of Pharmaceutical Sciences, Soochow University, Suzhou, China.,The Collaborative Innovation Center for Brain Science, Soochow University, Suzhou, China
| | - John Waddington
- Jiangsu Key Laboratory of Neuropsychiatric Diseases, College of Pharmaceutical Sciences, Soochow University, Suzhou, China.,Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
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20
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Kingston T, Scully PJ, Browne DJ, Baldwin PA, Kinsella A, O'Callaghan E, Russell V, Waddington JL. Functional outcome and service engagement in major depressive disorder with psychotic features: comparisons with schizophrenia, schizoaffective disorder and bipolar disorder in a 6-year follow-up of the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS). CNS Neurosci Ther 2018; 24:633-640. [PMID: 29575682 DOI: 10.1111/cns.12836] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE While long-term outcome following a first psychotic episode is well studied in schizophrenia (SZ), schizoaffective disorder (SA), and bipolar disorder (BD), major depressive disorder with psychotic features (MDDP) has received less investigation. This study compares MDDP with SZ, SA, and BD at 6-year follow-up. METHODS At 6 years after a first psychotic episode, follow-up data on psychopathology, functioning, quality of life, and service engagement were obtained for 27 cases of MDDP in comparison to 60 SZ, 27 SA, and 35 BD. RESULTS Positive psychotic symptoms were less prominent in MDDP and BD than in SZ and SA. Negative symptoms, impaired functioning, and reduction in objectively determined quality of life were less prominent in MDDP and BD, intermediate in SA and most prominent in SZ. However, subjectively determined quality of life was indistinguishable across diagnoses. Service engagement was highest for MDDP, intermediate for SA and BD, and lowest for SZ. CONCLUSIONS At 6-year follow-up, these diagnoses are characterized by quantitative rather than qualitative differences in psychopathology, functionality, quality of life, and service engagement, with considerable overlap between them. These findings suggest that MDDP should join SZ, SA, and BD in a milieu of psychosis that transcends arbitrary boundaries.
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Affiliation(s)
- Tara Kingston
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland.,Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paul J Scully
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland
| | - David J Browne
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland
| | - Patrizia A Baldwin
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland
| | - Anthony Kinsella
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Vincent Russell
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland.,Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - John L Waddington
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland.,Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric Disorders, Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
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