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He XY, Huang ZH, Wang F, Jia F, Hou CL. Individuals with genetic high-risk for psychosis experience impaired coping styles compared with healthy controls. Early Interv Psychiatry 2025; 19:e13598. [PMID: 39048537 DOI: 10.1111/eip.13598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/04/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Individuals with schizophrenia tend to have negative coping styles and low levels of self-esteem, but it is unclear whether coping styles and self-esteem levels are altered in people in the prodromal phase of psychosis. AIMS The study was designed to assess the role of coping style and self-esteem in the context of different phases of schizophrenia. METHODS Recurrent Schizophrenia (ReSch), first-episode schizophrenia patients (FEP), genetic-high risk for psychosis (GHR) patients, and healthy controls (HC) (40 per group) were subjected to in-person clinical interviews. The results of these interviews were then used to gauge coping style and self-esteem using the Coping Styles Questionnaire (CSQ) and the Rosenberg's Self-Esteem Scale (RSES). Data were analyzed through ANCOVAs and logistic regression analyses. RESULTS The results found that positive coping style (CSQ problem-solving and CSQ seeking for help) generally decline with progression through the HC, GHR, and FEP groups, while negative coping style (CSQ fantasy, CSQ repression and CSQ self-blame) generally increase with progression through the HC, GHR, and FEP groups (except that GHR group was slightly lower than HC group in CSQ self-blame). Results for members of ReSch group were in line with those of members of the FEP group in coping style. At the level of self-esteem, the GHR group was similar to the HC group and significantly higher than the FEP group and the ReSch group. Logistic regression analyses indicated that GHR group patients exhibited increased negative coping styles (CSQ fantasy) relative to members of the HC group, but had greater Positive coping style (CSQ problem-solving) than did members of the FEP group. DISCUSSION These findings suggest that both GHR individuals experience impaired negative coping styles which expands the understanding of the psychological characteristics of the prodromal group. Further explorations are warranted to develop optimal psychosocial interventions.
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Affiliation(s)
- Xiao-Yang He
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, WuXi, Jiangsu, China
| | - Zhuo-Hui Huang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Fei Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
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Gagiu C, Dionisie V, Manea MC, Mazilu DC, Manea M. Internalised Stigma, Self-Esteem and Perceived Social Support as Psychosocial Predictors of Quality of Life in Adult Patients with Schizophrenia. J Clin Med 2024; 13:6959. [PMID: 39598102 PMCID: PMC11594884 DOI: 10.3390/jcm13226959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 11/03/2024] [Accepted: 11/17/2024] [Indexed: 11/29/2024] Open
Abstract
Background: Schizophrenia is a chronic and severe mental illness that ultimately leads to reduced quality of life (QoL). Over the years, QoL has emerged as an important outcome in the treatment of schizophrenia patients, but the role of psychosocial variables in determining QoL is still ambiguous. Therefore, in the present research, demographic, clinical and psychosocial variables were examined for their influence on QoL. Methods: We conducted a prospective and cross-sectional study on a sample of 139 patients with schizophrenia (72.7% females, age 48.17 ± 10.22) attending an outpatient service. QoL was measured using Schizophrenia Quality of Life Revision-4 (SQLR4) and internalised stigma, self-esteem, perceived social support, resilience and coping mechanisms were assessed using a battery of standardized self-report scales. Results: Female patients and those less adherent to treatment had reduced cognition and vitality QoL. The worst QoL in all domains was observed in patients with a younger age at illness onset and with six or more hospitalizations. Regression analysis indicated that reduced self-esteem, perceived social support, a larger number of hospitalization and increased internalised stigma predicted poorer overall QoL and accounted for 44.9% in the variance in SQLSR4 global score (adjusted R2 = 0.449, p = 0.046). Conclusions: Routine assessment of internalised stigma, self-esteem and perceived social support, in addition to demographic and clinical variables and addressing possible deficits in these areas through personalized intervention, could improve QoL in schizophrenia patients.
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Affiliation(s)
- Corina Gagiu
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Vlad Dionisie
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Mihnea Costin Manea
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Doina Carmen Mazilu
- Department of Nursing, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mirela Manea
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
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Maran PL, Klokgieters SS, Giltay EJ, van Oppen P, Jörg F, Eikelenboom M, Rius Ottenheim N, Penninx BWJH, Kok AAL. The impact of COVID-19-pandemic-related adversity on mental health: longitudinal study in Dutch populations with and without mental health disorders. BJPsych Open 2023; 9:e181. [PMID: 37814416 PMCID: PMC10594261 DOI: 10.1192/bjo.2023.571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/20/2023] [Accepted: 08/22/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Despite growing concerns about mental health during the COVID-19 pandemic, particularly in people with pre-existing mental health disorders, research has shown that symptoms of depression and anxiety were generally quite stable, with modest changes in certain subgroups. However, individual differences in cumulative exposure to COVID-19 stressors have not been yet considered. AIMS We aimed to quantify and investigate the impact of individual-level cumulative exposure to COVID-19-pandemic-related adversity on changes in depressive and anxiety symptoms and loneliness. In addition, we examined whether the impact differed among individuals with various levels of pre-pandemic chronicity of mental health disorders. METHOD Between April 2020 and July 2021, 15 successive online questionnaires were distributed among three psychiatric case-control cohorts that started in the 2000s (N = 1377). Outcomes included depressive and anxiety symptoms and loneliness. We developed a COVID-19 Adversity Index (CAI) summarising up to 15 repeated measures of COVID-19-pandemic-related exposures (e.g. exposure to COVID-19 infection, negative economic impact and quarantine). We used linear mixed linear models to estimate the effects of COVID-19-related adversity on mental health and its interaction with pre-pandemic chronicity of mental health disorders and CAI. RESULTS Higher CAI scores were positively associated with higher increases in depressive symptoms, anxiety symptoms and loneliness. Associations were not statistically significantly different between groups with and without (chronic) pre-pandemic mental health disorders. CONCLUSIONS Individual differences in cumulative exposure to COVID-19-pandemic-related adversity are important predictors of mental health, but we found no evidence for higher vulnerability among people with (chronic) pre-pandemic mental health disorders.
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Affiliation(s)
- Patricia Laura Maran
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands; and Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands
| | - Silvia S. Klokgieters
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands
| | - Erik J. Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands; and Amsterdam Public Health, Mental Health Programme, Amsterdam, The Netherlands
| | - Frederike Jörg
- University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation, University of Groningen, Groningen, The Netherlands; Research Department, GGZ Friesland, Leeuwarden, The Netherlands
| | - Merijn Eikelenboom
- Amsterdam Public Health, Mental Health Programme, Amsterdam, The Netherlands
| | | | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands; and Amsterdam Public Health, Mental Health Programme, Amsterdam, The Netherlands
| | - Almar A. L. Kok
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands; and Amsterdam Public Health, Mental Health Programme, Amsterdam, The Netherlands
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Nguyen AD, Medrano O, Syed S. A Call for Integrated Psychiatry-Psychology Collaboration on Consult-Liaison Services: Experiences of a Psychology Extern and Recommendations for Collaborative Care. Cureus 2023; 15:e43874. [PMID: 37746511 PMCID: PMC10511300 DOI: 10.7759/cureus.43874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Few institutions have integrated psychologists into consult-liaison (CL) psychiatry services caring for patients with medical conditions and comorbid serious mental illnesses (SMI). To our knowledge, no studies have explored the experiences of an integrated pre-doctoral psychologist on a CL psychiatry service and applications of collaborative care. The present study aims to 1) highlight the experiences of a psychology extern on an adult CL psychiatry service in a public academic hospital, and 2) apply a collaborative care framework to provide recommendations for implementing integrated psychiatry-psychology collaboration. A semi-structured qualitative interview was performed with the team's psychology extern to elicit practice goals and setting. As of June 2022, the psychology extern saw 76 inpatient adults over the year-long externship period. Through diverse case vignettes, we illustrate the extern's unique roles in providing psychotherapeutic interventions to enhance patients' coping skills. We further found that embedding a psychology extern within the CL psychiatry service follows the integrated model of collaborative care. We thus apply a collaborative care framework to guide CL services in using multidisciplinary teams to improve care quality for inpatient adults. Leveraging the expertise of a psychology extern in real-time collaboration with CL psychiatry teams can enhance patient-centered care and warrants broader institutional implementation. Future studies are needed to explore the efficacy of integrated psychiatry-psychology collaboration on provider perspectives and clinical outcomes.
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Affiliation(s)
- Audrey D Nguyen
- Psychiatry, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, USA
- Psychiatry, Olive View-University of California Los Angeles (UCLA) Medical Center, Los Angeles, USA
| | - Osmara Medrano
- Psychiatry, Olive View-University of California Los Angeles (UCLA) Medical Center, Los Angeles, USA
| | - Saba Syed
- Psychiatry, Olive View-University of California Los Angeles (UCLA) Medical Center, Los Angeles, USA
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Nishiguchi Y, Ishikawa R, Ishigaki T, Hashimoto K. Less Maladaptiveness of the Maladaptive Coping Styles in Japan than in Germany: Cross-cultural Comparison of Adaptive and Maladaptive Coping Styles. Int J Cogn Ther 2022. [DOI: 10.1007/s41811-022-00143-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
The Maladaptive and Adaptive Coping Style Questionnaire (MAX) is a comprehensive tool for measuring coping styles including three subscales: maladaptive coping, adaptive coping, and avoidance. This study developed a Japanese version of MAX and evaluated the relationship between the coping styles and psychopathologies between the Japanese sample and the German sample. For the cross-cultural comparison, we used the Japanese community sample and German data set acquired by Moritz et al. (Journal of Affective Disorders 191:300–307, 2016). Factor analysis was conducted with the Japanese version of the MAX. Referring to the original version, we hypothesized the three-factor structure. However, the results showed that the adaptive coping subscale had less similarity to the original version, whereas the maladaptive coping and avoidance subscales were similar to the original. As the result of cultural comparison, the Japanese participants showed more maladaptive coping and avoidance. Moreover, the maladaptive coping styles had weaker correlations with the psychopathologies in the Japanese sample than with those in the German sample in the present study.
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Murphy O, Looney K, McNulty M, O’Reilly G. Exploring the factors that predict quality of life, and the relationship between recovery orientation and quality of life in adults with severe mental health difficulties. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractIntegration of intrapersonal, interpersonal and environmental factors has been proposed to enhance understanding of psychological quality of life (QOL) in adults with severe and enduring mental illness (SMI). This study examined the contribution of factors such as self-stigma, coping style and personal recovery orientation to psychological QOL in SMI; compared QOL outcomes to norms from the general population; and examined the association between personal recovery orientation and overall QOL. 70 participants with SMI completed measures of QOL (including psychological QOL), personal recovery orientation, coping, perceived stigma, psychological distress and demographic variables. Regression analysis found that only adaptive coping and psychological distress contributed significantly to psychological QOL. Personal recovery orientation was significantly associated with overall subjective QOL. Participants had lower QOL in the psychological and social relationships domains compared to the general population. Findings support the positive contribution of adaptive coping to psychological QOL, and the positive association between personal recovery orientation and overall QOL.
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Gumley AI, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Birchwood M, Briggs A, Bucci S, Cotton S, Engel L, French P, Lederman R, Lewis S, Machin M, MacLennan G, McLeod H, McMeekin N, Mihalopoulos C, Morton E, Norrie J, Reilly F, Schwannauer M, Singh SP, Sundram S, Thompson A, Williams C, Yung A, Aucott L, Farhall J, Gleeson J. Digital smartphone intervention to recognise and manage early warning signs in schizophrenia to prevent relapse: the EMPOWER feasibility cluster RCT. Health Technol Assess 2022; 26:1-174. [PMID: 35639493 DOI: 10.3310/hlze0479] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Relapse is a major determinant of outcome for people with a diagnosis of schizophrenia. Early warning signs frequently precede relapse. A recent Cochrane Review found low-quality evidence to suggest a positive effect of early warning signs interventions on hospitalisation and relapse. OBJECTIVE How feasible is a study to investigate the clinical effectiveness and cost-effectiveness of a digital intervention to recognise and promptly manage early warning signs of relapse in schizophrenia with the aim of preventing relapse? DESIGN A multicentre, two-arm, parallel-group cluster randomised controlled trial involving eight community mental health services, with 12-month follow-up. SETTINGS Glasgow, UK, and Melbourne, Australia. PARTICIPANTS Service users were aged > 16 years and had a schizophrenia spectrum disorder with evidence of a relapse within the previous 2 years. Carers were eligible for inclusion if they were nominated by an eligible service user. INTERVENTIONS The Early signs Monitoring to Prevent relapse in psychosis and prOmote Wellbeing, Engagement, and Recovery (EMPOWER) intervention was designed to enable participants to monitor changes in their well-being daily using a mobile phone, blended with peer support. Clinical triage of changes in well-being that were suggestive of early signs of relapse was enabled through an algorithm that triggered a check-in prompt that informed a relapse prevention pathway, if warranted. MAIN OUTCOME MEASURES The main outcomes were feasibility of the trial and feasibility, acceptability and usability of the intervention, as well as safety and performance. Candidate co-primary outcomes were relapse and fear of relapse. RESULTS We recruited 86 service users, of whom 73 were randomised (42 to EMPOWER and 31 to treatment as usual). Primary outcome data were collected for 84% of participants at 12 months. Feasibility data for people using the smartphone application (app) suggested that the app was easy to use and had a positive impact on motivations and intentions in relation to mental health. Actual app usage was high, with 91% of users who completed the baseline period meeting our a priori criterion of acceptable engagement (> 33%). The median time to discontinuation of > 33% app usage was 32 weeks (95% confidence interval 14 weeks to ∞). There were 8 out of 33 (24%) relapses in the EMPOWER arm and 13 out of 28 (46%) in the treatment-as-usual arm. Fewer participants in the EMPOWER arm had a relapse (relative risk 0.50, 95% confidence interval 0.26 to 0.98), and time to first relapse (hazard ratio 0.32, 95% confidence interval 0.14 to 0.74) was longer in the EMPOWER arm than in the treatment-as-usual group. At 12 months, EMPOWER participants were less fearful of having a relapse than those in the treatment-as-usual arm (mean difference -4.29, 95% confidence interval -7.29 to -1.28). EMPOWER was more costly and more effective, resulting in an incremental cost-effectiveness ratio of £3041. This incremental cost-effectiveness ratio would be considered cost-effective when using the National Institute for Health and Care Excellence threshold of £20,000 per quality-adjusted life-year gained. LIMITATIONS This was a feasibility study and the outcomes detected cannot be taken as evidence of efficacy or effectiveness. CONCLUSIONS A trial of digital technology to monitor early warning signs that blended with peer support and clinical triage to detect and prevent relapse is feasible. FUTURE WORK A main trial with a sample size of 500 (assuming 90% power and 20% dropout) would detect a clinically meaningful reduction in relapse (relative risk 0.7) and improvement in other variables (effect sizes 0.3-0.4). TRIAL REGISTRATION This trial is registered as ISRCTN99559262. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 27. See the NIHR Journals Library website for further project information. Funding in Australia was provided by the National Health and Medical Research Council (APP1095879).
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Affiliation(s)
- Andrew I Gumley
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Simon Bradstreet
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Ainsworth
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Stephanie Allan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Maximillian Birchwood
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Andrew Briggs
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sue Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Lidia Engel
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Paul French
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Reeva Lederman
- School of Computing and Information Systems, Melbourne School of Engineering, University of Melbourne, Melbourne, VIC, Australia
| | - Shôn Lewis
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Matthew Machin
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Hamish McLeod
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nicola McMeekin
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cathy Mihalopoulos
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Emma Morton
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - John Norrie
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | | | - Swaran P Singh
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Suresh Sundram
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Andrew Thompson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Chris Williams
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Alison Yung
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lorna Aucott
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - John Farhall
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.,NorthWestern Mental Health, Melbourne, VIC, Australia
| | - John Gleeson
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, VIC, Australia
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Grover S, Naskar C, Sharma P. Treatment-resistant non-catatonic mutism in schizophrenia: A case report and review of literature. Asian J Psychiatr 2022; 71:103067. [PMID: 35303591 DOI: 10.1016/j.ajp.2022.103067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Chandrima Naskar
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Pranshu Sharma
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Keller FM, Derksen C, Kötting L, Dahmen A, Lippke S. Distress, loneliness, and mental health during the COVID-19 pandemic: Test of the extension of the Evolutionary Theory of Loneliness. Appl Psychol Health Well Being 2022; 15:24-48. [PMID: 35266309 PMCID: PMC9111432 DOI: 10.1111/aphw.12352] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 01/18/2023]
Abstract
COVID-19 restrictions such as lockdowns or quarantines may increase the risk for social isolation and perceived loneliness. The mechanisms can be modeled by Cacioppo's Evolutionary Theory of Loneliness (ETL), which predicts that a lack of perceived social connectedness may lead, in the long-term, to mental and physical health consequences. However, the association between COVID-19 pandemic distress, mental health, and loneliness is not sufficiently understood. The present longitudinal study examined the relationship between distress and depression, and the mediating effects of anxiety and loneliness in a German rehabilitation sample (N = 403) at two timepoints (≤6 weeks pre-rehabilitation; ≥12 weeks post-rehabilitation; mean time between T1 and T2 was 52 days). Change scores between T1 and T2 were examined for the variables COVID-19 Peritraumatic Distress Index (CPDI), anxiety, loneliness, and depression. The results of the serial mediation analysis indicated that anxiety and loneliness were able to explain the relationship between distress and depression with 42% of variance in depression accounted for. Findings extend research on the relationship between COVID-19 and mental health by considering anxiety and loneliness as sustaining factors of depressive symptoms, thus, successfully applying the ETL. Results stress the necessity to consider anxiety and loneliness in the treatment or prevention of depression.
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Affiliation(s)
| | | | | | - Alina Dahmen
- Jacobs University Bremen gGmbHBremenGermany,Dr. Becker KlinikgruppeKölnGermany,Klinikum WolfsburgWolfsburgGermany
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10
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Li Y, Chen B, Hong Z, Sun Q, Dai Y, Basta M, Tang X, Qin Q. Insomnia symptoms during the early and late stages of the COVID-19 pandemic in China: a systematic review and meta-analysis. Sleep Med 2022; 91:262-272. [PMID: 34732293 PMCID: PMC8479411 DOI: 10.1016/j.sleep.2021.09.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Evidence suggests that the outbreak of the coronavirus disease 2019 (COVID-19) and the prevention/control measures for COVID-19 may cause insomnia during the acute phase of COVID-19 pandemic in China. However, it is unclear whether insomnia sustains during the later phases of the pandemic. METHODS We searched PubMed/Medline, EMBASE, PsycINFO and China National Knowledge Infrastructure from the 27th December 2019 to the 2nd February 2021. As early stage studies on COVID-19 pandemic in China were defined as those conducted prior to April 1st, 2020, while late stage studies were those conducted after April 1st, 2020. RESULTS A total of 98 studies with 193,889 participants were included. The pooled prevalence of insomnia symptoms among all populations was 39.1% (95% CI 36.2-42.0%); the pooled prevalence of insomnia symptoms during the early and late stages of COVID-19 in China were 37.0% (95% CI 34.1-39.9%) and 41.8% (95% CI 33.6-50.0%), respectively. Importantly, there was no significant difference regarding the prevalence of insomnia symptoms between the early and late stages of COVID-19. Meta-regression showed that healthcare workers, COVID-19 patients, patients with chronic medical conditions and patients with mental disorders had a higher prevalence of insomnia symptoms compared to the general population. This association remained significant in healthcare workers and patients with chronic medical conditions after adjusting for age, gender, areas of high or low prevalence of COVID-19 cases, anxiety and depression. CONCLUSIONS Over one third of our sample present insomnia symptoms during the early stage of COVID-19 pandemic in China. Interestingly, prevalence of insomnia symptoms sustains high during the late stage of the pandemic despite the control of the disease and the amelioration of its adverse effects. Our findings suggest that insomnia symptoms related to COVID-19 appear to persist of over time.
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Affiliation(s)
- Yun Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Baixin Chen
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Zhuoting Hong
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Qimeng Sun
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Yanyuan Dai
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Xiangdong Tang
- Sleep Medicine Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qingsong Qin
- Laboratory of Human Virology and Oncology, Shantou University Medical College, Shantou, China
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11
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Bornheimer LA, Martz ME, Suzuki T, Tso IF, Burton CZ, Li Verdugo J, Grove T, Heitzeg MM, Taylor SF. Affective Dysregulation Precedes Emergence of Psychosis-Like Experiences in a Community Sample of Young Adults. Schizophr Bull 2022; 48:664-672. [PMID: 35190837 PMCID: PMC9077429 DOI: 10.1093/schbul/sbac015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Affective dysregulation (AD) among persons with schizophrenia spectrum disorders, involving the tendency to exhibit sensitivity to minor stress and negative affective states, is an important diagnostic feature and relates to poorer functional and clinical outcomes. Studies of persons with elevated risk for psychosis demonstrate similar AD to those with schizophrenia, and literature suggest a potential influence of AD in the transition from psychosis-like symptoms (PLEs) to disorder. Cross-sectional investigations to date have supported the link between AD and psychosis, and longitudinal studies have mostly yielded mixed findings without demonstration of potential causal relationships between AD and psychosis. This study examined the concurrent and predictive relationships between AD and PLE in a community sample of youth (n = 630) with attention to distinct facets of AD as a latent construct, including low resiliency, low reactive control, and negative emotionality, using structural equation to estimate a longitudinal cross-lagged and autoregressive model across 3 study waves from 15 to 24 years of age. As hypothesized, AD in the mid-teen years predicted subsequent PLE 3 years later. In addition, we found that increasing PLE in the end of the teen years related to a subsequent increase in AD in the early 20s. A cross-sectional relationship between AD and PLE in the mid-teen years was also supported. Findings overall describe important relationships between AD and PLE that appear to vary with developmental stage, implicating various factors to inform approaches for identifying youth who may be at risk for subsequent PLE or other mental health conditions.
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Affiliation(s)
- Lindsay A Bornheimer
- To whom correspondence should be addressed; 1080 South University Ave, Ann Arbor, MI 48109; tel: (734) 615-2915, fax: 1 (734) 936-1961, e-mail:
| | - Meghan E Martz
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Takakuni Suzuki
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Ivy F Tso
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Cynthia Z Burton
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Tyler Grove
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Stephan F Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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12
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Caqueo-Urízar A, Urzúa A, Ponce-Correa F, Ferrer R. Psychosocial Effects of the COVID-19 Pandemic on Patients With Schizophrenia and Their Caregivers. Front Psychol 2021; 12:729793. [PMID: 34803806 PMCID: PMC8602112 DOI: 10.3389/fpsyg.2021.729793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/18/2021] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to analyze the psychosocial effects of the COVID-19 pandemic on 120 patients with schizophrenia, and their caregivers (control group), in the city of Arica, northern Chile. The hypotheses of this study hold that (1) self-reports of the impact of the COVID-19 pandemic among patients and caregivers would be positively correlated, (2) caregivers would self-report a greater impact of the pandemic on their daily lives, and (3) patients infected with COVID-19 would experience lower levels of mental health improvement and higher levels of psychological distress. Hypotheses were tested using correlations, mean differences, and effect sizes (Cohen’s d). The results showed that patients with schizophrenia who had been in quarantine for almost a year showed similar levels of concern as their caregivers in the domains of health and social life. However, caregivers showed significant differences from patients in the areas of income, concern, and employment status. In addition, patients who were infected with COVID-19 showed lower levels of well-being and worse psychological recovery. The implications of the findings highlight the need to incorporate mental health interventions in the pandemic health context for caregivers of people with schizophrenia. Finally, the results suggest that Covid-19 infection has a significant effect on the recovery and psychological well-being of patients with schizophrenia.
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Affiliation(s)
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | | | - Rodrigo Ferrer
- Escuela de Psicología y Filosofía, Universidad de Tarapacá, Arica, Chile
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13
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Godoy Izquierdo D, Vázquez Pérez ML, Lara Moreno R, Godoy García JF. Training coping skills and coping with stress self-efficacy for successful daily functioning and improved clinical status in patients with psychosis: A randomized controlled pilot study. Sci Prog 2021; 104:368504211056818. [PMID: 34939872 PMCID: PMC10450595 DOI: 10.1177/00368504211056818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Due to the symptom diversity and pervasive function impairments (e.g. in perception, cognition, language, affect, behavior, daily and social functioning and sense of self), recurrent relapses, elevated disability, high rates of (co)morbidity, heightened premature mortality and high burden of care of psychotic disorders, psychosocial interventions are part of patients' standard care. There is growing evidence on the relevance of self-efficacy for well-being and functioning among these patients, but specific coping with stress self-efficacy has rarely been investigated. This study explored the outcomes of an intervention for the improvement of coping resources based on training in coping skills and coping with stress self-efficacy. Fourteen adult volunteers with schizophrenia (n = 12) or schizoaffective disorder (n = 2) were matched in clinical and sociodemographic characteristics and randomly assigned to the study groups. The intervention group received the training-with 15 twice per week sessions (8 weeks)-along with their pharmacological therapy; the control group received their prescribed drug therapy. Participants completed self-reports on coping with stress self-efficacy, perceived successful daily functioning based on coping skills and clinical status (Expanded Brief Psychiatric Rating Scale). Trained patients showed a significant increase in coping with stress self-efficacy and reported greater successful functioning status, and significant improvements in their clinical status were also observed. All these enhancements remained at 3-month and 6-month follow-ups. The intervention condition interacted with coping with stress self-efficacy and perceived coping functioning in explaining improvements in clinical status: in the treatment group, greater coping with stress self-efficacy translated into enhanced daily functioning, and this improvement predicted better clinical status. These findings stress the relevance of promoting coping resources in psychotic disorders and provide preliminary evidence for the potential benefits of coping with stress self-efficacy.
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Affiliation(s)
- Débora Godoy Izquierdo
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (Health Psychology & Behavioral Medicine Research Group), (CTS-267), Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología Research Center “Mind, Brain and Behavior” CIMCYC, Universidad de Granada, Campus Universitario de Cartuja, Spain
| | - María Luisa Vázquez Pérez
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (Health Psychology & Behavioral Medicine Research Group), (CTS-267), Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología Research Center “Mind, Brain and Behavior” CIMCYC, Universidad de Granada, Campus Universitario de Cartuja, Spain
| | - Raquel Lara Moreno
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (Health Psychology & Behavioral Medicine Research Group), (CTS-267), Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología Research Center “Mind, Brain and Behavior” CIMCYC, Universidad de Granada, Campus Universitario de Cartuja, Spain
| | - Juan F Godoy García
- Grupo de Investigación Psicología de la Salud y Medicina Conductual (Health Psychology & Behavioral Medicine Research Group), (CTS-267), Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología Research Center “Mind, Brain and Behavior” CIMCYC, Universidad de Granada, Campus Universitario de Cartuja, Spain
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14
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Berry K, Haddock G, Barrowclough C, Gregg L. The role of attachment, coping style and reasons for substance use in substance users with psychosis. Clin Psychol Psychother 2021; 29:725-732. [PMID: 34432340 DOI: 10.1002/cpp.2666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 11/10/2022]
Abstract
Seventy substance users with psychosis who were participating in a clinical trial of a psychological therapy for psychosis were additionally assessed for attachment, coping styles and self-reported reasons for substance use in order to test a hypothesized sequential mediation model. In this model the relationship between insecure attachment and problematic substance use was assumed to be sequentially mediated by dysfunctional coping and the use of substances to cope with distress. Hypothesized associations between insecure-avoidant attachment and substance use were not supported, but the relationship between insecure-anxious attachment and problematic substance use was confirmed and found to be fully mediated by dysfunctional coping and coping reasons for use. Findings suggest that fostering secure attachments in people with psychosis might promote more successful coping and could prevent or reduce substance use related problems in this group.
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Affiliation(s)
- Katherine Berry
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Christine Barrowclough
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Lynsey Gregg
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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15
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Dekker TEG, van der Heijden HS, Schirmbeck F, van Amelsvoort T, Bartels-Velthuis AA, Simons CJP, de Haan L, Vermeulen JM. The association between smoking behaviour, social cognition and social functioning in patients with a non-affective psychotic disorder: A prospective follow-up study. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 26:100206. [PMID: 34258239 PMCID: PMC8259295 DOI: 10.1016/j.scog.2021.100206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
Introduction In patients with psychotic disorders, both tobacco smoking and deficits in social cognition and social functioning are highly prevalent. However, little is known about their relationship in psychosis. The authors sought to evaluate the multi-cross-sectional and longitudinal associations between tobacco smoking, social cognition and social functioning in a large prospective study. Methods This study was performed within the Genetic Risk and Outcome of Psychosis (GROUP) Study, a cohort study conducted in patients with non-affective psychosis (N = 1074), their unaffected siblings (N = 1047) and healthy controls (N = 549). At baseline, three years and six years of follow-up, data on tobacco smoking (using the Composite International Diagnostic Review), social cognition (emotion processing and theory of mind) and social functioning were collected. To assess associations between tobacco smoking and social cognition or social functioning, multivariate linear mixed-effects models and multiple linear regression models were used. Bonferroni correction for multiple testing was applied. Results A significant positive association was found between smoking and emotion processing (as part of social cognition) in the patient group (estimate = 1.96, SE = 0.6, p = 0.003). However, smoking was significantly negatively associated with participating in pro-social activities compared with non-smoking (estimate = −2.55, SE = 0.9, p = 0.004). Change in smoking behaviour was not associated with social cognition or social functioning in the longitudinal analyses. Conclusion Findings indicate that smoking patients with a non-affective psychotic disorder slightly outperformed their non-smoking peers on a task on social cognition, but participated less in pro-social activities. Commencement or cessation of smoking was not related to social cognition or functioning.
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Affiliation(s)
- Tobias E G Dekker
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands
| | | | - Frederike Schirmbeck
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands.,Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Therese van Amelsvoort
- Maastricht University Medical Center, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, the Netherlands
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| | - Claudia J P Simons
- Maastricht University Medical Center, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, the Netherlands.,GGzE Institute for Mental Health Care, Eindhoven, the Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands.,Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Jentien M Vermeulen
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands
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16
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Varela LF, Wong KHT, Shergill SS, Fett AKJ. Attachment styles moderate Theory of Mind differences between persons with schizophrenia, first-degree relatives and controls. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 60:339-356. [PMID: 34036577 DOI: 10.1111/bjc.12308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/04/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Theory of Mind (ToM) plays a role in social functioning and is impaired in patients with schizophrenia and to a lesser degree in first-degree relatives, compared to healthy controls. This study investigates whether attachment styles moderate these observed group differences in ToM. METHODS This cross-sectional study included a sample of 51 patients, 23 first-degree relatives, and 49 controls who completed assessments of anxious and avoidant attachment (Psychosis Attachment Measure), ToM (Reading the Mind in the Eyes Test), and estimated cognitive ability. Patients' symptoms were assessed with the Positive and Negative Syndrome Scale. RESULTS Patients differed from controls and relatives in ToM performance but not in attachment avoidance or attachment anxiety. Attachment anxiety showed an interaction with group over ToM. The interaction was significant only between patients and controls but not between patients and relatives or relatives and controls. Post-hoc analysis showed that patients and controls showed differential ToM performance at average and high attachment anxiety. In patients, symptom levels did not moderate the association between attachment and ToM. CONCLUSIONS Attachment anxiety is related to poorer levels of ToM in patients, suggesting this may have a contributory role in schizophrenia. The findings stress the need for longitudinal research into the directionality of the relationship between ToM and attachment anxiety. PRACTITIONER POINTS Relationships with significant others might be a factor that influences the way in which social information is processed by persons with a diagnosis of a psychotic disorder. In patients, higher levels of attachment anxiety - that is, low self-worth, fear of abandonment and rejection, continuous vigilance of threat-related cues - were associated with a lower ability to understand the mental states of others. However, at lower levels of attachment anxiety, their ToM performance was comparable to that of relatives and controls. This effect was not influenced by symptom severity. Further research is required to confirm the potential influence of attachment insecurity on ToM ability as the latter is strongly related to patient's functional outcomes.
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Affiliation(s)
- Luis F Varela
- Unidad de Psiquiatría, Escuela de Medicina, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile.,Servicio de Psiquiatría y Salud Mental, Hospital CRS El Pino, Servicio de Salud Metropolitano Sur, Santiago, Chile.,Cognition, Schizophrenia and Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Katie H T Wong
- Cognition, Schizophrenia and Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Sukhi S Shergill
- Cognition, Schizophrenia and Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Anne-K J Fett
- Cognition, Schizophrenia and Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,Department of Psychology, School of Arts and Social Sciences, City, University of London, UK
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17
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Affiliation(s)
- Helen M. Stallman
- School of Social Sciences, University of the Sunshine Coast, Maroochydore DC, QLD, Australia,
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18
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Sun Q, Qin Q, Basta M, Chen B, Li Y. Psychological reactions and insomnia in adults with mental health disorders during the COVID-19 outbreak. BMC Psychiatry 2021; 21:19. [PMID: 33419411 PMCID: PMC7791151 DOI: 10.1186/s12888-020-03036-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The 2019 coronavirus disease (COVID-19) has disrupted millions of lives and commerce. We investigated psychological reactions and insomnia during the COVID-19 outbreak in adults with mental health disorders (MDs). METHODS A self-reported psychological and sleep online survey was conducted in China between February 5th to 19th, 2020. A total of 244 adults with MDs and 1116 controls matched for age, gender and sites were included. Worsened symptoms of anxiety, depressive and insomnia were defined when severity levels shifted to a more severe category compared to pre-COVID-19. RESULTS During the COVID-19 outbreak, we found significantly increased prevalence of anxiety (MDs: 54.9% vs. 49.6%, controls: 25.5% vs. 14.3%), depression (MDs: 63.9% vs. 61.5%, controls: 29.9% vs. 21.2%) and insomnia (MDs: 66.0% vs. 57.8%, controls: 31.5% vs. 24.8%) compared to pre-COVID-19 period (all P-value < 0.001). Furthermore, adults with MDs had higher odds for developing COVID-19-related stress (OR = 3.41, 95% CI 2.49 ~ 4.67), worsened anxiety (OR = 1.95, 95% CI 1.38 ~ 2.76), depression (OR = 2.04, 95% CI 1.43 ~ 2.93) and insomnia (OR = 2.22, 95% CI 1.53 ~ 3.21) during the COVID-19 outbreak compared to controls. Moreover, higher COVID-19-related stress and lower levels of pre-COVID-19 anxiety, depressive and insomnia symptoms were predictors for worsened anxiety, depression and insomnia in adults with MDs, respectively. CONCLUSIONS Our findings suggest that adverse psychological reactions and insomnia are more pronounced in adults with mental health disorders during the COVID-19 outbreak, thus more attention need to be provided.
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Affiliation(s)
- Qimeng Sun
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Qingsong Qin
- Laboratory of Human Virology and Oncology, Shantou University Medical College, Shantou, Guangdong, China
| | - Maria Basta
- Department of Psychiatry, University, Hospital of Heraklion, Crete, Greece
| | - Baixin Chen
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Yun Li
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou, Guangdong, China.
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China.
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19
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Mollà Roig P. Psicosis reactiva breve a situación de confinamiento por PCR positiva para SARS-CoV-2. A propósito de un caso clínico. PSIQUIATRÍA BIOLÓGICA 2021. [PMCID: PMC7833116 DOI: 10.1016/j.psiq.2020.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Algunas personas presentan respuestas muy diferentes a los acontecimientos vitales estresantes. Diversos autores han observado una relación entre una circunstancia de vida que pueda resultar estresante para el individuo y la aparición de un primer episodio psicótico. Se presenta el caso de un varón de 43 años sin antecedentes psiquiátricos que, tras aproximadamente 10 días de confinamiento por PCR positiva para SARS-CoV-2, inicia un cuadro de clínica delirante.
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20
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Chang YC, Li WY, Lee LJH, Lee LJ. Interplay of Prenatal and Postnatal Risk Factors in the Behavioral and Histological Features of a "Two-Hit" Non-Genetic Mouse Model of Schizophrenia. Int J Mol Sci 2020; 21:ijms21228518. [PMID: 33198225 PMCID: PMC7697169 DOI: 10.3390/ijms21228518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 11/21/2022] Open
Abstract
Schizophrenia is a multifactorial developmental neuropsychiatric disorder. This study examined the interplay of maternal infection and postweaning social isolation, which are prenatal and postnatal risk factors, respectively. Pregnant mice received poly I:C or saline injection on gestation day 9 and the pups were weaned at postnatal day 28. After weaning, male offspring were randomly assigned into group-rearing and isolation-rearing groups. In their adulthood, we performed behavioral tests and characterized the histochemical features of their mesocorticolimbic structures. The sociability and anxiety levels were not affected by either manipulation, but synergistic effects of the two hits on stress-coping behavior was observed. Either of the single manipulations caused defects in sensorimotor gating, novel object recognition and spatial memory tests, but the combination of the two hits did not further exacerbate the disabilities. Prenatal infection increased the number of dopaminergic neurons in midbrain, whereas postweaning isolation decreased the GABAergic neurons in cortex. Single manipulation reduced the dendritic complexity and spine densities of neurons in the medial prefrontal cortex (mPFC) and dentate gyrus. Our results support the current perspective that disturbances in brain development during the prenatal or postnatal period influence the structure and function of the brain and together augment the susceptibility to mental disorders, such as schizophrenia.
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Affiliation(s)
- Yi-Chun Chang
- Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei 10048, Taiwan; (Y.-C.C.); (W.-Y.L.)
| | - Wai-Yu Li
- Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei 10048, Taiwan; (Y.-C.C.); (W.-Y.L.)
| | - Lukas Jyuhn-Hsiarn Lee
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan;
| | - Li-Jen Lee
- Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei 10048, Taiwan; (Y.-C.C.); (W.-Y.L.)
- Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei 10048, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei 10617, Taiwan
- Correspondence:
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21
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Serfaty DR, Cherniak AD, Strous RD. How are psychotic symptoms and treatment factors affected by religion? A cross-sectional study about religious coping among ultra-Orthodox Jews. Psychiatry Res 2020; 293:113349. [PMID: 32798928 DOI: 10.1016/j.psychres.2020.113349] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/27/2020] [Accepted: 08/01/2020] [Indexed: 10/23/2022]
Abstract
Religious coping is prevalent among individuals diagnosed with psychotic disorders, however its clinical relevance has been insufficiently studied. Thirty ultra-Orthodox Jewish patients experiencing current psychotic symptoms and receiving treatment in the inpatient and day-care units were administered measures assessing severity of psychotic symptoms, psychological distress/well-being, beliefs about treatment credibility/expectancy, and aspects of religious belief and coping. Among men, negative religious coping was associated with lower treatment credibility. Among women, positive religious coping was associated with increased treatment expectancy and greater quality of life; and trust in God was associated with reduced psychiatric symptoms and greater treatment expectancy. Study findings indicate that religious factors may promote treatment motivation and engagement, crucial factors for subpopulations facing culturally-based barriers to treatment, as well as boost more favorable outcomes. Sensitivity to religious factors in treatment appears to play an important role in the management of psychotic disorders and should be engaged when culturally appropriate in order to maximize treatment potential.
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Affiliation(s)
| | - Aaron D Cherniak
- Mayanei Hayeshua Medical Center, Bnei Brak, Israel; Stockholm University, Stockholm, Sweden
| | - Rael D Strous
- Mayanei Hayeshua Medical Center, Bnei Brak, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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22
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Kumar Sharma M, Anand N, Vishwakarma A, Sahu M, Thakur PC, Mondal I, Singh P, S J A, N S, John N, Biswas A, R A, Tapatrikar A, Murthy KD. Media use as a modality to cope with expressed emotion: Insight from a case with psychosis. Asian J Psychiatr 2020; 53:102122. [PMID: 32502766 DOI: 10.1016/j.ajp.2020.102122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Manoj Kumar Sharma
- SHUT Clinic (Service for Healthy use of Technology), National Institute of Mental health & Neurosciences, Bengaluru, Karnataka, India.
| | - Nitin Anand
- National Institute of Mental health & Neurosciences, Bengaluru, Karnataka, India.
| | - Akash Vishwakarma
- SHUT Clinic, Department of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
| | - Maya Sahu
- Department of Nursing, NIMHANS, Bangalore, Karnataka, India.
| | | | - Ishita Mondal
- Department of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
| | - Priya Singh
- SHUT Clinic, Department of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
| | - Ajith S J
- SHUT clinic, Department of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
| | - Suma N
- Clinical Psychologist, Department of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
| | - Nisha John
- Department of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
| | - Ankita Biswas
- SHUT Clinic, Department of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
| | - Archana R
- Department of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
| | - Ashwini Tapatrikar
- SHUT clinic, Department of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
| | - Keshava D Murthy
- Department of Psychiatric Social Work, NIMHANS, Bangalore, Karnataka, India.
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23
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The role of gender as a moderator in the relationship between disease perception and coping with stress strategies among psychiatric patients. CURRENT PROBLEMS OF PSYCHIATRY 2020. [DOI: 10.2478/cpp-2020-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: The perception of disease depends on the patient’s beliefs related to the nature of the illness, the previous personal or family experiences and his/her attitude to them. Patients try to understand and cope with health problems. The purpose of the present study was to answer the question which components of the relationship between the strategies for coping with stress and mental disease perception are moderated by gender.
Material and Methods: The study involved 98 patients with depressive disorders, anxiety disorders, schizophrenia, alcohol related disorders. The research of the variables was carried out using the COPE Inventory and Disease Perception Questionnaire.
Results: It has been noticed that in men, when their perception of the mental disorder as beneficial increases, the religious strategies for coping with stress become more frequent. Furthermore, the opposite sex pattern emerged. In the situation when an individual’s perception of the illness as a threat increased, female patients less frequently employed religious coping and planning. Furthermore, in women, when the perception of the mental disease as a weakness increases, the frequency of using emotional social support and acceptance decreases.
Conclusions: The result indicated that there are opposite patterns of gender specific coping strategy dependent on the mental illness perception.
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Addressing Delusions in Women and Men with Delusional Disorder: Key Points for Clinical Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124583. [PMID: 32630566 PMCID: PMC7344970 DOI: 10.3390/ijerph17124583] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 12/20/2022]
Abstract
Delusional disorders (DD) are difficult conditions for health professionals to treat successfully. They are also difficult for family members to bear. The aim of this narrative review is to select from the clinical literature the psychosocial interventions that appear to work best for these conditions and to see whether similar strategies can be modeled or taught to family members so that tensions at home are reduced. Because the content of men's and women's delusions sometimes differ, it has been suggested that optimal interventions for the two sexes may also differ. This review explores three areas: (a) specific treatments for men and women; (b) recommended psychological approaches by health professionals, especially in early encounters with patients with DD; and (c) recommended psychoeducation for families. Findings are that there is no evidence for differentiated psychosocial treatment for men and women with delusional disorder. What is recommended in the literature is to empathically elicit the details of the content of delusions, to address the accompanying emotions rather than the logic of the presented argument, to teach self-soothing techniques, and to monitor behavior with respect to its safety. These recommendations have only been validated in individual patients and families. More rigorous clinical trials need to be conducted.
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25
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Riera-López de Aguileta I, Vila-Badia R, Usall J, Butjosa A, Ochoa S. Coping strategies in first-episode psychosis: A systematic review. Early Interv Psychiatry 2020; 14:252-262. [PMID: 31318154 DOI: 10.1111/eip.12847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 06/09/2019] [Indexed: 12/12/2022]
Abstract
AIMS This paper reviews and discusses the published information on coping strategies in people with a first-episode psychosis (FEP). The objective is to update knowledge about coping strategies used by people with a FEP, to compare these strategies with those used by other mental disorders, and to examine the relationship between coping strategies and other variables in FEP. METHOD A search was conducted using PsycINFO, MEDLINE and PSICODOC between 1995 and 2018 using the following terms: coping strategies or Adaptation, Psychological and FEP. RESULTS A total of 167 studies were found, of which 14 were selected for review. The results suggest the need for a multiple and integrated approach, since there are several factors that are involved in the coping strategies (eg, socio-demographic, clinical and psychological variables) used in the different profiles of psychotic spectrum, specifically in FEP. CONCLUSIONS The role of coping skills is an important issue in psychopathological research in addition to clinical outcome, especially from the point of view of the patients, their social context and their recovery. Moreover, personalized therapies addressed to personal recovery should be considered to develop better coping specifically addressed to patients' needs.
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Affiliation(s)
| | | | - Judith Usall
- PARC SANITARI SANT JOAN DE DÉU. CIBERSAM, Barcelona, Spain
| | - Anna Butjosa
- PARC SANITARI SANT JOAN DE DÉU. CIBERSAM, Barcelona, Spain
| | - Susana Ochoa
- PARC SANITARI SANT JOAN DE DÉU. CIBERSAM, Barcelona, Spain
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Ferreira F, Castro D, Araújo AS, Fonseca AR, Ferreira TB. Exposure to Traumatic Events and Development of Psychotic Symptoms in a Prison Population: A Network Analysis Approach. Psychiatry Res 2020; 286:112894. [PMID: 32151849 DOI: 10.1016/j.psychres.2020.112894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 01/03/2023]
Abstract
Previous studies consistently observed an association between exposure to traumatic events and psychotic symptoms. However, little is known about the differential impact of distinct traumatic events and the role of general symptoms in mediating this relationship. Thus, our study aimed to explore the differential association of several traumatic events to the psychotic symptoms in a sample of prisoners and whether this association is mediated by general symptoms. The total sample from the Survey of Psychiatric Morbidity Among Prisoners in England and Wales (N = 3039; 75.4% male) was used. Participants completed a list of traumatic events experienced before reclusion, the Psychosis Screening Questionnaire, Clinical Review Schedule-Revised. Network analysis was used to estimate the network of interactions between traumatic events and general and psychotic symptoms. Shortest paths analysis was performed to identify the different development trajectories. Results suggested that memory problems, compulsions, and irritability might be key mediating symptoms for most traumatic events. However, sexual abuse showed alternative mediators that might be specific of this traumatic event. Finally, the traumatic events, suffered from violence at work, separation/divorce and been homeless showed direct associations with specific psychotic symptoms.
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Affiliation(s)
- Filipa Ferreira
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal; Center for Psychology at University of Porto.
| | - Daniel Castro
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal; Center for Psychology at University of Porto
| | - Ana Sofia Araújo
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal
| | - Ana Rita Fonseca
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal
| | - Tiago Bento Ferreira
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal; Center for Psychology at University of Porto
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Lawlor C, Hepworth C, Smallwood J, Carter B, Jolley S. Self-reported emotion regulation difficulties in people with psychosis compared with non-clinical controls: A systematic literature review. Clin Psychol Psychother 2020; 27:107-135. [PMID: 31661593 DOI: 10.1002/cpp.2408] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 01/10/2023]
Abstract
Emotions play a key role in the development and experience of psychosis, yet there are important gaps in our understanding of how individuals with psychosis understand and respond to their emotions. This systematic review investigated self-reported emotion regulation difficulties in individuals with psychosis compared with non-clinical controls. An electronic database search was conducted in Medline, PsychINFO, and Embase and supplemented by searches of reference lists and citations. Seventeen studies were included. A narrative synthesis was conducted because contextual diversity was present across the studies and outcomes. Individuals with psychosis reported greater difficulties in (i) emotional clarity (specifically with identifying, describing, and understanding their emotions), (ii) emotional acceptance, (iii) engaging in goal-directed behaviours when experiencing negative emotions, and (iv) willingness to experience emotional distress in the pursuit of meaningful activities in life. Evidence pertaining to other self-reported emotion regulation difficulties was less clear. Effect sizes were generally large in magnitude but there were few studies on some self-reported emotion regulation difficulties, and all studies were at moderate to high risk of bias. Further research is needed to clarify the nature of emotion regulation difficulties in individuals with psychosis to inform the provision of targeted clinical interventions.
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Affiliation(s)
- Caroline Lawlor
- North Lambeth Focused Support Team, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Claire Hepworth
- North Lambeth Focused Support Team, South London and Maudsley NHS Foundation Trust, London, UK
| | - Jane Smallwood
- North Lambeth Focused Support Team, South London and Maudsley NHS Foundation Trust, London, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Suzanne Jolley
- North Lambeth Focused Support Team, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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28
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Karadzhov D, Yuan Y, Bond L. Coping amidst an assemblage of disadvantage: A qualitative metasynthesis of first-person accounts of managing severe mental illness while homeless. J Psychiatr Ment Health Nurs 2020; 27:4-24. [PMID: 31099122 DOI: 10.1111/jpm.12524] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/17/2019] [Accepted: 05/13/2019] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Understanding what strategies individuals use to cope with serious mental illness is vital for enhancing their quality of life, mental well-being and recovery, and effective use of services; An episode of homelessness can be a profoundly disruptive event that often leads to chronic stress, social isolation, a negative belief about oneself and restricted access to care, among other adverse experiences; WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: In contrast to existing reviews of qualitative research focusing on escaping homelessness, managing problem substance use and growing resilience, the current review offers an in-depth, interpretive account of coping with serious mental illness during an episode of homelessness; This paper integrates evidence showing the diverse and intricate processes via which homelessness can impede an individual's ability to successfully cope with life stressors and with chronic mental illness; Despite experiencing severe social disadvantage, many individuals demonstrate positive adaptation and coping, and even personal growth; WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is important to be aware of the many ways in which coping with serious mental illness can be influenced by adverse environmental factors such as poverty, homelessness, traumatic life experiences and institutional discrimination; Nursing practice should recognize that coping efforts by individuals facing multiple forms of social disadvantage may be shaped by acute adverse life events and institutional interactions, as well as by the stresses and strains of living on the streets; Nursing practice should focus not only on reducing clients' mental illness symptoms and facilitating positive coping behaviours, but also on helping create the conditions that aid clients in leveraging inner resources for personal growth and constructive meaning-making. Abstract Introduction An evidence gap persists concerning the impact of extreme socio-structural disadvantage, such as homelessness, on the nature and effectiveness of coping with severe mental illness (SMI). While existing reviews of qualitative research into homelessness have focused on processes such as escaping homelessness and managing concurrent problem substance use, as well as on the experiences of specific vulnerable groups such as women and youth, no analogical review has been dedicated to understanding the management of SMI during an episode of homelessness. Aim/Question A qualitative metasynthesis of first-person accounts was conducted to understand how individuals cope with SMI when experiencing homelessness. Method The systematic search strategy yielded 481 potentially eligible sources. Following the team-based full-text screening and the two-tiered quality appraisal, 14 studies involving 377 participants with lived experience were synthesized following Noblit and Hare's metaethnographic method. Results Seven third-order concepts were derived capturing the complex nature and processual character of coping, as well as the web of contextual influences upon coping strategies. The resultant line-of-argument synthesis reveals the dialectical relationship between the two higher-order constructs-"the continuum of coping" and "the assemblage of disadvantage." Discussion Despite the profoundly adverse impacts of biographical and socio-structural conditions, many individuals mobilized internal and external resources to enable various coping processes. Coping in the context of multiple disadvantage is not a monolith but rather a multidimensional, contingent and fluid phenomenon. Implications for practice Nursing practice should espouse a humanizing, structurally competent, and strength- and meaning-oriented approach in order to meet the complex and multifaceted needs of such multiply disadvantaged persons.
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Affiliation(s)
- Dimitar Karadzhov
- Centre for Health Policy, International Public Policy Institute, School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK
| | - Yeqing Yuan
- Silver School of Social Work, New York University, New York, New York
| | - Lynden Bond
- Silver School of Social Work, New York University, New York, New York
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29
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Yee CI, Gupta T, Mittal VA, Haase CM. Coping with family stress in individuals at clinical high-risk for psychosis. Schizophr Res 2020; 216:222-228. [PMID: 31839553 PMCID: PMC10484199 DOI: 10.1016/j.schres.2019.11.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/26/2019] [Accepted: 11/28/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Despite the long-emphasized role of the family environment in the schizophrenia literature, coping with family stress has been neglected in research on the psychosis risk period. METHODS The sample consisted of 75 youth at clinical high-risk (CHR) for psychosis and 79 matched healthy controls who reported on their use of engagement and disengagement coping strategies in response to stress with parents and perceived social support (i.e., advice availability, family support and strain). Participants were also assessed for clinical symptoms. RESULTS Individuals at CHR reported similar levels of engagement strategies (e.g., emotion regulation, positive thinking) and more frequent use of disengagement strategies (e.g., avoidance, denial) compared to healthy controls. In individuals at CHR (as well as healthy controls), greater use of engagement strategies predicted greater perceptions of availability of advice support, whereas greater employment of disengagement strategies predicted lower perceived social support from the family and greater family strain. In individuals at CHR (as well as healthy controls), engagement strategies were not linked to any clinical outcomes, whereas disengagement strategies were closely tied to anxiety and depression (but not psychosis symptoms in individuals at CHR). CONCLUSIONS Individuals at CHR appeared to engage the same amount as controls, but disengage more often when coping with family stress; this pattern was linked to perceptions of social support and tied to a putative family environment as well as clinical phenomenology. The findings have implications for targeting interventions for CHR populations during a vulnerable period for stress and social change.
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Affiliation(s)
- Claire I Yee
- Department of Psychology, Northwestern University, United States of America; School of Education and Social Policy, Northwestern University, United States of America.
| | - Tina Gupta
- Department of Psychology, Northwestern University, United States of America
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, United States of America
| | - Claudia M Haase
- School of Education and Social Policy, Northwestern University, United States of America
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30
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Harris K, Gooding P, Haddock G, Peters S. Factors that contribute to psychological resilience to suicidal thoughts and behaviours in people with schizophrenia diagnoses: qualitative study. BJPsych Open 2019; 5:e79. [PMID: 31496458 PMCID: PMC6737512 DOI: 10.1192/bjo.2019.63] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Suicide is a leading cause of premature death in people with a diagnosis of schizophrenia. Although exposure to stressors can play a part in the pathways to death by suicide, there is evidence that some people with a diagnosis of schizophrenia can be resilient to the impact of suicide triggers. AIMS To investigate factors that contribute to psychological resilience to suicidal thoughts and behaviours from the perspectives of people with a diagnosis of schizophrenia. METHOD A qualitative design was used, involving semi-structured, face-to-face interviews. Twenty individuals with non-affective psychosis or schizophrenia diagnoses who had experience of suicide thoughts and behaviours participated in the study. The interviews were audio-recorded, transcribed verbatim and examined using inductive thematic analysis. RESULTS Participants reported that psychological resilience to suicidal thoughts and behaviours involved ongoing effort. This ongoing effort encompassed: (a) understanding experiences (including reconciliation to mental health experiences and seeking reasons to live), (b) active behaviours (including talking to people and keeping occupied), and (c) relationship dynamics (including feeling supported by significant others and mental health professionals). CONCLUSIONS Psychological resilience was described as a dynamic process that developed over time through the experiences of psychosis and the concomitant suicidal experiences. Psychological resilience can be understood using a multicomponential, dynamic approach that integrates buffering, recovery and maintenance resilience models. In order to nurture psychological resilience, interventions should focus on supporting the understanding and management of psychosis symptoms and concomitant suicidal experiences. DECLARATION OF INTEREST None.
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Affiliation(s)
- Kamelia Harris
- PhD candidate, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
| | - Patricia Gooding
- Lecturer, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
| | - Gillian Haddock
- Professor of Clinical Psychology, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
| | - Sarah Peters
- Lecturer, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
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31
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Lavin R, Bucci S, Varese F, Berry K. The relationship between insecure attachment and paranoia in psychosis: A systematic literature review. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 59:39-65. [PMID: 31390076 PMCID: PMC7028113 DOI: 10.1111/bjc.12231] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/05/2019] [Indexed: 12/15/2022]
Abstract
Objectives Paranoia is a key symptom in psychosis and associated with a range of poor outcomes. Earlier life experiences increase vulnerability to paranoid thinking, and attachment theory has been proposed as a key model in explaining this causal pathway. Previous reviews highlight evidence of associations between insecure attachment styles and overall severity of psychotic symptoms. Studies report on associations between insecure attachment and paranoia, but to date, this literature has not been adequately synthesized. The aim of the current review was to report the strength and consistency of associations between paranoia and insecure attachment across published studies, and provide systematic appraisal of study quality. Method We carried out a systematic review of electronic databases using search terms to capture concepts of adult attachment, paranoia, and psychosis. We pre‐registered the review protocol and followed PRISMA guidelines. Results Significant associations were reported in 11 out of 12 studies between an insecure attachment and paranoia, with associations remaining significant in studies that controlled for comorbid symptoms. The strongest, most commonly reported relationship was between an anxious attachment style and paranoia. Conclusions The findings support the proposed role of attachment insecurity in the development and maintenance of paranoia in psychosis and highlight the need to address insecure attachment representations in the treatment of paranoia. Practitioner points
There is consistent evidence of associations between insecure attachment style and paranoia. Insecure anxious attachment is more consistently associated with paranoia than an insecure avoidant attachment. Associations between attachment and paranoia remain significant when key confounders are controlled for in the analyses. Interventions that address insecure attachment representations and promote a more secure attachment are likely to help reduce paranoia.
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Affiliation(s)
- Rachel Lavin
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK.,Complex Trauma and Resilience Research Unit (C-TRU), Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Filippo Varese
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK.,Complex Trauma and Resilience Research Unit (C-TRU), Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK.,Complex Trauma and Resilience Research Unit (C-TRU), Greater Manchester Mental Health NHS Foundation Trust, UK
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32
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Choo CC, Chew PKH, Tan P, Choo JQ, Choo AMH, Ho RC, Quah TC. Health-Related Quality of Life in Pediatric Patients with Leukemia in Singapore: A Cross-Sectional Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122069. [PMID: 31212740 PMCID: PMC6617504 DOI: 10.3390/ijerph16122069] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 11/17/2022]
Abstract
There has been a paradigm shift in health service delivery to a more holistic approach, which considers Quality of Life (QoL) and overall functioning. Health-Related Quality of Life (HRQoL) is a multidimensional construct that encompasses physical functioning as well as psychosocial aspects of emotional and social functioning. This study explored factors related to HRQoL in Asian pediatric patients with leukemia in Singapore. The available variables included: age, treatment duration, household income, gender, ethnicity, religion, diagnosis, and phase of treatment. It is hypothesized that the relationships will be significant. In the current study, there were 60 patients (60% males) with leukemia; their ages ranged from 1 to 21 years (Mean = 8.03, Standard Deviation = 4.55). The hypothesis was partially supported. Age had a significant positive relationship with physical functioning, r(60) = 0.28, p < 0.05, physical health, r(60) = 0.28, p < 0.05, and the total HRQoL score, r(60) = 0.29, p < 0.05. Treatment duration had a positive relationship with school functioning, r(60) = 0.28, p < 0.05. All other correlations were statistically non-significant. The effects of the available psychosocial variables of gender, ethnicity, and religion were examined on scores from the Pediatric Quality of Life Inventory (PedsQL). Ethnicity had a significant effect on social functioning, U = 292.00, p < 0.05, r = 0.3 (medium effect size). Specifically, Chinese (Median = 85.00, n = 33) had significantly higher scores on social functioning than others (Median = 70.00, n = 27). The remaining comparisons were statistically non-significant. The current findings added to QoL research, and provided an impetus for more research in the area of HRQoL for children with leukemia in Singapore.
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Affiliation(s)
- Carol C Choo
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore.
| | - Peter K H Chew
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore.
| | - Pinhong Tan
- Department of Pediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Jessica Q Choo
- Department of Pediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Amanda M H Choo
- Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SP, UK.
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 117599, Singapore.
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam.
- Faculty of Education, Huaibei Normal University, 100 Dongshan Road, Huaibei 235000, China.
| | - Thuan Chong Quah
- Department of Pediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.
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Jacques MC, St-Cyr Tribble D, Bonin JP. Filters in the coping process of people with schizophrenia: A constructivist grounded theory study. J Psychiatr Ment Health Nurs 2019; 26:142-152. [PMID: 30825402 DOI: 10.1111/jpm.12515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/06/2019] [Accepted: 02/27/2019] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: In the nursing perspective of Roy's adaptation model, to be adapted means to have positive interactions with one's environment. The ability to use effective coping strategies is an essential ingredient of mental health recovery. However, coping difficulties are often a problem for people with a diagnosis of schizophrenia spectrum disorder, especially those who have inadequate social support. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: "Filters in the coping process" is a grounded theory of coping in people with a diagnosis of schizophrenia spectrum disorder. A filter effect impairs their ability and limits their opportunities to use effective coping strategies. These filters are as follows: to have been helped, to understand in one's own way, to act despite limited freedom and to modulate the process of self-disclosure. "Surface coping" is the product of the effect of these filters on coping attempts and possibilities. It does not reflect the person's real potential. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: By offering an alternative, holistic nursing perspective, the filter model provides the nurse with factors to consider when assessing clients with a diagnosis of schizophrenia spectrum disorder, so as to plan interventions towards improving their coping capacity. By allowing for the presence of surface coping, the nurse will have less tendency to form negative judgments about clients with a diagnosis of schizophrenia spectrum disorder. ABSTRACT: Introduction Numerous studies confirm the coping difficulties of people diagnosed with schizophrenia spectrum disorder, especially those with limited social support. Further, the coping process is itself poorly understood. Aim Starting from a conceptualization of the adaptation of Roy's model, the aim of this study was to describe the coping process of people with schizophrenia spectrum disorder in the context of an inadequate social support. Method A constructivist grounded theorization was performed with a sample of 30 persons with schizophrenia spectrum disorder. Results The results are a model named: "Filters in the coping process of people with a diagnosis of schizophrenia spectrum disorder who have inadequate social support." The type of coping strategies used evolves over time and in accordance with the filters. The consequence of the process is "surface coping." Discussion The coping potential of people with schizophrenia spectrum disorder is affected by environmental factors as well as factors inherent to the disorder itself. The filter model provides a holistic perspective, as opposed to merely focusing on behaviours. Implication for practice The findings of this study could improve nursing interventions through a better understanding of impediments to coping: what they are, how they arise and the nature of their effects.
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Affiliation(s)
- Marie-Claude Jacques
- School of Nursing, Faculty of Medicine and Health Sciences, Université of Montreal, Montreal, Québec, Canada.,Institut universitaire de première ligne en santé et services sociaux, Sherbrooke, Québec, Canada
| | - Denise St-Cyr Tribble
- École des sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-Pierre Bonin
- Faculté des sciences infirmières, Université de Montréal, Montréal, Québec, Canada
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van Dijk FA, Schirmbeck F, Boyette LL, de Haan L. Coping styles mediate the association between negative life events and subjective well-being in patients with non-affective psychotic disorders and their siblings. Psychiatry Res 2019; 272:296-303. [PMID: 30594763 DOI: 10.1016/j.psychres.2018.12.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 12/03/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022]
Abstract
Coping styles are associated with levels of subjective well-being. Negative life events and reduced subjective well-being are more prevalent in patients with psychotic disorders. The aims of the current study were to test a mediation model, with coping styles as potential mediators of the relation between negative life events and subjective well-being in patients with psychotic disorders (N = 259), and aimed to repeat the potential mediation model in patients' non-affected siblings (N = 309). Data pertains to a subsample of GROUP, a Dutch naturalistic cohort study. The Subjective Well-being under Neuroleptics-20 (SWN-20) scale was used to assess well-being. Coping styles were assessed with the Utrechtse Coping Lijst (UCL). Life events were assessed using an adaptation of the Interview of the Recent Life Event Scale (IRLES). Siblings, but not patients, who experienced negative life events in the previous three year period were more likely to experience a lower well-being. For both groups passive coping styles mediated the relation between negative life events and subjective well-being. Severity of positive, negative or affective symptoms did not change this relationship. Our findings point to a better recognition of copings styles as a therapeutic target to promote well-being and recovery.
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Affiliation(s)
- Floor A van Dijk
- Department of Early Psychosis, Academic Medical Centre of the University of Amsterdam, Amsterdam, the Netherlands.
| | - Frederike Schirmbeck
- Department of Early Psychosis, Academic Medical Centre of the University of Amsterdam, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Lindy-Lou Boyette
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Lieuwe de Haan
- Department of Early Psychosis, Academic Medical Centre of the University of Amsterdam, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
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Chisholm KE, Wigman JTW, Hallett D, Woodall T, Mahfouda S, Reniers RLEP, Killackey E, Yung AR, Wood SJ, Lin A. The role of coping in the association between subclinical psychotic experiences and functioning: A within study replication in two independent adolescent samples. Schizophr Res 2018; 201:91-97. [PMID: 29885966 DOI: 10.1016/j.schres.2018.05.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/09/2018] [Accepted: 05/13/2018] [Indexed: 11/16/2022]
Abstract
An inverse association between psychosocial functioning and psychotic experiences is now established in both clinical and non-clinical populations, however the mechanisms which drive this are unclear. Adolescents with subclinical psychotic experiences (SPE) are more likely to use maladaptive coping strategies and less likely to use adaptive ones, and maladaptive coping has also been associated with poor functioning. A within study replication in two adolescent samples from the general populations of Melbourne, Australia (n = 723) and Birmingham, United Kingdom (n = 239), was conducted to determine whether the association between SPE and psychosocial functioning is mediated by coping style. SPE were associated with reduced general and family functioning and to a lesser extent with reduced peer functioning. Task-oriented (focusing on solving the problem) and emotion-oriented (negative emotional responses) coping were found to mediate the relationship between SPE and three types of functioning in both the Melbourne and the Birmingham samples. The within study replication consistently found that coping style mediates SPE and psychosocial functioning, despite significant differences in age, gender, functioning, use of coping styles, and level of SPE between the two samples. Longitudinal research is needed to fully understand any causal role coping may play in the relationship between SPE and poor functioning. The results have important public health and clinical implications, and suggest that techniques which increase levels of adaptive coping and reduce levels of maladaptive coping (in particular emotion-oriented styles) may help to break the cycle between SPE, functional decline, and eventual need for care.
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Affiliation(s)
- Katharine E Chisholm
- Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, United Kingdom.
| | - Johanna T W Wigman
- University of Groningen, University Medical Center Groningen, Dept. of Psychiatry, ICPE, The Netherlands
| | - Danielle Hallett
- Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Tamara Woodall
- Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Simone Mahfouda
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Renate L E P Reniers
- Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, United Kingdom; Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Eoin Killackey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Alison R Yung
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom; Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Stephen J Wood
- Institute for Mental Health, School of Psychology, University of Birmingham, Edgbaston, Birmingham, United Kingdom; Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
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Rujkorakarn D, Buatee S, Jundeekrayom S, Mills AC. Living with schizophrenia in rural communities in north-east Thailand. Int J Ment Health Nurs 2018; 27:1481-1489. [PMID: 29484809 DOI: 10.1111/inm.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 11/29/2022]
Abstract
In the rural villages of Thailand, rich social support networks exist that bond the community members to help each other. This study explored the barriers and facilitators of living with schizophrenia in Thai villages. A descriptive qualitative study was conducted using semi-structured interviews with individuals with schizophrenia, family members, and significant others. Content analysis of transcripts involved examining the data, recording observations, data reduction, and coding themes. Four main themes emerged from the narratives: (i) keep doing day-to-day activities as a way of life; (ii) support sustains day-to-day living; (iii) controlling medication side effects maintains daily living; and (iv) managing self maintains daily living. Self-regulation and social support are keys to moving from dependence to a normative life goal in rural communities. The patterns of living in the rural communities provide a strong social network as people with schizophrenia learn to lead successful lives. Using supportive families and community members as resources is an alternative and effective way of providing supportive care.
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Affiliation(s)
- Darunee Rujkorakarn
- Faculty of Nursing, Mahasarakham University, Mahasarakham Province, Thailand
| | - Supatra Buatee
- Faculty of Nursing, Mahasarakham University, Mahasarakham Province, Thailand
| | - Surada Jundeekrayom
- Faculty of Nursing, Mahasarakham University, Mahasarakham Province, Thailand
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Mian L, Lattanzi GM, Tognin S. Coping strategies in individuals at ultra-high risk of psychosis: A systematic review. Early Interv Psychiatry 2018; 12:525-534. [PMID: 29761632 DOI: 10.1111/eip.12492] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/15/2017] [Accepted: 08/20/2017] [Indexed: 01/07/2023]
Abstract
AIM The impact of dysfunctional coping strategies during the prodromal phase of psychosis has recently been explored by several studies. What has yet to be clarified is whether maladaptive coping is evident in the prodromal phase and the impact that this might have on symptomatic and functional outcomes. The aim of this study was to review the findings on coping in individuals at ultra-high risk of psychosis (UHR) in relation to symptoms and level of functioning. METHODS Original articles were identified by searching 7 databases using the terms "prodrom*," "ultra high risk," "clinical high risk," "at-risk mental state," "coping style*," "coping strategies," "cope," "coping" and "psychosis". We included original articles that: (1) reported a measure of coping and (2) evaluated UHR individuals. RESULTS A total of 9 original articles of 335 that examined coping in individuals at high risk of psychosis were included. UHR subjects were more likely to use maladaptive coping strategies than healthy controls and were more likely to use emotion-focussed than task-oriented coping. Maladaptive coping was associated with higher levels of negative symptoms, whereas positive coping was associated with fewer negative symptoms. The coping style employed by UHR individuals was found to negatively influence their psychosocial functioning. CONCLUSIONS It is still unclear whether coping heightens or reduces the likelihood of transition to psychosis in relation to other factors, including environment. Longitudinal studies could clarify whether coping styles remain stable after the onset of psychosis or whether the emerging psychotic symptoms influence the coping strategies.
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Affiliation(s)
- Louise Mian
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Guido Maria Lattanzi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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38
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López-Navarro E, Del Canto C, Mayol A, Fernández-Alonso O, Munar E. Psychotic symptoms and quality of life: A mediation analysis of daily-life coping. Psychiatry Res 2018; 262:505-509. [PMID: 28942958 DOI: 10.1016/j.psychres.2017.09.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/12/2017] [Indexed: 11/17/2022]
Abstract
Prior studies suggest the relationship between psychotic symptoms and Quality of Life (QoL) may be mediated by diverse constructs. QoL in schizophrenia-related disorders has been related with coping with daily stressors. Based on previous studies, our hypothesis was that coping mediates the relationship between psychotic symptoms and QoL. Therefore, the aim of the study was to test the hypothesis in a sample of people with schizophrenia-related disorders from a community rehabilitation center. Sixty-six patients were assessed using PANSS, WHOQOL-BREF questionnaire, and COPE Inventory. Regression analyses were performed for each WHOQOL-BREF dimension using PANSS and COPE factors as predictors. Mediation analysis was performed for each WHOQOL-BREF dimension using significant PANSS scales as predictors and significant COPE factors as mediators. Sobel test showed that Self-Sufficient (Problem-focused) coping mediates the relationship between PANSS Positive and WHOQOL-BREF Psychological and WHOQOL-BREF Environmental scores. Results suggest that coping style based on personal abilities and oriented to the stressors mediates the relationship between positive symptoms and QoL associated to well-being and environmental features. However, in our study no coping style mediated the relationship between negative symptoms and QoL. Depressive symptoms predicted each QoL dimension and were not mediated by any coping style.
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Affiliation(s)
- Emilio López-Navarro
- EvoCog Group - Associated Unit to CSIC, University of Balearic Islands, Balearic Islands, Spain.
| | - Cristina Del Canto
- Department of Clinical Psychology - Son Espases Hospital, Balearic Health Service, Balearic Islands, Spain
| | - Antoni Mayol
- EvoCog Group - Associated Unit to CSIC, University of Balearic Islands, Balearic Islands, Spain; UCR Serralta Community Rehabilitation Centre, Balearic Health Service, Balearic Islands, Spain
| | - Ovidio Fernández-Alonso
- UCR Serralta Community Rehabilitation Centre, Balearic Health Service, Balearic Islands, Spain
| | - Enric Munar
- EvoCog Group - Associated Unit to CSIC, University of Balearic Islands, Balearic Islands, Spain
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40
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Rönngren Y, Björk A, Kristiansen L, Haage D, Enmarker I, Audulv Å. Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting. Int J Ment Health Nurs 2018; 27:390-399. [PMID: 28374967 DOI: 10.1111/inm.12333] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2017] [Indexed: 11/28/2022]
Abstract
Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16-25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting.
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Affiliation(s)
- Ylva Rönngren
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Annette Björk
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | | | - David Haage
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Ingela Enmarker
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden.,Department of Health and Occupational Studies, University of Gävle, Gävle, Sweden.,Center for Care Research, Mid-Norway, Steinkjer, Norway
| | - Åsa Audulv
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
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41
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van Dijk FA, Schirmbeck F, Haan LD. A longitudinal analysis of the effects of neuroticism and extraversion on subjective well-being in patients with schizophrenia. Psychiatry Res 2018; 259:538-544. [PMID: 29156427 DOI: 10.1016/j.psychres.2017.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/21/2017] [Accepted: 11/03/2017] [Indexed: 11/30/2022]
Abstract
One in five patients with a psychotic disorder has persistent low subjective well-being (SWB), which is associated with a poorer prognosis. In schizophrenia patients, personality traits are associated with SWB. The present study aims to evaluate whether neuroticism and extraversion influence SWB in patients with a psychotic disorder and healthy controls over the course of time. In 186 patients and 126 healthy control subjects, SWB was measured with the Subjective Well-being under Neuroleptics-20 (SWN) scale at baseline, three years and six years. We used the Five-Factor Inventory to assess neuroticism and extraversion. Mixed model analyses were conducted to investigate moderating associations of positive, negative and depressive symptoms, cannabis use, illness insight, weak social support and antipsychotic medication in patients. Higher neuroticism and lower extraversion were associated with lower SWB over six years in both groups. Personality traits did not have a differential effect on the course of SWB over time. In patients, a stable low SWB was found in 15.1% of the subjects. This group scored highest on neuroticism and lowest on extraversion compared to subjects with an increase in SWB or a stable high SWB. Our findings underline that personality traits are correlated to subjective well-being regardless of psychotic or depressive symptoms.
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Affiliation(s)
- Floor A van Dijk
- Department Early Psychosis, Academical Medical Centre of the University of Amsterdam, Amsterdam, The Netherlands.
| | - Frederike Schirmbeck
- Department Early Psychosis, Academical Medical Centre of the University of Amsterdam, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department Early Psychosis, Academical Medical Centre of the University of Amsterdam, Amsterdam, The Netherlands
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- Department Early Psychosis, Academical Medical Centre of the University of Amsterdam, Amsterdam, The Netherlands
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42
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Choo CC, Chew PKH, Ho CS, Ho RC. Quality of Life in Patients With a Major Mental Disorder in Singapore. Front Psychiatry 2018; 9:727. [PMID: 30713508 PMCID: PMC6346635 DOI: 10.3389/fpsyt.2018.00727] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/10/2018] [Indexed: 11/29/2022] Open
Abstract
Background: There has been a paradigm shift in mental health service delivery, from a focus on reducing symptoms to a more holistic approach, which considers Quality of Life (QoL). Method: This study aimed to explore prediction of Quality of Life (QoL) in Asian patients with a major mental disorder i.e., depression or schizophrenia in Singapore. In the current study, there were 43 patients (65.1% females) with depression. Their ages ranged from 18 to 65 (M = 44.63, SD = 12.22). The data were combined with the data on patients with schizophrenia, where there were 43 patients (65.1% females) with schizophrenia, their ages ranging from 18 to 65 (M = 44.60, SD = 12.19). Results: The components of QoL were examined i.e., Physical Component Summary (PCS) and Mental Component Summary (MCS). For all patients, social support and age accounted for 17.3% of the variance in PCS, F (2, 83) = 8.66, p < 0.001. For patients with depression, disorder severity, age, and duration of treatment accounted for 48.3% of the variance in PCS, F (3, 39) = 12.15, p < 0.001. For patients with schizophrenia, education (Primary or Lower vs. Post-Secondary or Higher) and emotional coping accounted for 21.3% of the variance in PCS, F (2, 40) = 5.40, p < 0.01. For all patients, self-efficacy and age accounted for 27.0% of the variance in MCS, F (2, 83) = 15.37, p < 0.001. For patients with depression, disorder severity accounted for 45.6% of the variance in MCS, F (1, 41) = 34.33, p < 0.001. For patients with schizophrenia, number of hospitalizations accounted for 18.5% of the variance in MCS, F (1, 41) = 9.29, p < 0.01. Conclusion: The findings were discussed in regards to implications in interventions to enhance QoL of patients with schizophrenia and depression in Singapore.
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Affiliation(s)
- Carol C Choo
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore, Singapore
| | - Peter K H Chew
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore, Singapore
| | - Cyrus S Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
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Buonocore M, Bosia M, Bechi M, Spangaro M, Cavedoni S, Cocchi F, Bianchi L, Guglielmino C, Mastromatteo AR, Cavallaro R. Targeting anxiety to improve quality of life in patients with schizophrenia. Eur Psychiatry 2017; 45:129-135. [PMID: 28756111 DOI: 10.1016/j.eurpsy.2017.06.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/29/2017] [Accepted: 06/29/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Several studies suggested that anxiety can significantly affect the outcome of schizophrenia. Despite this evidence, non-pharmacological interventions targeting anxiety are still heterogenous. This study aims to test the efficacy of a novel training specifically designed to target anxiety in patients with schizophrenia. Innovatively, this training, beyond psychoeducation and problem solving, also targets Theory of Mind, as it provides coping strategies. METHOD Twenty-seven outpatients with schizophrenia received a novel rehabilitative training targeting anxiety (Anxiety Management Group [AMG]) combined with a Computer-Assisted Cognitive Remediation (CACR), and twenty received CACR plus a control intervention (Control Newspaper discussion Group [CNG]). All patients were assessed at baseline and after treatment for quality of life, neurocognition and anxiety. RESULTS After training, patients treated with AMG+CACR showed significantly greater improvements on anxiety. A significant increase in quality of life was observed only for AMG+CACR group. Moreover, the participants' appraisal showed a significant difference between treatment groups with higher ratings among patients who received the AMG+CACR. CONCLUSIONS This study thus suggests feasibility and efficacy of the proposed intervention, that could be implemented in rehabilitative programs for patients with schizophrenia with potential benefits also on disease course and outcome.
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Affiliation(s)
- M Buonocore
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy.
| | - M Bosia
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - M Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy
| | - M Spangaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - S Cavedoni
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy
| | - F Cocchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy
| | - L Bianchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy
| | - C Guglielmino
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy
| | - A R Mastromatteo
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - R Cavallaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
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The relationships of personal resources with symptom severity and psychosocial functioning in persons with schizophrenia: results from the Italian Network for Research on Psychoses study. Eur Arch Psychiatry Clin Neurosci 2017; 267:285-294. [PMID: 27381016 DOI: 10.1007/s00406-016-0710-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022]
Abstract
The relationships of personal resources with symptom severity and psychosocial functioning have never been tested systematically in a large sample of people with schizophrenia. We applied structural equation models to a sample of 921 patients with schizophrenia collected in a nationwide Italian study, with the aim to identify, among a large set of personal resources, those that may have an association with symptom severity or psychosocial functioning. Several relevant demographic and clinical variables were considered concurrently. Poor service engagement and poor recovery style, as well as older age and younger age at onset, were related to greater symptom severity and poorer social functioning. Higher resilience and higher education were related to better social functioning only. Poor problem-focused coping and internalized stigma, as well as male gender and depression, were related to symptom severity only. The explored variables showed distinctive and partially independent associations with symptom severity and psychosocial functioning. A deeper understanding of these relationships may inform treatment decisions.
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45
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Gooding PA, Littlewood D, Owen R, Johnson J, Tarrier N. Psychological resilience in people experiencing schizophrenia and suicidal thoughts and behaviours. J Ment Health 2017. [PMID: 28635432 DOI: 10.1080/09638237.2017.1294742] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Negative stressors can aggravate the impact of schizophrenia. However, some people find ways of combating such stressors. There is a dearth of research examining factors which enable individuals with schizophrenia to show psychological resilience.Aims: The goal of this study was to investigate resilience to negative stressors in people with disorders on the schizophrenia spectrum using a qualitative methodology.Methods: Data were collected from 23 participants who had experienced schizophrenia and suicidal thoughts and behaviours. Semi-structured interviews followed a topic guide. Participants were asked (i) what resilience meant to them, (ii) which stressors they had experienced over 12 months and (iii) how they had counteracted those stressors. Thematic analysis was conducted to identify re-occurring themes across interviews.Results: A continuum of psychological mechanisms described participants' views about the meaning of resilience which ranged from passive acceptance to resistance (e.g. withstanding pressure), and then to active strategies to counter stressors (e.g. confronting). These themes were also evident in narratives expressing personal resilience strategies but, additionally, included emotional coping techniques. External factors were highlighted that supported resilience including social support, reciprocity and religious coping.Conclusions: People with schizophrenia develop ways of being resilient to negative events which should inform therapeutic interventions.
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Affiliation(s)
| | - Donna Littlewood
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Rebecca Owen
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Judith Johnson
- School of Psychology, University of Leeds, Leeds, UK.,Bradford Institute of Health Research, Bradford Teaching Hospitals, Bradford, UK, and
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46
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Choo CC, Chew PKH, Ho CS, Ho RC. Prediction of Quality of Life in Asian Patients with Schizophrenia: A Cross-sectional Pilot Study. Front Psychiatry 2017; 8:198. [PMID: 29051741 PMCID: PMC5634161 DOI: 10.3389/fpsyt.2017.00198] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/21/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There has been a shift in mental health services from an emphasis on treatment focused on reducing symptoms to a more holistic approach involving quality of life (QOL) and overall well-being. Many psychosocial variables are associated with QOL but a parsimonious framework is needed to deepen our understanding about the contribution of psychosocial factors in influencing the QOL of Asian patients with schizophrenia in Singapore. The study aimed to address the current gap in literature by analysis of QOL using available predictors in Asian patients with schizophrenia in Singapore. METHODS 43 Singaporean patients diagnosed with schizophrenia were recruited at a large teaching hospital in Singapore from January to May 2010 and were invited to complete questionnaires. Of the sample, 65.1% were females, ages ranged from 18 to 65 (M = 44.60, SD = 12.19). Available variables were subjected to regression analysis. FINDINGS The data were analyzed using SPSS Version 23 with the alpha level set at 0.05. The final model with five predictors was significant in predicting QOL. Positive Re-appraisal, Social Support, Avoidant Coping, Duration of Hospitalization, and Education accounted for 47.2% of the variance (Adjusted R2 = 40.0%) in QOL, F (5, 37) = 6.60, p < 0.001. Those with post-secondary or higher education had higher QOL than those with secondary or lower education. Duration of hospitalization negatively predicted QOL. CONCLUSION The findings were discussed in regards to clinical implications for informing interventions to enhance QOL in patients with schizophrenia.
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Affiliation(s)
- Carol C Choo
- College of Healthcare Sciences, James Cook University Singapore, Singapore, Singapore
| | - Peter K H Chew
- College of Healthcare Sciences, James Cook University Singapore, Singapore, Singapore
| | - Cyrus S Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Roger C Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
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Mingrone C, Montemagni C, Sandei L, Bava I, Mancini I, Cardillo S, Rocca P. Coping strategies in schizoaffective disorder and schizophrenia: Differences and similarities. Psychiatry Res 2016; 244:317-23. [PMID: 27517342 DOI: 10.1016/j.psychres.2016.06.059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 04/08/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022]
Abstract
Aims of the current study were to explore differences in coping between 58 patients with schizoaffective disorder (SAD) and 89 with schizophrenia (SZ) and to identify factors associated with coping in both disorders. The demographic and clinical characteristics of patients with SAD and with SZ were compared using ANOVA and χ(2). Pearson's correlations were calculated between coping styles and socio-demographic and clinical variables in each group. The significant ones were subsequently analyzed using multiple regressions. Patients with SAD used emotion oriented coping more frequently than patients 2016with SZ. In patients with SAD, self-esteem contributed to task-oriented; avolition-anhedonia (AA) to emotion-oriented; duration of illness and years of education to distraction; AA to social diversion. In patients with SZ, AA, the mental component summary score of the Short Form - 36 Health Survey (SF-36) and self-esteem contributed to emotion oriented coping; the mental component summary score of SF-36 to distraction; AA to social diversion. Our results suggest that patients with SAD and SZ use diverse coping strategies. A greater attention must be given to the presence of self-esteem and AA in individuals with both disorders. These factors are potentially modifiable from specific therapeutic interventions, which can produce effects on coping strategies.
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Affiliation(s)
- Cinzia Mingrone
- Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSCVD), Department of Mental Health ASL TO1- A.O.U. Città della Salute e della Scienza di Torino, Italy
| | - Cristiana Montemagni
- Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSCVD), Department of Mental Health ASL TO1- A.O.U. Città della Salute e della Scienza di Torino, Italy
| | - Luisa Sandei
- Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSCVD), Department of Mental Health ASL TO1- A.O.U. Città della Salute e della Scienza di Torino, Italy
| | - Irene Bava
- Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSCVD), Department of Mental Health ASL TO1- A.O.U. Città della Salute e della Scienza di Torino, Italy
| | - Irene Mancini
- Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSCVD), Department of Mental Health ASL TO1- A.O.U. Città della Salute e della Scienza di Torino, Italy
| | - Simona Cardillo
- Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSCVD), Department of Mental Health ASL TO1- A.O.U. Città della Salute e della Scienza di Torino, Italy
| | - Paola Rocca
- Department of Neuroscience, University of Turin, Struttura Semplice di Coordinamento a Valenza Dipartimentale (SSCVD), Department of Mental Health ASL TO1- A.O.U. Città della Salute e della Scienza di Torino, Italy.
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Jung E, Wiesjahn M, Wendt H, Bock T, Rief W, Lincoln TM. Symptoms, functioning and coping strategies in individuals with schizophrenia spectrum disorders who do not take antipsychotic medication: a comparative interview study. Psychol Med 2016; 46:2179-2188. [PMID: 27269768 DOI: 10.1017/s0033291716000775] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND A considerable proportion of people with schizophrenia spectrum disorders do not take antipsychotic medication but seem to be functioning well. However, little is known about this group. To test the assumption that absence of medication is compensated for by more effective coping and increased social support, this study compared symptoms, functioning, coping strategies and social support in non-medicated and medicated individuals with schizophrenia spectrum disorders. METHOD In all, 48 participants with a DSM-IV schizophrenia spectrum disorder who were taking (n = 25) or not taking antipsychotic medication (n = 23) were included. Assessment consisted of self-ratings of symptoms, symptom-related distress and social support combined with a semi-structured interview that assessed general and social functioning, subjective evaluation of symptoms and coping strategies. RESULTS Symptom severity and distress did not differ between the groups. However, the non-medicated participants had significantly higher levels of general functioning than medicated participants and a longer duration of being non-medicated was significantly associated with a higher level of general functioning. In contrast to the hypotheses, not taking medication was not associated with more effective coping strategies or with higher levels of social support. Medicated participants more frequently reported the use of professional help as a coping strategy. CONCLUSIONS Our results corroborate previous studies finding improved functioning in individuals with schizophrenia spectrum disorders who do not take medication compared with those who take medication, but do not support the notion that this difference is explicable by better coping or higher levels of social support. Alternative explanations and avenues for research are discussed.
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Affiliation(s)
- E Jung
- Department of Psychology,Division of Clinical Psychology and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - M Wiesjahn
- Department of Psychology,Division of Clinical Psychology and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - H Wendt
- Department of Clinical Psychology and Psychotherapy,Institute of Psychology,University of Hamburg,Hamburg,Germany
| | - T Bock
- Department of Psychiatry and Psychotherapy,University Medical Center Hamburg-Eppendorf,Hamburg,Germany
| | - W Rief
- Department of Psychology,Division of Clinical Psychology and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - T M Lincoln
- Department of Clinical Psychology and Psychotherapy,Institute of Psychology,University of Hamburg,Hamburg,Germany
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49
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Personality and coping in first episode psychosis linked to mental health care use. Psychiatry Res 2016; 238:218-224. [PMID: 27086236 DOI: 10.1016/j.psychres.2016.02.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/03/2016] [Accepted: 02/16/2016] [Indexed: 12/24/2022]
Abstract
A body of literature focuses on associations of neuroticism, extraversion, passive coping and active coping with the course of psychotic illness. Less is known about other personality and coping variables - and underlying causal mechanisms between variables remain unclear. We explored causal effects from personality, coping and symptoms on mental health care consumption over two years in 208 first episode patients. Causal inference search algorithms lead to formation of a hypothetical causal model based on presumptions on (non-)mutuality between variables and consistent with data. Structural equation modelling estimated effect sizes conditionally on the causal model. Our observed model implies that none of the coping or personality variables have any effect on the number of days of hospitalisation, whereas general psychopathology symptoms do have a direct positive effect. For ambulatory care it is proposed that openness to experience, depressive symptoms and age have direct positive effects. Reassuring thoughts as a coping strategy seems to have a direct negative effect on the use of ambulatory care and mediates indirect effects of other personality and coping variables on ambulatory care. Furthermore, while previously established relations between personality and symptoms are confirmed by our model, it challenges traditional ideas about causation between personality and symptoms.
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50
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Kommescher M, Wagner M, Pützfeld V, Berning J, Janssen B, Decker P, Bottlender R, Möller HJ, Gaebel W, Maier W, Klosterkötter J, Bechdolf A. Coping as a predictor of treatment outcome in people at clinical high risk of psychosis. Early Interv Psychiatry 2016; 10:17-27. [PMID: 24612629 DOI: 10.1111/eip.12130] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 12/20/2013] [Indexed: 12/17/2022]
Abstract
AIM The concept of coping is relevant to recent models of psychosis, and people with established psychotic disorders have been found to predominately use maladaptive coping strategies. This study aimed to examine the general coping patterns of people at clinical high risk of psychosis (CHR) and to investigate whether pre-therapy coping behaviour plays a role in predicting responsiveness to early interventions. METHODS One hundred twenty-eight help-seeking CHR outpatients were randomized into two treatment groups: either receiving integrated psychological intervention (IPI), including cognitive behaviour therapy, or supportive counselling (SC) for 12 months. Of those, 91 persons completed a Stress Coping Questionnaire (SCQ) at intake: 45 in the IPI group and 46 in the SC group. General coping behaviour in this sample was analysed and several regressions were conducted separately for each treatment group to examine coping as a predictor of outcome after 12 months of different forms of treatment. RESULTS Participants relied significantly more on negative than on positive coping strategies, t(90) = -7.185, P < 0.001, and within the positive strategies, stress control was the most preferred one, t(90) = 10.979, P < 0.001. Several pre-therapy coping strategies significantly predicted improvement in symptomatic outcome in both treatment groups, explaining between 16% and 25% of variance. The predictive value of coping was higher in the SC group. CONCLUSIONS Maladaptive coping behaviours were found to emerge in the early stages of psychosis and coping behaviour contributed significantly to the prediction of post-treatment symptom improvement. These findings indicate a need for psychosocial support and coping strategy enhancement in people at risk of psychosis.
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Affiliation(s)
- Mareike Kommescher
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Verena Pützfeld
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Julia Berning
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Birgit Janssen
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany
| | - Petra Decker
- Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany
| | - Ronald Bottlender
- Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | | | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
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