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Välimäki M, Lantta T, Kontio R. Risk assessment for aggressive behaviour in schizophrenia. Cochrane Database Syst Rev 2024; 5:CD012397. [PMID: 38695777 PMCID: PMC11064887 DOI: 10.1002/14651858.cd012397.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
BACKGROUND Aggressive or violent behaviour is often associated with people with schizophrenia in common perceptions of the disease. Risk assessment methods have been used to identify and evaluate the behaviour of those individuals who are at the greatest risk of perpetrating aggression or violence or characterise the likelihood to commit acts. Although many different interventions have been developed to decrease aggressive or violent incidences in inpatient care, staff working in inpatient settings seek easy-to-use methods to decrease patient aggressive events. However, many of these are time-consuming, and they require intensive training for staff and patient monitoring. It has also been recognised in clinical practice that if staff monitor patients' behaviour in a structured manner, the monitoring itself may result in a reduction of aggressive/violent behaviour and incidents in psychiatric settings. OBJECTIVES To assess the effects of structured aggression or violence risk assessment methods for people with schizophrenia or schizophrenia-like illnesses. SEARCH METHODS We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials, which is based on CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ISRCTN registry, ClinicalTrials.gov, and WHO ICTRP, on 10 February 2021. We also inspected references of all identified studies. SELECTION CRITERIA We included all randomised controlled trials (RCTs) comparing structured risk assessment methods added to standard professional care with standard professional care for the evaluation of aggressive or violent behaviour among people with schizophrenia. DATA COLLECTION AND ANALYSIS At least two review authors independently inspected citations, selected studies, extracted data, and appraised study quality. For binary outcomes, we calculated a standard estimation of the risk ratio (RR) and its 95% confidence interval (CI). For continuous outcomes, we calculated the mean difference (MD) and its 95% CI. We assessed risk of bias in the included studies and created a summary of findings table using the GRADE approach. MAIN RESULTS We included four studies in the review. The total number of participants was not identifiable, as some studies provided number of participants included, and some only patient days. The studies compared a package of structured assessment methods with a control group that included routine nursing care and drug therapy or unstructured psychiatric observations/treatment based on clinical judgement. In two studies, information about treatment in control care was not available. One study reported results for our primary outcome, clinically important change in aggressive/violent behaviour, measured by the rate of severe aggression events. There was likely a positive effect favouring structured risk assessment over standard professional care (RR 0.59, 95% CI 0.41 to 0.85; 1 RCT; 1852 participants; corrected for cluster design: RR 0.59, 95% CI 0.37 to 0.93; moderate-certainty evidence). One trial reported data for the use of coercive measures (seclusion room). Compared to standard professional care, structured risk assessment may have little or no effect on use of seclusion room as days (corrected for cluster design: RR 0.92, 95% CI 0.27 to 3.07; N = 20; low-certainty evidence) or use of seclusion room as secluded participants (RR 1.83, 95% CI 0.39 to 8.7; 1 RCT; N = 20; low-certainty evidence). However, seclusion room may be used less frequently in the standard professional care group compared to the structured risk assessment group (incidence) (corrected for cluster design: RR 1.63, 95% CI 0.49 to 5.47; 1 RCT; N = 20; substantial heterogeneity, Chi2 = 0.0; df = 0.0; P = 0.0; I2 = 100%; low-certainty evidence). There was no evidence of a clear effect on adverse events of escape (RR 0.2, 95% CI 0.01 to 4.11; 1 RCT; n = 200; very low-certainty evidence); fall down (RR 0.33, 95% CI 0.04 to 3.15; 1 RCT; n = 200; very low-certainty evidence); or choking (RR 0.2, 95% CI 0.01 to 4.11; 1 RCT; n = 200; very low-certainty evidence) when comparing structured risk assessment to standard professional care. There were no useable data for patient-related outcomes such as global state, acceptance of treatment, satisfaction with treatment, quality of life, service use, or costs. AUTHORS' CONCLUSIONS Based on the available evidence, it is not possible to conclude that structured aggression or violence risk assessment methods are effective for people with schizophrenia or schizophrenia-like illnesses. Future work should combine the use of interventions and structured risk assessment methods to prevent aggressive incidents in psychiatric inpatient settings.
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Affiliation(s)
- Maritta Välimäki
- School of Public Health, University of Helsinki, Helsinki, Finland
| | - Tella Lantta
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Raija Kontio
- Department of Nursing Science, University of Turku, Turku, Finland
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Raina S. Schizophrenia: Communication Disorders and Role of the Speech-Language Pathologist. Am J Speech Lang Pathol 2024; 33:1099-1112. [PMID: 38266230 DOI: 10.1044/2023_ajslp-23-00287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
PURPOSE This clinical focus article aims to provide a comprehensive overview of schizophrenia and understanding of communication disorders resulting from its psychopathology. Schizophrenia is a spectrum disorder with varying levels of symptom expression. It is characterized by positive and negative symptoms that can cause communication disorders of different severity levels. Communication difficulties manifest as a range of symptoms such as alogia, disorganized speech, and impaired social communication. These challenges may result in receptive and expressive language deficits that lead to misunderstandings, reduced social interactions, and difficulties expressing thoughts and emotions effectively. The purpose of this clinical focus article is to explore the role of the speech-language pathologist (SLP) in assessing and treating communication disorders presented in schizophrenia. CONCLUSIONS In order to understand the role of the SLP in assessing and treating communication disorders in schizophrenia, it is imperative to understand the overall course, etiology, assessment, and treatment consideration of this condition. SLPs can provide services in the areas of social skills training and community-based intervention contexts.
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Affiliation(s)
- Shivani Raina
- Department of Communication Disorders and Deafness, Kean University, Union, NJ
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Moran EK, Shapiro M, Culbreth AJ, Nepal S, Ben-Zeev D, Campbell A, Barch DM. Loneliness in the Daily Lives of People With Mood and Psychotic Disorders. Schizophr Bull 2024; 50:557-566. [PMID: 38429937 PMCID: PMC11059807 DOI: 10.1093/schbul/sbae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
BACKGROUND AND HYPOTHESIS Loneliness, the subjective experience of feeling alone, is associated with physical and psychological impairments. While there is an extensive literature linking loneliness to psychopathology, limited work has examined loneliness in daily life in those with serious mental illness. We hypothesized that trait and momentary loneliness would be transdiagnostic and relate to symptoms and measures of daily functioning. STUDY DESIGN The current study utilized ecological momentary assessment and passive sensing to examine loneliness in those with schizophrenia (N = 59), bipolar disorder (N = 61), unipolar depression (N = 60), remitted unipolar depression (N = 51), and nonclinical comparisons (N = 82) to examine relationships of both trait and momentary loneliness to symptoms and social functioning in daily life. STUDY RESULTS Findings suggest that both trait and momentary loneliness are higher in those with psychopathology (F(4,284) = 28.00, P < .001, ηp2 = 0.27), and that loneliness significantly relates to social functioning beyond negative symptoms and depression (β = -0.44, t = 6.40, P < .001). Furthermore, passive sensing measures showed that greater movement (β = -0.56, t = -3.29, P = .02) and phone calls (β = -0.22, t = 12.79, P = .04), but not text messaging, were specifically related to decreased loneliness in daily life. Individuals higher in trait loneliness show stronger relationships between momentary loneliness and social context and emotions in everyday life. CONCLUSIONS These findings provide further evidence pointing to the importance of loneliness transdiagnostically and its strong relation to social functioning. Furthermore, we show that passive sensing technology can be used to measure behaviors related to loneliness in daily life that may point to potential treatment implications or early detection markers of loneliness.
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Affiliation(s)
- Erin K Moran
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Madelyn Shapiro
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Adam J Culbreth
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, Baltimore, MD, USA
| | - Subigya Nepal
- Department of Computer Science, Dartmouth College, Hanover, NH, USA
| | - Dror Ben-Zeev
- Department of Psychiatry, BRiTE Center, University of Washington, Seattle, WA, USA
| | - Andrew Campbell
- Department of Computer Science, Dartmouth College, Hanover, NH, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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Petrescu C, Mihalache OA, Vilciu C, Petrescu DM, Marian G, Ciobanu CA, Ciobanu AM. Clinical and Sociodemographic Correlations with Neurological Soft Signs in Hospitalized Patients with Schizophrenia: A Preliminary Longitudinal Study. Biomedicines 2024; 12:787. [PMID: 38672143 PMCID: PMC11048323 DOI: 10.3390/biomedicines12040787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Schizophrenia is a severe, chronic neuropsychiatric disorder characterized by symptoms that profoundly impact behavior, cognition, perception, and emotions, leading to a reduced quality of life and physical impairment. Given the complexity of schizophrenia, there is a pressing need for clinical markers and tools to predict its course, enhance disease staging, facilitate early intervention, improve differential diagnosis, and tailor individualized treatment approaches. Previous studies focused on the relationship between neurological soft signs (NSS) and factors such as age, illness duration, and symptomatology, indicating NSS as state markers improving in parallel with psychotic symptom remission or predicting treatment resistance. However, there is a lack of consensus on NSS assessment tools, hindering routine clinical monitoring despite diagnostic and prognostic potential. The present longitudinal study involved 81 psychiatric inpatients diagnosed with schizophrenia. Patients were assessed at three time points: baseline, 1 month, and 6 months. The examination included the use of scales to evaluate psychotic and neurological symptoms, as well as the identification of adverse extrapyramidal reactions caused by neuroleptic treatment. The progression of NSS was correlated to both the symptomatology and the sociodemographic data of the patients. The main findings from the present investigation revealed a statistical correlation between NSS and psychopathological symptoms, especially with negative symptoms of schizophrenia. However, it is important to note that neuroleptic side effects only had a limited impact on NSS. Therefore, instead of being linked to extrapyramidal symptoms caused by neuroleptics, NSS appears to be more frequently related with symptoms of schizophrenia. Our findings provide further support for their strong association with the course of schizophrenia, independent of treatment side effects, thus emphasizing their potential as reliable assessment tools in both research and clinical settings.
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Affiliation(s)
- Cristian Petrescu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Oana A. Mihalache
- Department of Doctoral Studies, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Neurology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (D.M.P.)
| | - Crisanda Vilciu
- Department of Neurology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (D.M.P.)
- Neurology Clinic, ‘Fundeni’ Clinical Institute, 022328 Bucharest, Romania
| | - Diana M. Petrescu
- Department of Neurology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.V.); (D.M.P.)
- Neurology Clinic, ‘Fundeni’ Clinical Institute, 022328 Bucharest, Romania
| | - Gabriela Marian
- Academy of Romanian Scientists, 927180 Bucharest, Romania;
- Department of Psychiatry and Psychology, ‘Titu Maiorescu’ University of Medicine, 040051 Bucharest, Romania
| | - Constantin A. Ciobanu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020022 Bucharest, Romania
| | - Adela M. Ciobanu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
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Fan Y, Zhou L, Chen X, Su J, Zhong S. Determinants and outcomes of health-promoting lifestyle among people with schizophrenia. BMC Psychiatry 2024; 24:177. [PMID: 38439019 PMCID: PMC10913642 DOI: 10.1186/s12888-024-05625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Healthy lifestyle is an important protective factor of developing cardiovascular disease in people with schizophrenia. However, little is known about the determinants of lifestyle and its contribution to metabolic syndrome. This study aimed to explore the influencing factors of health-promoting lifestyle (HPL) and its association with metabolic syndrome among people with schizophrenia. METHODS A cross-sectional study was conducted in twenty-two primary health centers of Guangzhou, China between December 2022 and April 2023. A total of 538 patients with schizophrenia were recruited through convenience sampling. Self-administered scales, questionnaires, and clinical data were collected. Scales and questionnaires included social-demographic information, Health-Promoting Lifestyles Profile (HPLP-C), UCLA Loneliness Scale (ULS), and International Physical Activity Questionnaire-Short Form (IPAQ-SF). Cluster analyses were used to divide participants into two groups based on the distribution characteristics of HPLP-C scores. Logistic regression models were used to identify factors associated with HPL and the association between HPL and metabolic syndrome. RESULTS There were 271 participants in the high HPL group and 267 participants in the low HPL group. Logistic regression analysis revealed that loneliness posed a risk factor for high HPL, while high education and moderate-vigorous physical activity served as protective factors for high HPL. Low HPL was a risk factor for the prevalence of metabolic syndrome. CONCLUSIONS Promotion of high education literacy and a physically active lifestyle should be priority targets in the health management of schizophrenia. Primary healthcare providers can play a pivotal role in assisting patients to mitigate metabolic syndrome by reinforcing healthy lifestyle strategies.
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Affiliation(s)
- Yu Fan
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
| | - Xiyuan Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Jinghua Su
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Shaoling Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, 510370, Guangzhou, Guangdong , China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
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Cabrera-Mendoza B, Aydin N, Fries GR, Docherty AR, Walss-Bass C, Polimanti R. Estimating the direct effects of the genetic liabilities to bipolar disorder, schizophrenia, and behavioral traits on suicide attempt using a multivariable Mendelian randomization approach. Neuropsychopharmacology 2024:10.1038/s41386-024-01833-2. [PMID: 38396255 DOI: 10.1038/s41386-024-01833-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/25/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
Bipolar disorder (BD) and schizophrenia (SZ) are associated with higher odds of suicide attempt (SA). In this study, we aimed to explore the effect of BD and SZ genetic liabilities on SA, also considering the contribution of behavioral traits, socioeconomic factors, and substance use disorders. Leveraging large-scale genome-wide association data from the Psychiatric Genomics Consortium (PGC) and the UK Biobank (UKB), we conducted a two-sample Mendelian randomization (MR) analysis to evaluate the putative causal effect of BD (41,917 cases, 371,549 controls) and SZ (53,386 cases, 77,258 controls) on SA (26,590 cases, 492,022 controls). Then, we assessed the putative causal effect of BD and SZ on behavioral traits, socioeconomic factors, and substance use disorders. Considering the associations identified, we evaluated the direct causal effect of behavioral traits, socioeconomic factors, and substance use disorders on SA using a multivariable MR approach. The genetic liabilities to BD and SZ were associated with higher odds of SA (BD odds ratio (OR) = 1.24, p = 3.88 × 10-12; SZ OR = 1.09, p = 2.44 × 10-20). However, while the effect of mental distress (OR = 1.17, p = 1.02 × 10-4) and risk-taking (OR = 1.52, p = 0.028) on SA was independent of SZ genetic liability, the BD-SA relationship appeared to account for the effect of these risk factors. Similarly, the association with loneliness on SA was null after accounting for the effect of SZ genetic liability. These findings highlight the complex interplay between genetic risk of psychiatric disorders and behavioral traits in the context of SA, suggesting the need for a comprehensive mental health assessment for high-risk individuals.
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Affiliation(s)
- Brenda Cabrera-Mendoza
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, 06516, USA.
- VA CT Healthcare System, West Haven, CT, 06516, USA.
| | - Necla Aydin
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, 06516, USA
- Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gabriel R Fries
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 77054, Houston, TX, USA
| | - Anna R Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Mental Health Institute, Salt Lake City, UT, USA
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Consuelo Walss-Bass
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 77054, Houston, TX, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, 06516, USA
- VA CT Healthcare System, West Haven, CT, 06516, USA
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McCormick BP, Brusilovskiy E, Nagata S, Townley G, Snethen G, Salzer MS. The Role of Acceptance in Everyday Loneliness Among Adults with Serious Mental Illness. Community Ment Health J 2024; 60:308-316. [PMID: 37498513 DOI: 10.1007/s10597-023-01172-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/16/2023] [Indexed: 07/28/2023]
Abstract
There is a high prevalence of loneliness among adults with serious mental illness (SMI) with most research focusing on stable contributing factors. This study sought to identify the role of dispositional loneliness and internalized stigma, as well as the momentary feelings of acceptance on experiential loneliness among adults with SMI. Data were collected using ecological momentary assessment via smart phones, and 89 adults with a SMI were included. Hierarchical linear modeling was used to identify the role of dispositional and experience factors in experiential loneliness. Findings indicated that (a) dispositional internalized stigma, (b) being at home, (c) being alone and, (d) a cross-level interaction between dispositional loneliness and feelings of acceptance best fit the data. The relationship of acceptance to experiential loneliness was strongest among the most lonely. Supporting people with SMI to develop social connections contributing to their relational value may enhance feelings of acceptance and reduce loneliness.
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Affiliation(s)
- Bryan P McCormick
- Department of Health & Rehabilitation Sciences, Temple University, 1700 N. Broad St., Suite 304, Philadelphia, PA, 19122, USA.
| | - Eugene Brusilovskiy
- Department of Social & Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - Shinichi Nagata
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Greg Townley
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Gretchen Snethen
- Department of Health & Rehabilitation Sciences, Temple University, Philadelphia, PA, USA
| | - Mark S Salzer
- Department of Social & Behavioral Sciences, Temple University, Philadelphia, PA, USA
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Okruszek Ł, Jarkiewicz M, Piejka A, Chrustowicz M, Krawczyk M, Schudy A, Harvey PD, Penn DL, Ludwig K, Green MF, Pinkham AE. Loneliness is associated with mentalizing and emotion recognition abilities in schizophrenia, but only in a cluster of patients with social cognitive deficits. J Int Neuropsychol Soc 2024; 30:27-34. [PMID: 37154103 DOI: 10.1017/s1355617723000206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Loneliness is a concern for patients with schizophrenia. However, the correlates of loneliness in patients with schizophrenia are unclear; thus, the aim of the study is to investigate neuro- and social cognitive mechanisms associated with loneliness in individuals with schizophrenia. METHOD Data from clinical, neurocognitive, and social cognitive assessments were pooled from two cross-national samples (Poland/USA) to examine potential predictors of loneliness in 147 patients with schizophrenia and 103 healthy controls overall. Furthermore, the relationship between social cognition and loneliness was explored in clusters of patients with schizophrenia differing in social cognitive capacity. RESULTS Patients reported higher levels of loneliness than healthy controls. Loneliness was linked to increased negative and affective symptoms in patients. A negative association between loneliness and mentalizing and emotion recognition abilities was found in the patients with social-cognitive impairments, but not in those who performed at normative levels. CONCLUSIONS We have elucidated a novel mechanism which may explain previous inconsistent findings regarding the correlates of loneliness in individuals with schizophrenia.
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Affiliation(s)
- Ł Okruszek
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Jarkiewicz
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - A Piejka
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Chrustowicz
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Krawczyk
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - A Schudy
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - P D Harvey
- University of Miami Miller School of Medicine, Miami VA Healthcare System, Miami, FL, USA
| | - D L Penn
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - K Ludwig
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M F Green
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - A E Pinkham
- Department of Psychology, University of Texas at Dallas, Richardson, TX, USA
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
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Álvarez-Heredia P, Reina-Alfonso I, Domínguez-del-Castillo JJ, Hassouneh F, Gutiérrez-González C, Batista-Duharte A, Pérez AB, Sarramea F, Jaén-Moreno MJ, Camacho-Rodríguez C, Tarazona R, Solana R, Molina J, Pera A. Spanish HCMV Seroprevalence in the 21st Century. Viruses 2023; 16:6. [PMID: 38275940 PMCID: PMC10819642 DOI: 10.3390/v16010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/05/2023] [Accepted: 12/16/2023] [Indexed: 01/27/2024] Open
Abstract
Human cytomegalovirus (HCMV) is linked to age-related diseases like cardiovascular disease, neurodegenerative conditions, and cancer. It can also cause congenital defects and severe illness in immunocompromised individuals. Accurate HCMV seroprevalence assessment is essential for public health planning and identifying at-risk individuals. This is the first HCMV seroprevalence study conducted in the general Spanish adult population in 30 years. We studied HCMV seroprevalence and HCMV IgG antibody titres in healthy adult donors (HDs) and HCMV-related disease patients from 2010 to 2013 and 2020 to 2023, categorized by sex and age. We compared our data with 1993 and 1999 studies in Spain. The current HCMV seroprevalence among HDs in Spain is 73.48%. In women of childbearing age, HCMV seroprevalence has increased 1.4-fold in the last decade. HCMV-seropositive individuals comprise 89.83% of CVD patients, 69% of SMI patients, and 70.37% of COVID-19 patients. No differences in HCMV seroprevalence or HCMV IgG antibody titres were observed between patients and HDs. A significant reduction in Spanish HCMV seroprevalence among HDs was observed in 1993. However, women of childbearing age have shown an upturn in the last decade that may denote a health risk in newborns and a change in HCMV seroprevalence trends.
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Affiliation(s)
- Pablo Álvarez-Heredia
- Immunology and Allergy Group (GC01), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (I.R.-A.); (F.H.); (C.G.-G.); (A.B.-D.); (R.S.); (J.M.)
| | - Irene Reina-Alfonso
- Immunology and Allergy Group (GC01), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (I.R.-A.); (F.H.); (C.G.-G.); (A.B.-D.); (R.S.); (J.M.)
| | - José Joaquín Domínguez-del-Castillo
- Cardiovascular Pathology (GA09), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain;
| | - Fakhri Hassouneh
- Immunology and Allergy Group (GC01), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (I.R.-A.); (F.H.); (C.G.-G.); (A.B.-D.); (R.S.); (J.M.)
| | - Carmen Gutiérrez-González
- Immunology and Allergy Group (GC01), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (I.R.-A.); (F.H.); (C.G.-G.); (A.B.-D.); (R.S.); (J.M.)
| | - Alexander Batista-Duharte
- Immunology and Allergy Group (GC01), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (I.R.-A.); (F.H.); (C.G.-G.); (A.B.-D.); (R.S.); (J.M.)
| | - Ana-Belén Pérez
- Microbiology Service, Reina Sofia University Hospital of Cordoba/Maimonides Biomedical Research Institute (IMIBIC)/CIBERINFEC, Av. Menendez Pidal s/n, 14004 Cordoba, Spain;
| | - Fernando Sarramea
- Severe Mental Illness-Health Alerts (GA12), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (F.S.); (M.J.J.-M.); (C.C.-R.)
- Department of Morphological and Socio-Health Sciences, University of Cordoba, Av. Menendez Pidal s/n, 14004 Cordoba, Spain
- Mental Health Clinical Management Unit, Reina Sofía University Hospital/ CIBERSAM, Av. Menendez Pidal s/n, 14004 Cordoba, Spain
| | - María José Jaén-Moreno
- Severe Mental Illness-Health Alerts (GA12), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (F.S.); (M.J.J.-M.); (C.C.-R.)
- Department of Morphological and Socio-Health Sciences, University of Cordoba, Av. Menendez Pidal s/n, 14004 Cordoba, Spain
| | - Cristina Camacho-Rodríguez
- Severe Mental Illness-Health Alerts (GA12), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (F.S.); (M.J.J.-M.); (C.C.-R.)
| | - Raquel Tarazona
- Immunology Unit, Department of Physiology, University of Extremadura, 10003 Cáceres, Spain;
| | - Rafael Solana
- Immunology and Allergy Group (GC01), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (I.R.-A.); (F.H.); (C.G.-G.); (A.B.-D.); (R.S.); (J.M.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Av. Menendez Pidal s/n, 14004 Cordoba, Spain
- Immunology and Allergy Service, Reina Sofia University Hospital of Cordoba, Av. Menendez Pidal s/n, 14004 Cordoba, Spain
| | - Juan Molina
- Immunology and Allergy Group (GC01), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (I.R.-A.); (F.H.); (C.G.-G.); (A.B.-D.); (R.S.); (J.M.)
- Immunology and Allergy Service, Reina Sofia University Hospital of Cordoba, Av. Menendez Pidal s/n, 14004 Cordoba, Spain
| | - Alejandra Pera
- Immunology and Allergy Group (GC01), Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba/Reina Sofia University Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain; (I.R.-A.); (F.H.); (C.G.-G.); (A.B.-D.); (R.S.); (J.M.)
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Av. Menendez Pidal s/n, 14004 Cordoba, Spain
- Immunology and Allergy Service, Reina Sofia University Hospital of Cordoba, Av. Menendez Pidal s/n, 14004 Cordoba, Spain
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Lin CW, Chang YP, Yen CF. Predictors of Motivation to Receive a COVID-19 Vaccination and the Number of COVID-19 Vaccine Doses Received in Patients with Schizophrenia. Vaccines (Basel) 2023; 11:1781. [PMID: 38140185 PMCID: PMC10747192 DOI: 10.3390/vaccines11121781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
Individuals with schizophrenia are more likely to be infected with COVID-19 than are members of the general population. No prospective study has examined the associations of multi-dimensional factors with the motivation to receive vaccination against COVID-19. This follow-up study investigated the effects of individual (sociodemographic and illness characteristics, depression, and self-esteem), environmental (perceived social support), and individual-environmental interaction factors (self-stigma and loneliness) on the motivation to receive vaccination against COVID-19 and the number of COVID-19 vaccine doses received one year later among 300 individuals with schizophrenia. The associations of baseline factors with motivation to receive vaccination against COVID-19 and the number of vaccine doses received 1 year later were examined through linear regression analysis. The results indicated that greater loneliness (p < 0.01) and being married or cohabitating (p < 0.05) at baseline were significantly associated with lower motivation to receive vaccination against COVID-19 at follow-up. Disorganization (p < 0.05) at baseline was significantly associated with fewer COVID-19 vaccine doses at follow-up; greater motivation to receive vaccination was significantly associated with more COVID-19 vaccine doses at follow-up (p < 0.001). Health professionals should consider the identified predictors while developing intervention programs aimed at enhancing vaccination against COVID-19 in individuals with schizophrenia.
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Affiliation(s)
- Chien-Wen Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, New York, NY 14214-8013, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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11
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Şahin Altun Ö, Özer D, Güngör Z, Şahin F. Investigation of the Relationship Between Internalized Stigma and Happiness Levels of Individuals Diagnosed with Schizophrenia. Florence Nightingale J Nurs 2023; 31:145-151. [PMID: 37823830 PMCID: PMC10724841 DOI: 10.5152/fnjn.2023.22249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 06/13/2023] [Indexed: 10/13/2023]
Abstract
AIM This study aimed to examine the relationship between internalized stigma and happiness levels of individuals diagnosed with schizophrenia. METHOD This cross-sectional study was conducted between March and June 2021 with 100 individuals diagnosed with schizophrenia conducted in a Community Mental Health Centre in the Eastern Black Sea region of Turkey. Data were collected using Internalized Stigma of Mental Illness and the Oxford Happiness Questionnaire. RESULTS A negative statistically significant relationship was determined between the Internalized Stigma of Mental Illness and Oxford Happiness Questionnaire. In addition, there was a positive correlation between the stigma resistance subdimension of the Internalized Stigma of Mental Illness and Oxford Happiness Questionnaire. The internalized stigma levels of the participating patients accounted for 35.1% of their happiness levels. The stigma resistance subdimension of the Internalized Stigma of Mental Illness scale affected the patients' happiness levels. CONCLUSION There was a negative significant relationship between the individuals' internalized stigma and happiness levels. More comprehensive interventions are needed to combat the stigma of mental disorders in Türkiye so that individuals diagnosed with schizophrenia can lead a happy life in society.
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Affiliation(s)
- Özlem Şahin Altun
- Department of Psychiatric Nursing, Ataturk University Faculty of Nursing, Erzurum, Turkey
| | - Duygu Özer
- Department of Psychiatry, University of Health Sciences, Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Zeynep Güngör
- Recep Tayyip Erdogan Training and Research Hospital, Rize, Turkey
| | - Fatih Şahin
- Department of Nursing, Muş Alparslan University Faculty of Health Sciences, Muş, Turkey
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12
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Fulford D, Holt DJ. Social Withdrawal, Loneliness, and Health in Schizophrenia: Psychological and Neural Mechanisms. Schizophr Bull 2023; 49:1138-1149. [PMID: 37419082 PMCID: PMC10483452 DOI: 10.1093/schbul/sbad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
BACKGROUND AND HYPOTHESIS Some of the most debilitating aspects of schizophrenia and other serious mental illnesses (SMI) are the impairments in social perception, motivation, and behavior that frequently accompany these conditions. These impairments may ultimately lead to chronic social disconnection (ie, social withdrawal, objective isolation, and perceived social isolation or loneliness), which may contribute to the poor cardiometabolic health and early mortality commonly observed in SMI. However, the psychological and neurobiological mechanisms underlying relationships between impairments in social perception and motivation and social isolation and loneliness in SMI remain incompletely understood. STUDY DESIGN A narrative, selective review of studies on social withdrawal, isolation, loneliness, and health in SMI. STUDY RESULTS We describe some of what is known and hypothesized about the psychological and neurobiological mechanisms of social disconnection in the general population, and how these mechanisms may contribute to social isolation and loneliness, and their consequences, in individuals with SMI. CONCLUSIONS A synthesis of evolutionary and cognitive theories with the "social homeostasis" model of social isolation and loneliness represents one testable framework for understanding the dynamic cognitive and biological correlates, as well as the health consequences, of social disconnection in SMI. The development of such an understanding may provide the basis for novel approaches for preventing or treating both functional disability and poor physical health that diminish the quality and length of life for many individuals with these conditions.
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Affiliation(s)
- Daniel Fulford
- Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
- Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Daphne J Holt
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital, Boston, MA, USA
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Bell V, Velthorst E, Almansa J, Myin-Germeys I, Shergill S, Fett AK. Do loneliness and social exclusion breed paranoia? An experience sampling investigation across the psychosis continuum. Schizophr Res Cogn 2023; 33:100282. [PMID: 37006705 PMCID: PMC10064439 DOI: 10.1016/j.scog.2023.100282] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/28/2023] Open
Abstract
Background The role of loneliness and social exclusion in the development of paranoia is largely unexplored. Negative affect may mediate potential associations between these factors. We investigated the temporal relationships of daily-life loneliness, felt social exclusion, negative affect, and paranoia across the psychosis continuum. Method Seventy-five participants, including 29 individuals with a diagnosis of non-affective psychosis, 20 first-degree relatives, and 26 controls used an Experience Sampling Method (ESM) app to capture the fluctuations in loneliness, feelings of social exclusion, paranoia, and negative affect across a 1-week period. Data were analysed with multilevel regression analyses. Results In all groups, loneliness and feelings of social exclusion were independent predictors of paranoia over time (b = 0.05, p < .001 and b = 0.04, p < .05, respectively). Negative affect predicted paranoia (b = 0.17, p < .001) and partially mediated the associations between loneliness, social exclusion, and paranoia. It also predicted loneliness (b = 0.15, p < .0001), but not social exclusion (b = 0.04, p = .21) over time. Paranoia predicted social exclusion over time, with more pronounced effects in controls (b = 0.43) than patients (b = 0.19; relatives: b = 0.17); but not loneliness (b = 0.08, p = .16). Conclusion Paranoia and negative affect worsen in all groups following feelings of loneliness and social exclusion. This highlights the importance of a sense of belonging and being included for mental well-being. Loneliness, feeling socially excluded, and negative affect were independent predictors of paranoid thinking, suggesting they represent useful targets in its treatment.
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Cabrera-Mendoza B, Aydin N, Fries GR, Docherty AR, Walss-Bass C, Polimanti R. Estimating the direct effects of the genetic liabilities to bipolar disorder, schizophrenia, and behavioral traits on suicide attempt using a multivariable Mendelian randomization approach. medRxiv 2023:2023.08.14.23294083. [PMID: 37645805 PMCID: PMC10462224 DOI: 10.1101/2023.08.14.23294083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Bipolar disorder (BD) and schizophrenia (SZ) are associated with higher odds of suicide attempt (SA). In this study, we aimed to explore the effect of BD and SZ genetic liabilities on SA, also considering the contribution of behavioral traits, socioeconomic factors, and substance use disorders. Leveraging large-scale genome-wide association data from the Psychiatric Genomics Consortium (PGC) and the UK Biobank (UKB), we conducted a two-sample Mendelian randomization (MR) analysis to evaluate the putative causal effect of BD (41,917 cases, 371,549 controls) and SZ (53,386 cases, 77,258 controls) on SA (26,590 cases, 492,022 controls). Then, we assessed the putative causal effect of BD and SZ on behavioral traits, socioeconomic factors, and substance use disorders. Considering the associations identified, we evaluated the direct causal effect of behavioral traits, socioeconomic factors, and substance use disorders on SA using a multivariable MR approach. The genetic liabilities to BD and SZ were associated with higher odds of SA (BD odds ratio (OR)=1.24, p=3.88×10-12; SZ OR=1.09, p=2.44×10-20). However, while the effect of mental distress (OR=1.17, p=1.02×10-4) and risk-taking (OR=1.52, p=0.028) on SA was independent of SZ genetic liability, the BD-SA relationship appeared to account for the effect of these risk factors. Similarly, the association with loneliness on SA was null after accounting for the effect of SZ genetic liability. These findings highlight the complex interplay between genetic risk of psychiatric disorders and behavioral traits in the context of SA, suggesting the need for a comprehensive mental health assessment for high-risk individuals.
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Affiliation(s)
- Brenda Cabrera-Mendoza
- Department of Psychiatry, Yale School of Medicine, West Haven, CT 06516, USA
- VA CT Healthcare System, West Haven, CT, 06516, USA
| | - Necla Aydin
- Department of Psychiatry, Yale School of Medicine, West Haven, CT 06516, USA
- Faculty of Medicine, Istanbul University, Turkey
| | - Gabriel R. Fries
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), 77054 Houston, Texas, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 77054 Houston, Texas, USA
| | - Anna R. Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Mental Health Institute, Salt Lake City, UT, USA
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Consuelo Walss-Bass
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), 77054 Houston, Texas, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 77054 Houston, Texas, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, West Haven, CT 06516, USA
- VA CT Healthcare System, West Haven, CT, 06516, USA
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Kangarloo T, Mote J, Abplanalp S, Gold A, James P, Gard D, Fulford D. The Influence of Greenspace Exposure on Affect in People With and Those Without Schizophrenia: Exploratory Study. JMIR Form Res 2023; 7:e44323. [PMID: 37535418 PMCID: PMC10436123 DOI: 10.2196/44323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/12/2023] [Accepted: 06/05/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Exposure to natural vegetation (ie, "greenspace") is related to beneficial outcomes, including higher positive and lower negative affect, in individuals with and those without mental health concerns. Researchers have yet to examine dynamic associations between greenspace exposure and affect within individuals over time. Smartphone-based ecological momentary assessment (EMA) and passive sensors (eg, GPS, microphone) allow for frequent sampling of data that may reveal potential moment-to-moment mechanisms through which greenspace exposure impacts mental health. OBJECTIVE In this study, we examined associations between greenspace exposure and affect (both self-reported and inferred through speech) in people with and those without schizophrenia spectrum disorder (SSD) at the daily level using smartphones. METHODS Twenty people with SSD and 14 healthy controls reported on their current affect 3 times per day over 7 days using smartphone-based EMA. Affect expressed through speech was labeled from ambient audio data collected via the phone's microphone using Linguistic Inquiry and Word Count (LIWC). Greenspace exposure, defined as the normalized difference vegetation index (NDVI), was quantified based on continuous geo-location data collected from the phone's GPS. RESULTS Overall, people with SSD used significantly more positive affect words (P=.04) and fewer anger words (P=.04) than controls. Groups did not significantly differ in mean EMA-reported positive or negative affect, LIWC total word count, or NDVI exposure. Greater greenspace exposure showed small to moderate associations with lower EMA-reported negative affect across groups. In controls, greenspace exposure on a given day was associated with significantly lower EMA-reported anxiety on that day (b=-0.40, P=.03, 95% CI -0.76 to -0.04) but significantly higher use of negative affect words (b=0.66, P<.001, 95% CI 0.29-1.04). There were no significant associations between greenspace exposure and affect at the daily level among participants with SSD. CONCLUSIONS Our findings speak to the utility of passive and active smartphone assessments for identifying potential mechanisms through which greenspace exposure influences mental health. We identified preliminary evidence that greenspace exposure could be associated with improved mental health by reducing experiences of negative affect. Future directions will focus on furthering our understanding of the relationship between greenspace exposure and affect on individuals with and those without SSD.
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Affiliation(s)
- Tairmae Kangarloo
- Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Jasmine Mote
- Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Samuel Abplanalp
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Alisa Gold
- Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Peter James
- Harvard Medical School and Harvard Pilgram Health Care Institute, Boston, MA, United States
- Harvard TH Chan School of Public Health, Boston, MA, United States
| | - David Gard
- Department of Psychology, San Francisco State University, San Francisco, CA, United States
| | - Daniel Fulford
- Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States
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16
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Chen YL, Jian CR, Chang YP, Chao SR, Yen CF. Association of loneliness with suicide risk and depression in individuals with schizophrenia: moderating effects of self-esteem and perceived support from families and friends. Schizophrenia (Heidelb) 2023; 9:41. [PMID: 37402821 PMCID: PMC10319791 DOI: 10.1038/s41537-023-00368-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023]
Abstract
Loneliness is prevalent among individuals with mental illnesses. This cross-sectional survey study examined the moderating effects of self-esteem and perceived support from families and friends on the association of loneliness with suicide risk and depression in individuals with schizophrenia. In total, 300 participants (267 with schizophrenia and 33 with schizoaffective disorder) completed the University of California, Los Angeles, Loneliness Scale (Version 3); suicide module of the Mini International Neuropsychiatric Interview; Center for Epidemiologic Studies Depression Scale; Family and Friend Adaptability, Partnership, Growth, Affection, and Resolve Index; and Rosenberg Self-Esteem Scale. Moderation analysis was performed to examine the moderating effects of self-esteem and perceived support from families and friends on the association of loneliness with suicide risk and depression. The results found that self-esteem was significantly associated with a reduced magnitude of depression in participants with loneliness. In addition, perceived support from friends was significantly associated with a reduced magnitude of suicide risk in participants with loneliness. Our findings indicate the importance of intervention programs that strengthen support from friends and self-esteem in reducing suicide risk and depression among lonely individuals with schizophrenia.
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Affiliation(s)
- Yi-Lung Chen
- Department of Psychology, Asia University, Taichung, Taiwan
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Cian-Ruei Jian
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY, USA
| | - Shu-Ru Chao
- Department of Social Work, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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17
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Jeste DV, Malaspina D, Bagot K, Barch DM, Cole S, Dickerson F, Dilmore A, Ford CL, Karcher NR, Luby J, Rajji T, Pinto-Tomas AA, Young LJ. Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: III. Biology. Schizophr Bull 2023; 49:867-880. [PMID: 37023360 PMCID: PMC10318888 DOI: 10.1093/schbul/sbad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
BACKGROUND Social determinants of health (SDoHs) are nonmedical factors that significantly impact health and longevity. We found no published reviews on the biology of SDoHs in schizophrenia-spectrum psychotic disorders (SSPD). STUDY DESIGN We present an overview of pathophysiological mechanisms and neurobiological processes plausibly involved in the effects of major SDoHs on clinical outcomes in SSPD. STUDY RESULTS This review of the biology of SDoHs focuses on early-life adversities, poverty, social disconnection, discrimination including racism, migration, disadvantaged neighborhoods, and food insecurity. These factors interact with psychological and biological factors to increase the risk and worsen the course and prognosis of schizophrenia. Published studies on the topic are limited by cross-sectional design, variable clinical and biomarker assessments, heterogeneous methods, and a lack of control for confounding variables. Drawing on preclinical and clinical studies, we propose a biological framework to consider the likely pathogenesis. Putative systemic pathophysiological processes include epigenetics, allostatic load, accelerated aging with inflammation (inflammaging), and the microbiome. These processes affect neural structures, brain function, neurochemistry, and neuroplasticity, impacting the development of psychosis, quality of life, cognitive impairment, physical comorbidities, and premature mortality. Our model provides a framework for research that could lead to developing specific strategies for prevention and treatment of the risk factors and biological processes, thereby improving the quality of life and increasing the longevity of people with SSPD. CONCLUSIONS Biology of SDoHs in SSPD is an exciting area of research that points to innovative multidisciplinary team science for improving the course and prognosis of these serious psychiatric disorders.
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Affiliation(s)
- Dilip V Jeste
- Department of Psychiatry, University of California, San Diego (Retired), CA, USA
| | - Dolores Malaspina
- Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kara Bagot
- Department of Psychiatry, Addiction Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deanna M Barch
- Departments of Psychological and Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Steve Cole
- Departments of Psychiatry and Biobehavioral Sciences, and Medicine, University of California, Los Angeles, CA, USA
| | - Faith Dickerson
- Department of Psychology, Sheppard Pratt, Baltimore, MD, USA
| | - Amanda Dilmore
- Department of Pediatrics, University of California, San Diego, CA, USA
| | - Charles L Ford
- Center for Translational Social Neuroscience, Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Nicole R Karcher
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Joan Luby
- Department of Psychiatry (Child), Washington University in St. Louis, St. Louis, MO, USA
| | - Tarek Rajji
- Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Adrián A Pinto-Tomas
- Biochemistry Department, School of Medicine, Universidad de Costa Rica, San José, Costa Rica
| | - Larry J Young
- Center for Translational Social Neuroscience, Department of Psychiatry, Emory University, Atlanta, GA, USA
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18
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Thompson A, Pollet TV. An exploratory psychometric network analysis of loneliness scales in a sample of older adults. Curr Psychol 2023:1-15. [PMID: 37359673 PMCID: PMC10182353 DOI: 10.1007/s12144-023-04697-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 06/28/2023]
Abstract
To examine the relationships within and between commonly used measures of loneliness to determine the suitability of the measures in older adults. Further, to determine whether certain items in these measures are more psychometrically robust in terms of capturing different types of loneliness across this population. Data were obtained from 350 older adults via completion of an online survey. Four measures of loneliness were completed. These were the University of California Los Angeles Loneliness Scale 4 (Version 3), the de Jong Gierveld Loneliness Scale, the Social and Emotional Loneliness Scale for Adults (Short Version) and a direct measure of loneliness. Analysis via a regularized partial correlation network and via clique percolation revealed that only the SELSA-S encompassed loneliness relating to deficits in social, family and romantic relationships. The remaining measures tapped mostly into social loneliness alone. The direct measure of loneliness had the strongest connection to the UCLA item-4 and the de Jong Gierveld item-1 exhibited the strongest bridge centrality, being a member of the most clusters. The results indicate that should researchers be interested in assessing loneliness resulting from specific relationships, then the SELSA-S would be the most suitable measure. Whereas the other measures are suitable for assessing loneliness more generally. The results further suggest that the de Jong Gierveld item-1 may be a more suitable direct measure of loneliness than that currently employed as it taps into a greater number of relationships.
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Affiliation(s)
- Alexandra Thompson
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, UK
| | - Thomas V. Pollet
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, UK
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19
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Okruszek Ł, Piejka A, Chrustowicz M, Krawczyk M, Jarkiewicz M, Schudy A, Ludwig K, Pinkham A. Social cognitive bias increases loneliness both directly and by decreasing social connection in patients with schizophrenia. Schizophr Res 2023; 256:72-78. [PMID: 37163867 DOI: 10.1016/j.schres.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/04/2023] [Accepted: 04/30/2023] [Indexed: 05/12/2023]
Abstract
While considerable emphasis has been put on investigating the mechanisms that drive reduced social connection in patients with schizophrenia (SCZ), recent studies have increasingly focused on the issue of loneliness in SCZ. As both social cognitive bias and self-reported empathy predict loneliness in non-clinical populations, the current study aims to examine the relationship between loneliness, reduced social connection and social cognitive biases, and self-reported empathy in SCZ. Ninety-three adult SCZ and sixty-six matched healthy individuals completed a battery of questionnaires measuring loneliness and social connection (Revised-UCLA Loneliness Scale, Lubben-Social Network Scale, Social Disconnectedness Scale), cognitive biases (Ambiguous Intentions Hostility Questionnaire, Davos Assessment of Cognitive Biases Scale, Cognitive Biases Questionnaire for psychosis) and self-reported empathy (Interpersonal Reactivity Index). Significant predictors of loneliness in SCZ were entered into two latent variables ("Social Threat Bias", "Social Connection"), and structural equation modeling was used to explore the direct and indirect relationships between Social Threat Bias, symptoms. and loneliness in SCZ. Patients reported higher levels of loneliness, cognitive biases and personal distress compared to controls. Furthermore, SCZ reported less social connection and perspective taking compared to controls. Structural equation modeling revealed that Social Threat Bias was linked to increased loneliness in SCZ both directly and indirectly via decreased social connection. Negative symptoms were directly linked with loneliness, while the association between affective symptoms and loneliness was mediated via Social Threat Bias. The results of the current study suggest that social threat bias should be considered while planning the interventions aimed to reduce loneliness in schizophrenia.
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Affiliation(s)
- Ł Okruszek
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland.
| | - A Piejka
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | - M Chrustowicz
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | - M Krawczyk
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | - M Jarkiewicz
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Poland
| | - A Schudy
- Faculty of Psychology, University of Warsaw, Poland
| | - K Ludwig
- Department of Psychology, University of North Carolina at Chapel Hill, United States of America
| | - A Pinkham
- Department of Psychology, University of Texas at Dallas, United States of America; Department of Psychiatry, UT Southwestern Medical Center, United States of America
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20
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Landreth K, Burgess M, Watson L, Lorusso JM, Grayson B, Harte MK, Neill JC. Handling prevents and reverses cognitive deficits induced by sub-chronic phencyclidine in a model for schizophrenia in rats. Physiol Behav 2023; 263:114117. [PMID: 36781093 DOI: 10.1016/j.physbeh.2023.114117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/23/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
Treatments for schizophrenia are not effective in ameliorating cognitive deficits. Therefore, novel therapies are needed to treat cognitive impairments associated with schizophrenia (CIAS), which are modelled in rats through administration of sub-chronic phencyclidine (scPCP). We have previously shown that enrichment via voluntary exercise prevents and reverses impairments in novel object recognition (NOR) in this model. The present study aimed to investigate if handling could prevent delay-induced NOR deficits and prevent and reverse scPCP-induced NOR deficits. Two cohorts of adult female Lister Hooded rats were used. In experiment one, handling (five minutes/day, five days/week for two weeks), took place before scPCP administration (2 mg/kg, i.p. twice-daily for seven days). NOR tests were conducted at two, four, and seven weeks post-handling with a one-minute inter-trial interval (ITI) and at five weeks post-dosing with a six-hour ITI. In experiment two, rats were handled after scPCP administration and tested immediately in the one-minute ITI NOR task and again at two weeks post-handling. In both handling regimens, the scPCP control groups failed to discriminate novelty, conversely the scPCP handled groups significantly discriminated in this task. In the 6 h ITI test, vehicle control and scPCP control failed to discriminate novelty; however, the vehicle handled and scPCP handled groups did significantly discriminate. Handling rats prevented and reversed scPCP-induced deficits and prevented delay-induced NOR deficits. These findings add to evidence that environmental enrichment is a viable treatment for cognitive deficits in rodent tests and models of relevance to schizophrenia, with potential to translate into effective treatments for CIAS.
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Affiliation(s)
- K Landreth
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, United Kingdom
| | - M Burgess
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, United Kingdom
| | - L Watson
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, United Kingdom
| | - J M Lorusso
- Division of Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, United Kingdom
| | - B Grayson
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, United Kingdom.
| | - M K Harte
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, United Kingdom
| | - J C Neill
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, United Kingdom; Medical Psychedelics Working Group, Drug Science, United Kingdom
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21
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Suman A, Nehra R, Sahoo S, Grover S. Prevalence of loneliness and its correlates among patients with schizophrenia. Int J Soc Psychiatry 2022. [PMID: 36573290 DOI: 10.1177/00207640221141646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND There are limited data on loneliness and its correlates in patients with schizophrenia. OBJECTIVE To evaluate prevalence and correlates of loneliness in patients with schizophrenia, currently in clinical remission. METHODOLOGY A total of 160 patients of schizophrenia in clinical remission were assessed on UCLA Loneliness Scale, Positive and Negative syndrome scale, Calgary Depression Scale for Schizophrenia (CDSS), Internalized Stigma of Mental Illness Scale, Rosenberg Self-esteem Scale, Brief COPE, Beck's Hopelessness Scale, Brief Dyadic Scale of Expressed Emotions, and Self-report Quality of Life Measure. RESULTS The mean age of the study sample was 34.99 (SD = 9.13) years. The prevalence of loneliness in the study sample was 80%, with mean total UCLA-loneliness scale score of 30.04 (16.9).Compared to participants without loneliness, those with loneliness had had higher CDSS score, had poor quality of life, lower self-esteem, experienced higher level of stigma, more often used maladaptive coping strategies such as self-blaming and reported a higher level of hopelessness. In the correlation analysis, higher level of loneliness was associated higher severity of depression, higher level of stigma (except for stigma resistance) and discrimination, poorer quality of life, lower self-esteem, perception of a higher level of expressed emotions, higher use of maladaptive coping in the domains of behavioral disengagement, and self-blaming, and a higher level of hopelessness. In regression analysis, the maximum variance of loneliness was explained by quality of life score (29%), followed by hopelessness score (8.8%) and discrimination score (2%). CONCLUSION There is a high prevalence of loneliness in patients with schizophrenia, and there is a need to routinely evaluate the patients of schizophrenia for loneliness and address the same.
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Affiliation(s)
- Aarzoo Suman
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritu Nehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Swapnajeet Sahoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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22
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Schutter N, Holwerda TJ, Kuipers H, Van RHL, Stek ML, Comijs HC, Peen J, Dekker JJM. The Association Between Loneliness and Psychiatric Symptomatology in Older Psychiatric Outpatients. J Geriatr Psychiatry Neurol 2022; 35:778-788. [PMID: 34937438 DOI: 10.1177/08919887211060022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Loneliness in adults increases with age. Although loneliness has been found to be associated with psychiatric disorders and dementia, no information is available on prevalence of loneliness in older psychiatric patients. The aims of this study were to examine prevalence of loneliness in older psychiatric outpatients, including gender differences and associations with psychiatric disorders and social isolation. METHODS Cross-sectional study in an outpatient clinic for geriatric psychiatry between September 2013 and February 2018. Interviews were done in 181 patients. RESULTS 80% of participants were lonely. Loneliness was associated with having contacts in less social network domains, in women but not in men. There were no associations with DSM-IV-TR-classifications. However, loneliness was associated with higher scores on questionnaires for depression and cognitive function. Intensity of treatment did not differ significantly between lonely and non-lonely participants. CONCLUSION Loneliness is highly prevalent in older psychiatric outpatients, with men and women equally affected. Loneliness should be assessed in all older psychiatric patients, especially when they show high scores on symptom checklists or have a restricted social network.
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Affiliation(s)
- Natasja Schutter
- Department of Geriatric Psychiatry, 120662Arkin Mental Health Care, Amsterdam, Netherlands
| | - Tjalling J Holwerda
- Department of Psychiatry, 120662Arkin Mental Health Care, Amsterdam, Netherlands
| | - Hanna Kuipers
- Department of Psychiatry, Amici Zorgt, Heerhugowaard, Netherlands
| | - Rien H L Van
- Department of General Psychiatry Residency Training/Netherlands Psychoanalytical Institute, 120662Arkin Mental Health Care, Amsterdam, Netherlands
| | - Max L Stek
- GGZ InGeest/Department of Psychiatry and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Hannie C Comijs
- GGZ InGeest/Department of Psychiatry and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Jaap Peen
- Department of Clinical Research, 120662Arkin Mental Health Care, Amsterdam, Netherlands
| | - Jack J M Dekker
- Department of Clinical Research, 120662Arkin Mental Health Care, Amsterdam, Netherlands.,Department of Psychology, VU University, Amsterdam, Netherlands
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23
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Seki Öz H, Ayhan D, Taktak Ş. The effect of insight, loneliness, and hope levels on medication adherence in patients with schizophrenia. Perspect Psychiatr Care 2022; 58:2208-2214. [PMID: 35124816 DOI: 10.1111/ppc.13048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/21/2022] [Accepted: 01/29/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE It is important to investigate the negative factors affecting medication compliance to continue the treatment of schizophrenia. DESIGN AND METHODS In this descriptive and analytical study, the effects of insight, loneliness, and hope levels on medication adherence in 202 patients with schizophrenia were studied. FINDINGS The correlation was positive between medication adherence and insight, negative between medication adherence and loneliness, and no correlation between medication adherence and hope. A 1-point increase in insight scores increased medication adherence 1.226 times and a 1-point increase in loneliness scores decreased medication adherence 0.946 times. Medication adherence was 0.499 times lower in nonsmokers compared to smokers. PRACTICE IMPLICATIONS Further studies on patients with schizophrenia should be conducted to evaluate factors affecting medication adherence and preventing smoking in schizophrenia.
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Affiliation(s)
- Hilal Seki Öz
- Department of Nursing, Faculty of Health Sciences, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Didem Ayhan
- Department of Nursing, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma/Balıkesir, Turkey
| | - Şafak Taktak
- Department of Mental Health and Illness, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
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24
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Reynolds CF, Jeste DV, Sachdev PS, Blazer DG. Mental health care for older adults: recent advances and new directions in clinical practice and research. World Psychiatry 2022; 21:336-363. [PMID: 36073714 PMCID: PMC9453913 DOI: 10.1002/wps.20996] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The world's population is aging, bringing about an ever-greater burden of mental disorders in older adults. Given multimorbidities, the mental health care of these people and their family caregivers is labor-intensive. At the same time, ageism is a big problem for older people, with and without mental disorders. Positive elements of aging, such as resilience, wisdom and prosocial behaviors, need to be highlighted and promoted, both to combat stigma and to help protect and improve mental health in older adults. The positive psychiatry of aging is not an oxymoron, but a scientific construct strongly informed by research evidence. We champion a broader concept of geriatric psychiatry - one that encompasses health as well as illness. In the present paper, we address these issues in the context of four disorders that are the greatest source of years lived with disability: neurocognitive disorders, major depression, schizophrenia, and substance use disorders. We emphasize the need for implementation of multidisciplinary team care, with comprehensive assessment, clinical management, intensive outreach, and coordination of mental, physical and social health services. We also underscore the need for further research into moderators and mediators of treatment response variability. Because optimal care of older adults with mental disorders is both patient-focused and family-centered, we call for further research into enhancing the well-being of family caregivers. To optimize both the safety and efficacy of pharmacotherapy, further attention to metabolic, cardiovascular and neurological tolerability is much needed, together with further development and testing of medications that reduce the risk for suicide. At the same time, we also address positive aging and normal cognitive aging, both as an antidote to ageism and as a catalyst for change in the way we think about aging per se and late-life mental disorders more specifically. It is in this context that we provide directions for future clinical care and research.
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Affiliation(s)
| | - Dilip V. Jeste
- Department of PsychiatryUniversity of California San DiegoLa JollaCAUSA
| | | | - Dan G. Blazer
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNCUSA
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25
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Christensen R, Haenschel C, Gaigg SB, Fett AKJ. Loneliness, positive, negative and disorganised Schizotypy before and during the COVID-19 pandemic. Schizophr Res Cogn 2022; 29:100243. [PMID: 35223431 PMCID: PMC8860670 DOI: 10.1016/j.scog.2022.100243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/11/2022] [Accepted: 02/11/2022] [Indexed: 11/29/2022] Open
Abstract
Loneliness is common in psychosis and occurs along a continuum. Here we investigate inter-relationships between loneliness, three-dimensional schizotypy, and depressive symptoms before and during the COVID-19 pandemic. The sample included 507 university students (48.3% participated before and 51.7% during the COVID-19 pandemic) who completed the Multidimensional Schizotypy Scale-Brief, the Counseling Center Assessment of Psychological Symptoms depression scale and the University of California, Los Angeles Loneliness Scale. Schizotypy and depression scores were regressed onto loneliness individually and in multiple regressions. The cohorts did not differ in any of the schizotypy domains (all p > .29). Depressive symptoms (p = .05) and loneliness (p = .006) were higher during the pandemic than before. Across cohorts, loneliness was significantly associated with positive (β = 0.23, p < .001), negative (β = 0.44, p < .001), and disorganised schizotypy (β = 0.44, p < .001), and with depression (β = 0.72, p < .001). Schizotypy together explained a significant amount of variance in loneliness (R2 = 0.26), with significant associations with positive (β = −0.09, p = .047), negative (β = 0.31, p < .001) and disorganised schizotypy (β = 0.34, p < .001). When depression was included (β = 0.69, p < .001), only positive (β = −0.09, p = .008) and negative schizotypy (β = 0.22, p < .001) significantly predicted loneliness. When all schizotypy dimensions and depression were considered together, only negative schizotypy and depression significantly predicted loneliness. Loneliness and depressive symptoms were higher during the pandemic, but this did not relate to cohort differences in schizotypy. Loneliness is uniquely associated with negative schizotypy and depression, but not disorganised schizotypy. Certain aspects of positive schizotypy may protect against loneliness. Loneliness and depressive symptoms were higher in students during the COVID-19 pandemic than before. Cohorts of students assessed before and during the pandemic showed similar levels of schizotypy.
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Affiliation(s)
- Ronja Christensen
- Department of Psychology, City, University of London, London ECIV 0HB, UK.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, De Crespigny Park, SE5 8AF London, UK
| | - Corinna Haenschel
- Department of Psychology, City, University of London, London ECIV 0HB, UK
| | - Sebastian B Gaigg
- Department of Psychology, City, University of London, London ECIV 0HB, UK
| | - Anne-Kathrin J Fett
- Department of Psychology, City, University of London, London ECIV 0HB, UK.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, De Crespigny Park, SE5 8AF London, UK
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26
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Maes M, Qualter P, Lodder GMA, Mund M. How (Not) to Measure Loneliness: A Review of the Eight Most Commonly Used Scales. Int J Environ Res Public Health 2022; 19:ijerph191710816. [PMID: 36078540 PMCID: PMC9518421 DOI: 10.3390/ijerph191710816] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 05/27/2023]
Abstract
Loneliness affects well-being and has long-term negative impacts on physical and mental health, educational outcomes, and employability. Because of those current and long-term impacts, loneliness is a significant issue for which we need reliable and appropriate measurement scales. In the current paper, psychometric properties of the eight most commonly used loneliness scales are reviewed both descriptively and meta-analytically. Results suggest that for many of the scales, the psychometric properties are promising. However, for some psychometric features, especially test-retest reliability and measurement invariance, evidence is rather scarce. Most striking, however, is the fact that all of the scales included items that do not measure loneliness. Surprisingly, for many (sub)scales, this was even the case for about half of the items. Because our measures are the foundation of our research work, it is crucial to improve the way loneliness is being measured.
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Affiliation(s)
- Marlies Maes
- Interdisciplinary Social Science: Youth Studies, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Pamela Qualter
- Manchester Institute of Education, The University of Manchester, Manchester M13 9PL, UK
| | - Gerine M. A. Lodder
- Department of Developmental Psychology, Tilburg University, 5037 AB Tilburg, The Netherlands
| | - Marcus Mund
- Personality Psychology and Psychological Assessment, Klagenfurt University, 9020 Klagenfurt, Austria
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27
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Chau AKC, So SH, Sun X, Zhu C, Chiu CD, Chan RCK, Leung PWL. A network analysis on the relationship between loneliness and schizotypy. J Affect Disord 2022; 311:148-156. [PMID: 35594977 DOI: 10.1016/j.jad.2022.05.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Schizotypy is a multidimensional personality trait related to the heightened risk for the development of schizophrenia spectrum disorders. While it has been suggested that loneliness may be associated with schizotypy in general, whether it relates to the specific schizotypal traits differentially remains unknown. Besides, as loneliness often co-occurs with depression and anxiety, it is important to delineate its relationship with schizotypy in consideration of these co-occurring emotional disturbances. METHODS A demographically diverse sample of young people was obtained from multiple sources. The validated sample consisted of 2089 participants (68.4% female, age range: 18-30). The structural relationship between loneliness and schizotypy was modelled using a network analytic approach. The Gaussian graphical model with loneliness and nine schizotypal traits as nodes was first estimated without, and then with adjustment for the levels of depressive and anxiety symptoms. Edges were estimated as unique associations between nodes. RESULTS 'Suspiciousness', 'odd beliefs or magical thinking', 'no close friends', 'constricted affect' and 'excessive social anxiety' were linked to loneliness directly. Loneliness was found to be more strongly associated with 'suspiciousness' and 'no close friends' than other schizotypal traits. After adjustment for the levels of depressive and anxiety symptoms, the above direct edges remained robust. LIMITATIONS The use of cross-sectional data indicated only undirected associations between variables. CONCLUSIONS Loneliness was more strongly linked to some schizotypal traits than others, with the relationships maintaining above and beyond the effects of anxiety and depression. These findings warrant further investigation of the specific relationships between loneliness and individual schizotypal traits.
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Affiliation(s)
- Anson Kai Chun Chau
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Suzanne H So
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Xiaoqi Sun
- Department of Psychology, Hunan Normal University, Hunan, China
| | - Chen Zhu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Chui-De Chiu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Patrick Wing-Leung Leung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
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28
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Packard K, Opendak M. Rodent models of early adversity: Impacts on developing social behavior circuitry and clinical implications. Front Behav Neurosci 2022; 16:918862. [PMID: 35990728 PMCID: PMC9385963 DOI: 10.3389/fnbeh.2022.918862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Flexible and context-appropriate social functioning is key for survival across species. This flexibility also renders social behavior highly plastic, particularly during early development when attachment to caregiver can provide a template for future social processing. As a result, early caregiving adversity can have unique and lasting impacts on social behavior and even confer vulnerability to psychiatric disorders. However, the neural circuit mechanisms translating experience to outcome remain poorly understood. Here, we consider social behavior scaffolding through the lens of reward and threat processing. We begin by surveying several complementary rodent models of early adversity, which together have highlighted impacts on neural circuits processing social cues. We next explore these circuits underlying perturbed social functioning with focus on dopamine (DA) and its role in regions implicated in social and threat processing such as the prefrontal cortex (PFC), basolateral amygdala (BLA) and the lateral habenula (LHb). Finally, we turn to human populations once more to examine how altered DA signaling and LHb dysfunction may play a role in social anhedonia, a common feature in diagnoses such as schizophrenia and major depressive disorder (MDD). We argue that this translational focus is critical for identifying specific features of adversity that confer heightened vulnerability for clinical outcomes involving social cue processing.
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Affiliation(s)
- Katherine Packard
- Department of Neuroscience, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Maya Opendak
- Department of Neuroscience, Kennedy Krieger Institute, Baltimore, MD, United States
- Solomon H. Snyder Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- *Correspondence: Maya Opendak
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29
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Contreras A, Valiente C, Vázquez C, Trucharte A, Peinado V, Varese F, Bentall RP. The network structure of paranoia dimensions and its mental health correlates in the general population: The core role of loneliness. Schizophr Res 2022; 246:65-73. [PMID: 35717741 DOI: 10.1016/j.schres.2022.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
Paranoid ideas are the most common abnormal beliefs in the schizophrenia spectrum, are also prevalent in non-clinical populations, and are highly correlated with other mental health problems such as anxiety, depression and low levels of well-being. Two previous studies with the same British population sample used confirmatory factor analysis and network analysis to show that the spectrum of paranoid beliefs is made up of four factors or dimensions (i.e., interpersonal sensitivity, mistrust, ideas of reference and ideas of persecution). The aims of this study are: 1) to explore the distribution and the structure of paranoid beliefs in a Spanish general population by applying the network approach and 2) to use network analysis to explore for the first time whether specific domains of paranoid ideation (i.e., dimensions) are specifically associated with mental health correlates such as depression, anxiety, loneliness, and well-being. We found a continuous distribution of paranoid beliefs among the 1328 individuals constituting the sample (e.g., 29,2 % did not endorse any items, 4.6 % endorsed half of the items, while 0.8 % endorsed all paranoid items). Paranoid ideas form three dimensions; interpersonal sensitivity, mistrust, and ideas of persecution (ideas of reference did not form a separate factor). The network model showed that loneliness has a pivotal role in connecting paranoid ideation with general psychopathology measures (i.e., depression, anxiety, loneliness and well-being). Research and clinical implications derived from our findings are also discussed.
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Affiliation(s)
- Alba Contreras
- Université Catholique de Louvain (UCLouvain), Psychological Sciences Research Institute, Belgium
| | - Carmen Valiente
- University Complutense of Madrid, Faculty of Psychology, Department of Personality, Assessment and Clinical Psychology, Spain.
| | - Carmelo Vázquez
- University Complutense of Madrid, Faculty of Psychology, Department of Personality, Assessment and Clinical Psychology, Spain
| | - Almudena Trucharte
- University Complutense of Madrid, Faculty of Psychology, Department of Personality, Assessment and Clinical Psychology, Spain
| | - Vanesa Peinado
- University Complutense of Madrid, Faculty of Psychology, Department of Personality, Assessment and Clinical Psychology, Spain
| | - Filippo Varese
- University of Manchester, Manchester Academic Health Science Centre, School of Health Sciences, Division of Psychology and Mental Health, United Kingdom; Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| | - Richard P Bentall
- University of Sheffield, Clinical Psychology Unit, Department of Psychology, United Kingdom
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30
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Brandizzi M, Polselli A, Corigliano V, Tamorri SM, Venturini P, Azzoni A, Grasso S, Onofri A, Pesce S, Romani F, Polselli GM, Forte A. Psychiatric emergencies during, after, and before the COVID-19 lockdown: what happened to our patients? A naturalistic observational study. Ann Gen Psychiatry 2022; 21:29. [PMID: 35907967 DOI: 10.1186/s12991-022-00408-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite concerns on mental health problems related to lockdowns, recent reports revealed a reduction in psychiatric admissions in Emergency Departments (ED) during the lockdown period compared with the previous year in several countries. Most of the existing studies focused on the first lockdown not considering the different phases of the COVID-19 crisis. The present study aimed to analyze differences in ED admission for psychiatric consultation during three different phases of the COVID-19 health crisis in Italy. METHODS Information on ED admission for psychiatric consultations were retrospectively collected at the ED of the Santo Spirito Hospital in Rome (Italy), and compared between the three periods: the lockdown (March-June 2020) and the post-lockdown period (June 2020-June 2021) compared to the pre-lockdown (January 2019-March 2020). Multinomial logistic regression was used to assess the risk of accessing ED for psychiatric consultation before, during, after the lockdown. RESULTS Three thousand and eight hundred seventy-one ED psychiatric consultations were collected. A significant reduction of psychiatric consultations in ED during the lockdown period and the post-lockdown (H 762,45; p < 0.001) was documented. Multinomial logistic regression analysis showed that compared to pre-lockdown during the lockdown and post-lockdown patients were more likely to be men (RRR 1.52; 95% CI 1.10-2.12) and more often diagnosed with non-severe mental illnesses (nSMI) (relative risk ratio [RRR] 1.53, 95% CI 1.10-2.15; and 1.72, 95% CI 1.42-2.08); during the lockdown, patients were also more often diagnosed with alcohol/substance abuse (A&S) (RRR 1.70; 95% CI 1.10-2.65). CONCLUSIONS several changes in the clinical characteristics of psychiatric consultations during and after the lockdown emerged from the present study; nSMI and A&S abuse patients were more likely to present at the ED in the lockdown and post-lockdown periods while SMI patients appeared to be less likely. These may inform clinicians and future preventive strategies among community mental health services.
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Lin CY, Tsai CS, Jian CR, Chao SR, Wang PW, Lin HC, Huang MF, Yeh YC, Liu TL, Chen CS, Lin YP, Lee SY, Chen CH, Wang YC, Chang YP, Chen YM, Yen CF. Comparing the Psychometric Properties among Three Versions of the UCLA Loneliness Scale in Individuals with Schizophrenia or Schizoaffective Disorder. IJERPH 2022; 19:ijerph19148443. [PMID: 35886310 PMCID: PMC9319140 DOI: 10.3390/ijerph19148443] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 02/04/2023]
Abstract
The UCLA Loneliness Scale (Version 3; UCLA-LSV3) is widely used for assessing loneliness. Nevertheless, the validity of this scale for assessing loneliness in individuals with schizophrenia or schizoaffective disorder has not been determined. Additionally, studies validating the eight-item and three-item versions of UCLA-LSV3 have not included individuals with severe mental illness; therefore, whether the short versions are comparable to the full 20-item version of UCLA-LSV3 for this population is unclear. The present study examined the unidimensional structure, internal consistency, concurrent validity, and test–retest reliability of the Chinese versions of UCLA-LSV3 (i.e., 20-item, 8-item, and 3-item versions) to determine which version is most appropriate for assessing loneliness in individuals with schizophrenia or schizoaffective disorder in Taiwan. A total of 300 participants (267 with schizophrenia and 33 with schizoaffective disorder) completed the scales, comprising UCLA-LSV3, the Center for Epidemiological Studies Depression Scale (CES-D), the suicidality module of the Kiddie Schedule for Affective Disorders and Schizophrenia–Epidemiological Version (K-SADS-E), and the family and peer Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) index. Construct validity was evaluated through confirmatory factor analysis. The three versions of UCLA-LSV3 were compared with the CES-D, the suicidality module of the K-SADS-E, and the family and peer APGAR index to establish concurrent validity. The results indicated that all three versions of UCLA-LSV3 exhibited acceptable to satisfactory psychometric properties in terms of unidimensional constructs, concurrent validity, and test–retest reliability. The full version of UCLA-LSV3 had the best performance, followed by the eight-item version and the three-item version. Moreover, the three versions had relatively strong associations with each other. Therefore, when deliberating which version of UCLA-LSV3 is the best choice for assessing loneliness in individuals with schizophrenia or schizoaffective disorder, healthcare providers and therapists should consider time availability and practicality.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Cian-Ruei Jian
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Shu-Ru Chao
- Department of Social Work, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan;
| | - Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Huang-Chi Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Mei-Feng Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yi-Chun Yeh
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ya-Ping Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Shu-Ying Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ching-Hua Chen
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-H.C.); (Y.-C.W.)
| | - Yun-Chi Wang
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-H.C.); (Y.-C.W.)
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY 14260, USA;
| | - Yu-Min Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Correspondence: (Y.-M.C.); (C.-F.Y.); Tel.: +886-7-3121101 (ext. 6816) (Y.-M.C.); +886-7-3124941 (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan; (C.-R.J.); (P.-W.W.); (H.-C.L.); (M.-F.H.); (Y.-C.Y.); (T.-L.L.); (C.-S.C.); (Y.-P.L.); (S.-Y.L.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (Y.-M.C.); (C.-F.Y.); Tel.: +886-7-3121101 (ext. 6816) (Y.-M.C.); +886-7-3124941 (C.-F.Y.)
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Toh WL, Sumner PJ, Meyer D, Neill E, Phillipou A, Tan EJ, Van Rheenen TE, Rossell SL. Investigating predictors contributing to the expression of schizotypy during the COVID-19 pandemic. J Psychiatr Res 2022; 150:231-236. [PMID: 35398666 PMCID: PMC8976875 DOI: 10.1016/j.jpsychires.2022.03.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/15/2022] [Accepted: 03/31/2022] [Indexed: 12/16/2022]
Abstract
The coronavirus (COVID-19) pandemic has caused major disruptions to social and other forms of functioning, which may influence schizotypy expression. The current study aimed to explore possible distal and proximal predictors contributing to schizotypy in a sample of the Australian general population during the COVID-19 pandemic. The COvid-19 and you: mentaL heaLth in AusTralia now survEy (COLLATE) project is an online mental health study aimed at tracking key mental health indicators over the progression of the pandemic. Adults residing in Australia were invited to take part using non-discriminative snowball sampling. Demographic-clinical information was collected for 850 participants in either October 2020 or January 2021. To assess schizotypy facets, the Launay-Slade Hallucinations Scale-Extended (LSHS-E) and Peters Delusions Inventory (PDI-21) were used to measure hallucination and delusion proneness respectively. Generalised linear models (with gamma and negative binomial distributions) were employed. Age, negative emotions and loneliness significantly contributed to both hallucination and delusion proneness; gender, education and religiosity also significantly contributed to delusion proneness, in the final regression models. Our study corroborated the specific contribution of loneliness, amongst other factors, in the prediction of schizotypy facets. Tackling loneliness represents a public health challenge that needs to be urgently addressed, especially in the face of the ongoing COVID-19 pandemic.
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Affiliation(s)
- Wei Lin Toh
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Philip J. Sumner
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia,Corresponding author. Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Denny Meyer
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Erica Neill
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia,Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Andrea Phillipou
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia,Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia,Department of Mental Health, Austin Hospital, Melbourne, VIC, Australia
| | - Eric J. Tan
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia,Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Tamsyn E. Van Rheenen
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia,Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Susan L. Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia,Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
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Yeo JJ, Chew QH, Sim K. Resilience and its inter-relationship with symptomatology, illness course, psychosocial functioning, and mediational roles in schizophrenia: A systematic review. Asia Pac Psychiatry 2022; 14:e12486. [PMID: 34431616 DOI: 10.1111/appy.12486] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/26/2021] [Accepted: 08/14/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Schizophrenia is a major psychiatric disorder which poses substantial illness burden on affected individuals. In view of the need to better understand the growing literature on resilience (adaptation in the face of adversity) and its clinical correlates to inform and optimize clinical management in schizophrenia, we sought to summarize the extant literature which examined the inter-relationships between resilience and demographic features, phenomenology, illness course, psychosocial functioning, and its mediational role among relevant factors. METHODS A systematic review was conducted on published empirical studies examining the topic of resilience and clinical correlates within schizophrenia spectrum conditions up until December 2020. RESULTS Higher level of resilience was associated with lower severity of specific symptomatology including positive, negative, depressive symptoms, suicidal ideation, cognitive deficits, and better insight. Moreover, higher resilience was significantly associated with different aspects of illness course (such as shorter duration of untreated psychosis, longer duration of illness, improved symptom remission and recovery), internal factors (such as lower stigma, better self-esteem), and psychosocial functioning (better overall, real-life, social and interpersonal functioning, better quality of life). Resilience also acts as a mediator in pathways leading to depression, functioning, and quality of life within schizophrenia spectrum conditions. DISCUSSION Viewed within the context of various resiliency models (compensatory, challenge, protective factor models), suggestions were made to enhance resilience and balance risk versus protective factors in order to improve disease management. Future research should seek to better elucidate associated biomarkers, inter-relationships with carer resilience, and evaluate the efficacy of suitable resilience-targeted interventions in schizophrenia.
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Affiliation(s)
- Jerry Jay Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qian Hui Chew
- Institute of Mental Health, Buangkok Green Medical Park, Singapore, Singapore
| | - Kang Sim
- Institute of Mental Health, Buangkok Green Medical Park, Singapore, Singapore
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Brilliant T D, Takeuchi H, Nouchi R, Yokoyama R, Kotozaki Y, Nakagawa S, Hanawa S, Sekiguchi A, Ikeda S, Sakaki K, Kawata KHDS, Nozawa T, Yokota S, Magistro D, Kawashima R. Loneliness inside of the brain: evidence from a large dataset of resting-state fMRI in young adult. Sci Rep 2022; 12:7856. [PMID: 35550564 PMCID: PMC9098468 DOI: 10.1038/s41598-022-11724-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/25/2022] [Indexed: 12/12/2022] Open
Abstract
Although loneliness itself is a natural emotion, prolonged loneliness is detrimental to human health. Despite its detrimental effect, few loneliness-related neuroimaging studies have been published and some have limitations on the sample size number. This study aims to find the difference in resting-state functional connectivity associated with loneliness within a big sample size via the seed-based approach. Functional connectivity analysis was performed on a large cohort of young adults (N = 1336) using the seed-based functional connectivity approach to address the concern from previous studies. The analysis yielded statistically significant positive correlations between loneliness and functional connectivities between the inferior frontal gyrus and supplementary motor area, precentral gyrus, and superior parietal lobule. Additionally, the analysis replicated a finding from a previous study, which is increased functional connectivities between the inferior frontal gyrus and supplementary motor area. In conclusion, greater loneliness is reflected by stronger functional connectivity of the visual attention brain area.
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Affiliation(s)
- Denilson Brilliant T
- Department of Advanced Brain Science, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, Japan.
| | - Hikaru Takeuchi
- Division of Developmental Cognitive Neuroscience, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, Japan
| | - Rui Nouchi
- Smart-Aging Research Center, Tohoku University, Sendai, Japan.,Departments of Cognitive Health Science, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, Japan
| | | | - Yuka Kotozaki
- Division of Clinical Research, Medical-Industry Translational Research Center, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seishu Nakagawa
- Department of Human Brain Science, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, Japan.,Division of Psychiatry, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Sugiko Hanawa
- Department of Human Brain Science, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, Japan
| | - Atsushi Sekiguchi
- Department of Behavioral Medicine, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Shigeyuki Ikeda
- RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Kohei Sakaki
- Department of Advanced Brain Science, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, Japan
| | | | - Takayuki Nozawa
- Research Institute for the Earth Inclusive Sensing, Tokyo Institute of Technology, Tokyo, Japan
| | - Susumu Yokota
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| | - Daniele Magistro
- Department of Sport Science, Nottingham Trent University, Nottingham, England
| | - Ryuta Kawashima
- Department of Advanced Brain Science, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, Japan.,Division of Developmental Cognitive Neuroscience, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, Japan.,Smart-Aging Research Center, Tohoku University, Sendai, Japan
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Barrett EA, Simonsen C, Aminoff SR, Hegelstad WTV, Lagerberg TV, Melle I, Mork E, Romm KL. The COVID-19 pandemic impact on wellbeing and mental health in people with psychotic and bipolar disorders. Brain Behav 2022; 12:e2559. [PMID: 35385888 PMCID: PMC9110908 DOI: 10.1002/brb3.2559] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/24/2022] [Accepted: 03/08/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic affects people globally, but it may affect people with psychotic and bipolar disorders disproportionally. Our aims were to investigate the pandemic impact on perceived wellbeing and mental health in this population, including which pandemic-related factors have had an impact. METHODS People with psychotic and bipolar disorders (N = 520; female = 81%; psychotic disorders n = 75/bipolar disorder n = 445) completed an online survey about wellbeing and mental health in the early phase of the COVID-19 pandemic (June 5-July 5, 2020). RESULTS Many participants experienced deteriorated wellbeing and mental health after the pandemic outbreak, especially in life satisfaction, meaning in life, positive feelings, depression, anxiety, and self-harm/suicidal ideation. Experienced recovery from mental health difficulties was significantly lower after compared to before the outbreak. Participants with psychotic disorders had significantly poorer wellbeing and mental health than participants with bipolar disorders, although they experienced significantly more worsening only of psychotic symptoms. Nearly half the participants reported coping with the situation; however, most factors potentially important to wellbeing and mental health changed adversely, including sufficiency and quality of treatment. More loneliness, low coping, insufficient mental health treatment during the COVID-19 pandemic, pandemic worry, more insomnia symptoms, and increased alcohol use predicted poor wellbeing and poor mental health. CONCLUSIONS During a pandemic, it is particularly important that mental health services strive to offer the best possible treatment under the current conditions and target loneliness, coping strategies, pandemic worry, insomnia, and increased alcohol use to uphold wellbeing and reduce mental health difficulties. For some, teletherapy is an agreeable substitute for traditional therapy.
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Affiliation(s)
- Elizabeth Ann Barrett
- Early Intervention in Psychosis Advisory Unit for South East Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Carmen Simonsen
- Early Intervention in Psychosis Advisory Unit for South East Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Sofie Ragnhild Aminoff
- Early Intervention in Psychosis Advisory Unit for South East Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wenche Ten Velden Hegelstad
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway.,Institute of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Trine Vik Lagerberg
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erlend Mork
- Early Intervention in Psychosis Advisory Unit for South East Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kristin Lie Romm
- Early Intervention in Psychosis Advisory Unit for South East Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Saris IMJ, Aghajani M, Jongs N, Reus LM, van der Wee NJA, Bilderbeck AC, Winter van Rossum I, Arango C, de la Torre-Luque A, Malik A, Raslescu A, Dawson GR, Ayuso-Mateos JL, Kas MJ, Penninx BWJH. Cross-disorder and disorder-specific deficits in social functioning among schizophrenia and alzheimer's disease patients. PLoS One 2022; 17:e0263769. [PMID: 35421108 DOI: 10.1371/journal.pone.0263769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 01/26/2022] [Indexed: 12/18/2022] Open
Abstract
Background Social functioning is often impaired in schizophrenia (SZ) and Alzheimer’s disease (AD). However, commonalities and differences in social dysfunction among these patient groups remain elusive. Materials and methods Using data from the PRISM study, behavioral (all subscales and total score of the Social Functioning Scale) and affective (perceived social disability and loneliness) indicators of social functioning were measured in patients with SZ (N = 56), probable AD (N = 50) and age-matched healthy controls groups (HC, N = 29 and N = 28). We examined to what extent social functioning differed between disease and age-matched HC groups, as well as between patient groups. Furthermore, we examined how severity of disease and mood were correlated with social functioning, irrespective of diagnosis. Results As compared to HC, both behavioral and affective social functioning seemed impaired in SZ patients (Cohen’s d’s 0.81–1.69), whereas AD patients mainly showed impaired behavioral social function (Cohen’s d’s 0.65–1.14). While behavioral indices of social functioning were similar across patient groups, SZ patients reported more perceived social disability than AD patients (Cohen’s d’s 0.65). Across patient groups, positive mood, lower depression and anxiety levels were strong determinants of better social functioning (p’s <0.001), even more so than severity of disease. Conclusions AD and SZ patients both exhibit poor social functioning in comparison to age- and sex matched HC participants. Social dysfunction in SZ patients may be more severe than in AD patients, though this may be due to underreporting by AD patients. Across patients, social functioning appeared as more influenced by mood states than by severity of disease.
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Heron P, Spanakis P, Crosland S, Johnston G, Newbronner E, Wadman R, Walker L, Gilbody S, Peckham E. Loneliness among people with severe mental illness during the COVID-19 pandemic: Results from a linked UK population cohort study. PLoS One 2022; 17:e0262363. [PMID: 35025915 PMCID: PMC8757957 DOI: 10.1371/journal.pone.0262363] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/22/2021] [Indexed: 11/18/2022] Open
Abstract
AIM/GOAL/PURPOSE Population surveys underrepresent people with severe mental ill health. This paper aims to use multiple regression analyses to explore perceived social support, loneliness and factor associations from self-report survey data collected during the Covid-19 pandemic in a sample of individuals with severe mental ill health. DESIGN/METHODOLOGY/APPROACH We sampled an already existing cohort of people with severe mental ill health. Researchers contacted participants by phone or by post to invite them to take part in a survey about how the pandemic restrictions had impacted health, Covid-19 experiences, perceived social support, employment and loneliness. Loneliness was measured by the three item UCLA loneliness scale. FINDINGS In the pandemic sub-cohort, 367 adults with a severe mental ill health diagnosis completed a remote survey. 29-34% of participants reported being lonely. Loneliness was associated with being younger in age (adjusted OR = -.98, p = .02), living alone (adjusted OR = 2.04, p = .01), high levels of social and economic deprivation (adjusted OR = 2.49, p = .04), and lower perceived social support (B = -5.86, p < .001). Living alone was associated with lower perceived social support. Being lonely was associated with a self-reported deterioration in mental health during the pandemic (adjusted OR = 3.46, 95%CI 2.03-5.91). PRACTICAL IMPLICATIONS Intervention strategies to tackle loneliness in the severe mental ill health population are needed. Further research is needed to follow-up the severe mental ill health population after pandemic restrictions are lifted to understand perceived social support and loneliness trends. ORIGINALITY Loneliness was a substantial problem for the severe mental ill health population before the Covid-19 pandemic but there is limited evidence to understand perceived social support and loneliness trends during the pandemic.
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Affiliation(s)
- Paul Heron
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
- * E-mail:
| | - Panagiotis Spanakis
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Suzanne Crosland
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | | | - Elizabeth Newbronner
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Ruth Wadman
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Lauren Walker
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Simon Gilbody
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Emily Peckham
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
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Andreu-Bernabeu Á, Díaz-Caneja CM, Costas J, De Hoyos L, Stella C, Gurriarán X, Alloza C, Fañanás L, Bobes J, González-Pinto A, Crespo-Facorro B, Martorell L, Vilella E, Muntané G, Nacher J, Molto MD, Aguilar EJ, Parellada M, Arango C, González-Peñas J. Polygenic contribution to the relationship of loneliness and social isolation with schizophrenia. Nat Commun 2022; 13:51. [PMID: 35013163 PMCID: PMC8748758 DOI: 10.1038/s41467-021-27598-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 11/26/2021] [Indexed: 12/24/2022] Open
Abstract
Previous research suggests an association of loneliness and social isolation (LNL-ISO) with schizophrenia. Here, we demonstrate a LNL-ISO polygenic score contribution to schizophrenia risk in an independent case-control sample (N = 3,488). We then subset schizophrenia predisposing variation based on its effect on LNL-ISO. We find that genetic variation with concordant effects in both phenotypes shows significant SNP-based heritability enrichment, higher polygenic contribution in females, and positive covariance with mental disorders such as depression, anxiety, attention-deficit hyperactivity disorder, alcohol dependence, and autism. Conversely, genetic variation with discordant effects only contributes to schizophrenia risk in males and is negatively correlated with those disorders. Mendelian randomization analyses demonstrate a plausible bi-directional causal relationship between LNL-ISO and schizophrenia, with a greater effect of LNL-ISO liability on schizophrenia than vice versa. These results illustrate the genetic footprint of LNL-ISO on schizophrenia.
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Affiliation(s)
- Álvaro Andreu-Bernabeu
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Javier Costas
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Galicia, Spain
| | - Lucía De Hoyos
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Carol Stella
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Xaquín Gurriarán
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Galicia, Spain
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Lourdes Fañanás
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Julio Bobes
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Faculty of Medicine and Health Sciences-Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, Oviedo, Spain
| | - Ana González-Pinto
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- BIOARABA Health Research Institute, OSI Araba, University Hospital, University of the Basque Country, Vitoria, Spain
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
| | - Lourdes Martorell
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Elisabet Vilella
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Gerard Muntané
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Juan Nacher
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Neurobiology Unit, Department of Cell Biology, Interdisciplinary Research Structure for Biotechnology and Biomedicine (BIOTECMED), University of Valencia, Valencia, 46100, Spain
| | - María Dolores Molto
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Department of Genetics, University of Valencia, Campus of Burjassot, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
| | - Eduardo Jesús Aguilar
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
- Fundación Investigación Hospital Clínico de Valencia, INCLIVA, 46010, Valencia, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Javier González-Peñas
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.
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Ludwig KA, Brandrett B, Lim MH, Mihas P, Penn DL. Lived experience of loneliness in psychosis: A qualitative approach. J Ment Health 2022; 31:543-550. [PMID: 34978239 DOI: 10.1080/09638237.2021.2022622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Loneliness impedes recovery from mental illness. Despite increased interest in loneliness in psychosis, qualitative methods are underused in clinical research on this topic. AIMS We used qualitative interviews to explore loneliness among persons with schizophrenia spectrum disorders (SSDs). We examined which aspects of living with psychosis were associated with the experience of loneliness, including symptomatology, social relationships, and disruptions in school/work. METHODS Sixteen participants diagnosed with SSDs engaged in semi-structured, qualitative interviews about loneliness. Participants commented on current activities and social relationships, including their perceptions of the quantity, quality and types of relationships. Important demographic and clinical information was acquired through communication with participants and/or through medical record review. Thematic analysis was used to examine interview content. RESULTS Our analyses revealed four key topic areas and several sub-themes related to loneliness across participants, including aspects of the physical environment (e.g. financial limitations), social context (e.g. lacking a romantic partner), and psychological functioning (e.g. psychotic/symptoms) that impact lonely feelings. Participants commented on coping strategies to manage loneliness and provided suggestions for possible interventions. CONCLUSIONS Persons diagnosed with SSDs report significant and impactful feelings of loneliness. This study highlights the need for novel and effective treatments targeting loneliness in this population.
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Affiliation(s)
- Kelsey A Ludwig
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, NC, USA
| | - Benjamin Brandrett
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Michelle H Lim
- Iverson Health Innovation Research Institute & Center for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Paul Mihas
- Odum Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - David L Penn
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, NC, USA.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
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Chen P, Chein K, Hsieh YT, Tseng HH, Lee IH, Yang Y. Childhood trauma, loneliness, and quality of life in adults with euthymic bipolar disorder. Taiwan J Psychiatry 2022. [DOI: 10.4103/tpsy.tpsy_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Heron P, Spanakis P, Crosland S, Johnston G, Newbronner E, Wadman R, Walker L, Gilbody S, Peckham E. Loneliness among people with severe mental illness during the COVID-19 pandemic: Results from a linked UK population cohort study. PLoS One 2022. [PMID: 35025915 DOI: 10.1101/2021.07.14.21260307] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
AIM/GOAL/PURPOSE Population surveys underrepresent people with severe mental ill health. This paper aims to use multiple regression analyses to explore perceived social support, loneliness and factor associations from self-report survey data collected during the Covid-19 pandemic in a sample of individuals with severe mental ill health. DESIGN/METHODOLOGY/APPROACH We sampled an already existing cohort of people with severe mental ill health. Researchers contacted participants by phone or by post to invite them to take part in a survey about how the pandemic restrictions had impacted health, Covid-19 experiences, perceived social support, employment and loneliness. Loneliness was measured by the three item UCLA loneliness scale. FINDINGS In the pandemic sub-cohort, 367 adults with a severe mental ill health diagnosis completed a remote survey. 29-34% of participants reported being lonely. Loneliness was associated with being younger in age (adjusted OR = -.98, p = .02), living alone (adjusted OR = 2.04, p = .01), high levels of social and economic deprivation (adjusted OR = 2.49, p = .04), and lower perceived social support (B = -5.86, p < .001). Living alone was associated with lower perceived social support. Being lonely was associated with a self-reported deterioration in mental health during the pandemic (adjusted OR = 3.46, 95%CI 2.03-5.91). PRACTICAL IMPLICATIONS Intervention strategies to tackle loneliness in the severe mental ill health population are needed. Further research is needed to follow-up the severe mental ill health population after pandemic restrictions are lifted to understand perceived social support and loneliness trends. ORIGINALITY Loneliness was a substantial problem for the severe mental ill health population before the Covid-19 pandemic but there is limited evidence to understand perceived social support and loneliness trends during the pandemic.
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Affiliation(s)
- Paul Heron
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Panagiotis Spanakis
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Suzanne Crosland
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | | | - Elizabeth Newbronner
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Ruth Wadman
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Lauren Walker
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Simon Gilbody
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Emily Peckham
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
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Heron P, Spanakis P, Crosland S, Johnston G, Newbronner E, Wadman R, Walker L, Gilbody S, Peckham E. Loneliness among people with severe mental illness during the COVID-19 pandemic: Results from a linked UK population cohort study. PLoS One 2022; 17:e0262363. [PMID: 35025915 DOI: 10.1101/2021.07.07.21260130] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/22/2021] [Indexed: 05/19/2023] Open
Abstract
AIM/GOAL/PURPOSE Population surveys underrepresent people with severe mental ill health. This paper aims to use multiple regression analyses to explore perceived social support, loneliness and factor associations from self-report survey data collected during the Covid-19 pandemic in a sample of individuals with severe mental ill health. DESIGN/METHODOLOGY/APPROACH We sampled an already existing cohort of people with severe mental ill health. Researchers contacted participants by phone or by post to invite them to take part in a survey about how the pandemic restrictions had impacted health, Covid-19 experiences, perceived social support, employment and loneliness. Loneliness was measured by the three item UCLA loneliness scale. FINDINGS In the pandemic sub-cohort, 367 adults with a severe mental ill health diagnosis completed a remote survey. 29-34% of participants reported being lonely. Loneliness was associated with being younger in age (adjusted OR = -.98, p = .02), living alone (adjusted OR = 2.04, p = .01), high levels of social and economic deprivation (adjusted OR = 2.49, p = .04), and lower perceived social support (B = -5.86, p < .001). Living alone was associated with lower perceived social support. Being lonely was associated with a self-reported deterioration in mental health during the pandemic (adjusted OR = 3.46, 95%CI 2.03-5.91). PRACTICAL IMPLICATIONS Intervention strategies to tackle loneliness in the severe mental ill health population are needed. Further research is needed to follow-up the severe mental ill health population after pandemic restrictions are lifted to understand perceived social support and loneliness trends. ORIGINALITY Loneliness was a substantial problem for the severe mental ill health population before the Covid-19 pandemic but there is limited evidence to understand perceived social support and loneliness trends during the pandemic.
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Affiliation(s)
- Paul Heron
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Panagiotis Spanakis
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Suzanne Crosland
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | | | - Elizabeth Newbronner
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Ruth Wadman
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Lauren Walker
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
| | - Simon Gilbody
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Emily Peckham
- Mental Health and Addiction Research Group, University of York, York, United Kingdom
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Vasconcelos GS, Dos Santos Júnior MA, Monte AS, da Silva FER, Lima CNDC, Moreira Lima Neto AB, Medeiros IDS, Teixeira AL, de Lucena DF, Vasconcelos SMM, Macedo DS. Low-dose candesartan prevents schizophrenia-like behavioral alterations in a neurodevelopmental two-hit model of schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110348. [PMID: 33984421 DOI: 10.1016/j.pnpbp.2021.110348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/28/2021] [Accepted: 05/07/2021] [Indexed: 11/27/2022]
Abstract
Schizophrenia is a severe mental disorder with complex etiopathogenesis. Based on its neurodevelopmental features, an animal model induced by "two-hit" based on perinatal immune activation followed by peripubertal unpredictable stress was proposed. Sex influences the immune response, and concerning schizophrenia, it impacts the age of onset and symptoms severity. The neurobiological mechanisms underlying the influence of sex in schizophrenia is poorly understood. Our study aimed to evaluate sex influence on proinflammatory and oxidant alterations in male and female mice exposed to the two-hit model of schizophrenia, and its prevention by candesartan, an angiotensin II type 1 receptor (AT1R) blocker with neuroprotective properties. The two-hit model induced schizophrenia-like behavioral changes in animals of both sexes. Hippocampal microglial activation alongside the increased expression of NF-κB, and proinflammatory cytokines, namely interleukin (IL)-1β and TNF-α, were observed in male animals. Conversely, females presented increased hippocampal and plasma levels of nitrite and plasma lipid peroxidation. Peripubertal administration of low-dose candesartan (0.3 mg/kg PO) prevented behavioral, hippocampal, and systemic changes in male and female mice. While these results indicate the influence of sex on inflammatory and oxidative changes induced by the two-hit model, candesartan was effective in both males and females. The present study advances the neurobiological mechanisms underlying sex influence in schizophrenia and opens new avenues to prevent this devasting mental disorder.
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Affiliation(s)
- Germana Silva Vasconcelos
- Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Manuel Alves Dos Santos Júnior
- Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Aline Santos Monte
- University of International Integration of Afro-Brazilian Lusophony (Unilab-CE), Brazil
| | - Francisco Eliclécio Rodrigues da Silva
- Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Camila Nayane de Carvalho Lima
- Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | | | - Ingridy da Silva Medeiros
- Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Antonio Lucio Teixeira
- Institute of Education and Research, Santa Casa BH, Belo Horizonte, Brazil; Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, UTHealth Houston, United States of America
| | - David Freitas de Lucena
- Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Silvânia Maria Mendes Vasconcelos
- Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Danielle S Macedo
- Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil; National Institute for Translational Medicine (INCT-TM, CNPq), Ribeirão Preto, SP, Brazil.
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Moe AM, Weiss DM, Pine JG, Wastler HM, Breitborde NJK. Social motivation and behavior in first-episode psychosis: Unique contributions to social quality of life and social functioning. J Psychiatr Res 2021; 144:441-447. [PMID: 34749220 PMCID: PMC8667854 DOI: 10.1016/j.jpsychires.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/26/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022]
Abstract
Social functioning is diminished among people early in the course of psychotic illnesses, and is likely influenced by the negative symptoms that accompany these disorders, including changes in motivation and experience of pleasure. Though social impairments have a deleterious impact on functioning, socialization is a multifaceted behavior and little is known about how the various aspects may influence social functioning and social quality of life among people with first-episode psychosis. In the present study, we investigated the associations of specific aspects of social motivation and behavior with social functioning and social quality of life in a group of 54 young people (aged 15 to 35) with first-episode psychosis. Though different aspects of social motivation and behavior correlated positively with one another, social motivation for peer interactions was uniquely associated with social functioning and social quality of life - including when a broad measure of negative symptoms was considered within the same model. When these same associations were examined longitudinally, social motivation for peer interactions again emerged as a unique predictor of change in social functioning over 6 months. Our results suggest that the unique contribution of aspects of social motivation has implications for treatment, including the importance of developmentally-informed interventions to improve peer socialization in youth and young adults with psychosis.
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Affiliation(s)
- Aubrey M Moe
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA; Department of Psychology, The Ohio State University, USA.
| | - David M Weiss
- Department of Psychology, The Ohio State University, USA
| | - Jacob G Pine
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Heather M Wastler
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Nicholas J K Breitborde
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA; Department of Psychology, The Ohio State University, USA
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Abstract
ABSTRACT The consequences of loneliness include anxiety, depression, and chronic illnesses, but little is known about its association with cognitive distortions. Three experiments investigated the effect of loneliness, and current context, on the content of false perceptions. A total of 446 participants completed psychometric tests (University of California, Los Angeles Loneliness Scale, Hospital Anxiety and Depression Scale, and a Schizotypy Scale) and a word detection task. The word detection task explored the effects of "lonely" and "neutral" contexts (experiments 1 and 2), as well as "positive social" contexts (experiment 3), on false perceptions. In all experiments, participants reporting higher loneliness reported more false perceptions with a lonely content, but only when in a context reflecting a lonely theme. The results show current environmental context and individuals' psychological state combine to affect false perception content. That such findings are found with loneliness, when controlling for depression, anxiety, and schizotypy, show the degree to which this state can distort cognition and perception.
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46
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Fortuna KL, Williams A, Mois G, Jason K, Bianco CL. Social Processes Associated With Health and Health Behaviors Linked to Early Mortality in People With a Diagnosis of a Serious Mental Illness. Perspect Psychol Sci 2021; 17:183-190. [PMID: 34264159 DOI: 10.1177/1745691621990613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Individuals with serious mental illness (SMI) experience a 10- to 25-year reduced life expectancy compared with the general population. Early mortality for people with SMI has mainly been attributed to unhealthy behaviors (e.g., poor diet, sedentary lifestyle), which has led to the development of health promotion and self-management interventions specifically for people with SMI to promote health behavior change. Yet after decades of research, the mortality gap between people with SMI and the general population is increasing. To address this early mortality disparity for individuals with SMI, a new paradigm must be explored. In this article, we present the social processes impacting early mortality in people with SMI paradigm, which highlights the powerful role of social processes in shaping the health and health behaviors of people with SMI. This paradigm explores how loneliness, stigma (social and self), trauma, social exclusion, social isolation, and social norms are related to early mortality in people with SMI. This new paradigm is an important step in understanding and potentially addressing early mortality in people with SMI.
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Affiliation(s)
- Karen L Fortuna
- Dartmouth Centers for Health and Aging, Lebanon, New Hampshire
| | | | - George Mois
- School of Social Work, University of Georgia
| | - Kendra Jason
- Department of Sociology, University of North Carolina Charlotte
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47
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Badcock JC, Di Prinzio P, Ambrosi T, Waterreus A, Morgan VA. Loneliness, social isolation and suicide risk in people with psychotic disorders. Schizophr Res 2021; 233:60-61. [PMID: 34229293 DOI: 10.1016/j.schres.2021.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/09/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Johanna C Badcock
- School of Psychological Science, University of Western Australia, Perth 6009, Australia; Perth Voices Clinic, Murdoch 6150, Australia.
| | - Patsy Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Australia
| | - Taryn Ambrosi
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Australia
| | - Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia; Clinical Research Centre, North Metropolitan Health Services Mental Health, Perth, WA, Australia
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48
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Fulford D, Mote J, Gonzalez R, Abplanalp S, Zhang Y, Luckenbaugh J, Onnela JP, Busso C, Gard DE. Smartphone sensing of social interactions in people with and without schizophrenia. J Psychiatr Res 2021; 137:613-620. [PMID: 33190842 PMCID: PMC8084875 DOI: 10.1016/j.jpsychires.2020.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/17/2020] [Accepted: 11/02/2020] [Indexed: 12/23/2022]
Abstract
Social impairment is a cardinal feature of schizophrenia spectrum disorders (SZ). Smaller social network size, diminished social skills, and loneliness are highly prevalent. Existing, gold-standard assessments of social impairment in SZ often rely on self-reported information that depends on retrospective recall and detailed accounts of complex social behaviors. This is particularly problematic in people with SZ given characteristic cognitive impairments and reduced insight. Ecological Momentary Assessment (EMA; repeated self-reports completed in the context of daily life) allows for the measurement of social behavior as it occurs in vivo, yet still relies on participant input. Momentary characterization of behavior using smartphone sensors (e.g., GPS, microphone) may also provide ecologically valid indicators of social functioning. In the current study we tested associations between both active (e.g., EMA-reported number of interactions) and passive (GPS-based mobility, conversations captured by microphone) smartphone-based measures of social activity and measures of social functioning and loneliness to examine the promise of such measures for understanding social impairment in SZ. Our results indicate that passive markers of mobility were more consistently associated with EMA measures of social behavior in controls than in people with SZ. Furthermore, dispositional loneliness showed associations with mobility metrics in both groups, while general social functioning was less related to these metrics. Finally, interactions detected in the ambient audio were more tied to social functioning in SZ than in controls. Findings speak to the promise of smartphone-based digital phenotyping as an approach to understanding objective markers of social activity in people with and without schizophrenia.
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Affiliation(s)
- Daniel Fulford
- Sargent College of Health & Rehabilitation Sciences, Boston University, USA; Department of Psychological & Brain Sciences, Boston University, USA.
| | - Jasmine Mote
- Sargent College of Health & Rehabilitation Sciences, Boston University, USA
| | - Rachel Gonzalez
- Department of Psychology, San Francisco State University, USA
| | - Samuel Abplanalp
- Sargent College of Health & Rehabilitation Sciences, Boston University, USA
| | - Yuting Zhang
- Department of Computer Science, Metropolitan College, Boston University, USA
| | - Jarrod Luckenbaugh
- Department of Electrical and Computer Engineering, The University of Texas at Dallas, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, USA
| | - Carlos Busso
- Department of Electrical and Computer Engineering, The University of Texas at Dallas, USA
| | - David E Gard
- Department of Psychology, San Francisco State University, USA
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Abstract
PURPOSE OF REVIEW The aim of this review was to summarize the recent literature on the clinical symptoms, functioning, outcomes and treatments for older adults with chronic schizophrenia. RECENT FINDINGS The number and proportion of older adults with schizophrenia is rapidly increasing. Schizophrenia is a heterogeneous disorder and older adults with schizophrenia display significant variability in symptom severity, quality of life and overall outcomes. Many achieve stable disease remission, some display persistent nonremission and others experience fluctuating symptoms. Depression is commonly reported, and although rates of suicide are higher when compared with age-matched peers, the excess mortality seen in this population is mainly attributed to natural causes of death. Cognitive decline and reduced illness awareness have important implications for functional status and quality of life. Antipsychotics remain essential in the treatment regimen, although elderly patients with chronic disease may be good candidates for gradual dose reduction. Interdisciplinary treatment approaches as well as nonpharmacologic psychosocial interventions play a critical adjunctive role in the treatment of older adults with schizophrenia. SUMMARY Research focusing on schizophrenia in late life is sparse. Too often, older patients are eliminated from research studies or averaged in with all age groups. Thus, there continues to be gaps in our understanding of modifiable predictors of remission and recovery, and the most efficacious and safest treatment approaches for this age group.
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50
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Abstract
Approximately 4.5% of U.S. adults live with a serious mental illness (SMI) (Substance Abuse and Mental Health Services Administration, 2018). Creating a place for people seeking structure, connection, and purpose following psychiatric hospitalization or for mental health recovery is difficult given several factors associated with illness trajectories, lack of community-based support programs, and reliance on traditional models of care. Using semi-structured interviews, the current study examined the reasons people attend community programs referred to as psychosocial "clubhouses." Interviews with 140 people across 10 clubhouse programs in one state were conducted. Qualitative analyses revealed that social connections and the need to reduce social isolation were driving forces for attending. Further, individuals noted that the "structure" of engaging in meaningful activities and roles was a main reason for participating. Authors discuss the continued need for community models that provide a "place" for all people to successfully engage and recover from psychiatric illnesses.
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Affiliation(s)
| | - Megan H Price
- Wayne State University, 333 College of Education, Detroit, MI, 48202, USA
| | - Kevin Rice
- Fountain House New York, 425 West 47th Street, New York, NY, 10036, USA
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