Debate surrounding assisted outpatient treatment has mostly focused on issues of due process, cost-effectiveness, and efficacy as measured by readmission and incarceration rates. Less attention has been paid to whether long-term use of antipsychotic treatment is supported by sufficient evidence to warrant its compulsory use in assisted outpatient treatment programs. The authors examine the rationale and evidence for long-term use of antipsychotics, noting the pervasive belief within the psychiatric community that psychotic illness, especially schizophrenia, requires lifelong medication. They argue that although antipsychotics are clearly indicated for patients in the acute phase of psychotic illness, the evidence for long-term use is less convincing and may not justify compulsory long-term use. Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://bit.ly/1Xyazai
Cannabis use among patients with first episode psychosis is associated with substantially worse clinical outcomes, a large study published in BMJ Open has found. To read the full article, log in using your NHS OpenAthens details
Agreement between client and therapist is an essential part of the therapeutic alliance. While there are general challenges to the creation of agreement and shared meaning in all psychotherapies, there are specific challenges while working with persons with psychosis. These challenges include the different narratives of the client and the therapist with regard to their roles and the description of the condition or problem, as well as possible stigmatic views and theoretical bias. Here we present a metacognitive intersubjective model as a framework for the understanding and resolutions of these challenges. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - http://bit.ly/1Xyazai
Psychotherapy 53.1 (Mar 2016): 57-67.
Objective: Caring for a family member with schizophrenia often results in high degrees of self-conscious emotions (shame and guilt/self-blame), burden, and other serious mental health consequences. Research suggests that ethnic and cultural factors strongly influence the manner in which family members respond to mental illness. Research further indicates that certain cultural practices and values (spirituality, collectivism) may assist family members in coping with the self-conscious emotions and burden associated with caregiving. With this in mind, the authors have developed a family-focused, culturally informed treatment for schizophrenia (CIT-S). To read the full article, log in using your NHS OpenAthens details
Because there is no conclusive evidence on whether early signs of improvement predict later non-response to antipsychotics in patients with schizophrenia spectrum disorders, the treatment guidelines for schizophrenia, such as those from National Institute for Health and Care Excellence,1 remain unclear as to when a treatment should be changed if patients are unresponsive to a recently prescribed antipsychotic.
Therefore, Samara and colleagues performed this diagnostic meta-analysis to examine whether a lack of significant improvement at week 2 could predict ultimate treatment failure. To read the full commentary, log in using your NHS OpenAthens details
Childhood abuse has been implicated as an environmental factor that increases the risk for developing schizophrenia. A recent large population-based case–control study found that abuse may be a risk factor for schizophrenia in women, but not men. Given the sex differences in onset and clinical course of schizophrenia, we hypothesized that childhood abuse may cause phenotypic differences in the disorder between men and women.
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Objective To investigate whether cannabis use is associated with increased risk of relapse, as indexed by number of hospital admissions, and whether antipsychotic treatment failure, as indexed by number of unique antipsychotics prescribed, may mediate this effect in a large data set of patients with first episode psychosis (FEP). Open Access Article
Open access. The potential dynamics of cognitive impairment in schizophrenia is discussed in the literature of the field. Recent publications suggest modest changes in level of cognitive impairment after first psychotic episode. Present article attempts to explore cognitive differences between patients and controls across age groups and differences between age groups in clinical group.
Open access. Current practice guidelines for schizophrenia care recommend that antipsychotic medication is essential for patients’ long-term maintenance treatment but their non-adherence to this medication is still a main obstacle to relapse prevention. This study evaluated the effects of a motivational-interviewing-based adherence therapy for people with schizophrenia spectrum disorders.
To investigate the likelihood of early diagnosis and treatment in patients with schizophrenia who have cancer and their prognosis. Library Services do not currently have access to this journal through this site, but you can request a copy of the article online and we will get a copy to you: http://bit.ly/1Xyazai
.....But here’s the rub, despite intuitively feeling integrated care is the best option, the evidence to date doesn’t support its effectiveness. So when a study is published exploring integrated care over a long time period for people with a dual diagnosis, it’s a must read.....
Despite the multitude of longitudinal neuroimaging studies that have been published, a basic question on the progressive brain loss in schizophrenia remains unaddressed: Does it reflect accelerated aging of the brain, or is it caused by a fundamentally different process? The authors used support vector regression, a supervised machine learning technique, to address this question. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
In this article, we focus on the emerging evidence in pharmacogenetics and biomarkers for assessing individual response and tolerability of antipsychotic medication in schizophrenia. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Previous qualitative studies have found that exercise may facilitate symptomatic and functional recovery in people with long-term schizophrenia. This study examined the perceived effects of exercise as experienced by people in the early stages of psychosis, and explored which aspects of an exercise intervention facilitated or hindered their engagement.
What are the implications for practice?
We think our study highlights the complicated internal struggles that people with first episode psychosis have with medication.
Our study highlights how Nurses and Doctors need to try and better understand what it is like to take these drugs and work collaboratively with patients to support them to make informed choices about treatment. Login using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://www.sssft.nhs.uk/library
Three biomarker-based categories, called biotypes, outperformed traditional diagnoses, such as schizophrenia and bipolar disorder with psychosis, in sorting psychosis cases into distinct subgroups on the basis of brain biology, report researchers funded by the National Institutes of Health. A hallmark of severe mental illness, psychosis is marked by hallucinations and delusions, or false, irrational beliefs.
Versions of a gene linked to schizophrenia may trigger runaway pruning of the teenage brain’s still-maturing communications infrastructure, NIH-funded researchers have discovered. People with the illness show fewer such connections between neurons, or synapses. The gene switched on more in people with the suspect versions, who faced a higher risk of developing the disorder, characterized by hallucinations, delusions and impaired thinking and emotions.
New research shows that treating people with first episode psychosis with a team-based, coordinated specialty care approach produces better clinical and functional outcomes than typical community care. Investigators also found that treatment is most effective for people who receive care soon after psychotic symptoms begin.
Stigma and Health1.1 (Feb 2016): 29-43.
The aims of this study are to verify this sequential structure and to determine if self-stigma is associated with lower quality of life (QoL) and depression. A total of 160 patients with schizophrenia participated in this study. To read the full article, log in using your NHS OpenAthens details
Psychotic phenomena can occur in non-clinical subjects. The goals of this study were to assess the prevalence of delusions, hallucinations and minor ‘psychotic’ phenomena (visual illusions, feeling of presence and passage hallucinations) and to describe the characteristics of the latter in a non-clinical older population. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
The cognitive impairments that are common in schizophrenia are associated with impairments across multiple domains, including attention/vigilance, verbal learning and memory, executive functioning, verbal fluency, and speed of processing. As a result, they are targets for drug development. There is a clear need for pharmacological agents that target cognitive impairment in schizophrenia for which there are currently no approved medications. The α7 nicotinic acetylcholine receptors (α7 receptors) have been shown to play an important role in cognition in animals and humans. Encenicline is an agonist exhibiting priming behaviour at the α7 receptor by potentiating the response to the natural agonist acetylcholine (ACh). Encenicline may work as a neuromodulator, with its impact on cognition mediated in part by modulating multiple …To read the full commentary, log in using your NHS OpenAthens details
Paranoia is characterized by a lack of perceived social safeness and associated negative affect. Low self-esteem, negative self-concepts and negative emotions have been shown to contribute to paranoid symptom formation. Thus, interventions focusing on affiliation and positive affect might be particularly helpful for patients with paranoia. The present study experimentally tested the effect of a one-session, brief compassion-focused imagery derived from Compassion-Focused Therapy (Gilbert, 2009) versus a control imagery condition in a repeated measures randomized design. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
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Background There is no available evidence providing detailed and valid accounts of how people with schizophrenia construct meaning in their lives.
Aim To explore the lived experiences of people with schizophrenia who had been prescribed atypical antipsychotic medications. Login using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://www.sssft.nhs.uk/library
Obsessive–compulsive symptoms (OCS) frequently occur in psychotic disorders. Cross-sectional associations between OCS and cognitive impairment have led to different causal explanations. Whereas one assumes that higher cognitive impairment reflects a risk factor for psychotic patients to develop OCS, another suggests that deficits reflect a consequence of OCS. This study investigated the longitudinal interrelation between OCS and cognitive functioning. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
While the original goal of intensive community-based service programs such as assertive community treatment (ACT) was reduction of hospital use, this goal has diminished in importance because of the extensive reduction in inpatient bed availability and use. This study sought to identify target populations that benefit most from such programs, hypothesizing that those with psychotic symptoms would show more benefits than others because of improved medication compliance. To read the full article, log in using your NHS Athens
Open access. The Maintaining Adherence Programme (MAP) is a new model of care for patients with schizophrenia, schizoaffective disorder and bipolar affective disorder which aims to encourage adherence and prevent relapse. This evaluation, conducted by retrospective and prospective data collection (including patient questionnaires and staff interviews), aimed to describe MAP's impact on healthcare resource use, clinical measures and patient and staff satisfaction, following its implementation in a university National Health Service (NHS) foundation trust in England.
To establish whether frontal dysfunction, as indexed by slowing, would be associated with functional impairments. Library Services do not currently have access to this journal through this site, but you can request a copy of the article online and we will get a copy to you: http://bit.ly/1Xyazai
We sought to assess the impact of eQTL variants on bipolar disorder risk by combining data from both bipolar disorder genome-wide association studies (GWAS) and brain eQTL. Library Services do not currently have access to this journal through this site, but you can request a copy of the article online and we will get a copy to you: http://bit.ly/1Xyazai
Open access. Music therapy (MT) has been used as adjunct therapy for schizophrenia for decades. However, its role is still inconclusive. A recent meta-analysis demonstrated that MT for schizophrenic patients only significantly benefits negative symptoms and mood symptoms rather than positive symptoms. In addition, the association between specific characteristics of MT and the treatment effect remains unclear. The aim of this study was to update the published data and to explore the role of music therapy in adjunct treatment in schizophrenia with a thorough meta-analysis.
While much research has focused on individual therapies, the benefits of group psychotherapies for schizophrenia (including CBT, music and art therapies, social skills training etc.) have received less attention from researchers.
Findings suggest that the way an individual understands their experiences has important consequences on subsequent health behaviour. One aspect of an individual's understanding is what they believe has caused their experiences. This has been associated with treatment outcome and attitudes towards mental health problems. The aim of this systematic review was to examine the impact of causal beliefs on treatment outcome and stigma in people experiencing psychosis. Login using your SSOTP NHS OpenAthens for full text. SSSFT - request a copy of the article from the library - www.sssft.nhs.uk/library
To examine the prevalence of nightmares in people with psychosis and to describe the link between nightmares and sleep quality, psychotic, affective, and cognitive symptoms. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Multiple etiological and prognostic factors have been implied in schizophrenia and its outcome. Advanced paternal age has been reported as a risk factor in schizophrenia. Whether this may affect schizophrenia outcome was not previously studied. We hypothesized that advanced paternal age may have a negative effect on the outcome of relapse in schizophrenia. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
It has been reported that up to 50% of patients receiving mental health services disengage from treatment, with adolescents and young adults being particularly at high risk. Even in the context of specialized services in youth mental health, such as early intervention programs for psychosis, disengagement rates remain high. There is a need for extensive and innovative efforts to address the issue of service disengagement in first-episode psychosis (FEP). A multi-dimensional understanding of the phenomenon of engagement can help to inform the development of strategies to address this important clinical issue. In our paper, we propose a conceptual framework for understanding service engagement, provide an overview of the issues pertaining to service engagement in FEP, and suggest future directions for research and practice. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Psychoanalytic Psychology33.1 (Jan 2016): 147-160.
A review of psychoanalytic writings reveals a vibrant but overlooked history of descriptions of the phenomenology of schizophrenia. In this paper we suggest that neglect of these important psychoanalytic contributions to the understanding of alterations of self-experience in schizophrenia is at least partially due to an absence of sufficient operational definitions by which to study these constructs. To read the full article, log in using your NHS OpenAthens details
Open access. Conclusion: The results clearly show that after one year of treatment with risperidone LAI, RSWG-remitted patients have a high level of global functioning, which is significantly higher than in stable, non-remitted patients. Social functioning was also higher in remitted patients as compared with stable, non-remitted patients.
The Cochrane Collaboration, known for their high-quality reviews and meta-analyses, recently published a systematic review of the efficacy of lithium as used to treat schizophrenia (Leucht et al, 2015).
SEminar paper on Schizophrenia by Prof. Michael J. Owen. Library Services do not currently have access to this journal, but you can request a copy of the article online and we will try to get a copy to you: http://bit.ly/1Xyazai
Background
It is important that mental health nurses meet the safety, security and care needs of persons suffering from psychotic illness to enhance these persons’ likelihood of feeling better during their time in acute psychiatric wards. Certain persons in care describe nurses’ mental health care as positive, whereas others report negative experiences and express a desire for improvements. There is limited research on how persons with psychotic illness experience nurses’ mental health care acts and how such acts help these persons feel better. Therefore, the aim of this study was to explore, describe and understand how the mental health nurses in acute psychiatric wards provide care that helps persons who experienced psychotic illness to feel better, as narrated by these persons. Open Access Article
Cardiac vagal tone, indexed by heart rate variability (HRV), is a proxy for the functional integrity of feedback mechanisms integrating central and peripheral physiology. Library Services do not currently have access to this journal through this site, but you can request a copy of the article online and we will get a copy to you: http://bit.ly/1Xyazai
Despite advances in schizophrenia treatment, symptom relapses and rehospitalizations impede recovery for many people and are a principal driver of the high cost of care. Technology-delivered or technology-enhanced treatment may be a cost-effective way to provide flexible, personalized evidence-based treatments directly to people in their homes and communities. Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://www.sssft.nhs.uk/library
Mental Elf Blog post. An appraisal of a meta-analysis looking at the effectiveness of a diagnostic screening tool for schizophrenia using multivariate pattern recognition techniques on brain images. This is part of the largely unsuccessful quest for clinically useful biomarkers in psychiatry for “functional” disorders (i.e. no obvious “organic” cause) like schizophrenia.
Mental Elf Blog post. Our limited understanding of the molecular basis of schizophrenia has restricted our ability to apply research findings in the clinic.
Antipsychotics are the mainstay of treatment, but they have low success rates (~60%), disabling adverse effects, damaging impact on physical health, and poor patient outcomes following ineffective treatment are well documented in the literature. The authors of a new paper published last month in npj Schizophrenia (Martins-de-Souza et al, 2015) examine the effects of antipsychotics on the blood plasma profile of 58 acutely ill schizophrenia patients who were either antipsychotic naive (n=23) or antipsychotic free for >6 weeks (n=35).
Mental Elf Blog post. The paper reviews the evidence for increased microglial activity in schizophrenia, such as post-mortem evidence and smaller studies including negative studies.
ABSTRACT FROM: Muller DR, Schmidt SJ, Roder V. One-year randomized controlled trial and follow-up of Integrated Neurocognitive Therapy for schizophrenia outpatients. Schizophr Bull 2015;41:604–16. To read the full commentary, log in using your NHS OpenAthens details
Findings.
Young adults with psychosis were significantly less likely to be engaged in postsecondary education. No difference appeared for the extent of engagement, but performance and satisfaction were lower among participants with psychosis. Participants engaged in reflexive decision making to access postsecondary education and to maintain adequate academic performance. Strategies used by successful students with mental illness were identified.
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The objectives of this study were to (1) analyze the prevalence of diabetes, prediabetes, and antidiabetic medication in patients with psychosis compared with control subjects and (2) determine what factors in patients with psychosis were associated with antidiabetic medication. Open Access Article
ABSTRACT FROM: Bergink V, Burgerhout KM, Koorengevel KM, et al. Treatment of psychosis and mania in the postpartum period. Am J Psychiatry 2015;172:115–23. To read the full article, log in using your NHS OpenAthens details
ABSTRACT FROM: Freeman D, Dunn G, Startup H, et al. Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): a parallel, single-blind, randomised controlled trial with a mediation analysis. Lancet Psychiatry 2015;2:305–13. To read the full article, log in using your NHS OpenAthens details
Animal models suggest that the development of psychosis involves hyperactivity in the hippocampus that drives increased activity in the midbrain and basal ganglia. The authors examined this hypothesis by measuring resting perfusion in the hippocampus, basal ganglia, and midbrain in people at high risk of psychosis. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Social disability is prevalent in FEP, although distinct recovery profiles are evident. Where social disability is present on entry into EIP services it can remain stable, highlighting a need for targeted intervention. Library Services do not currently have access to this journal, but you can request a copy of the article online and we will try to get a copy to you: http://bit.ly/1Xyazai
Some patients are at higher risk of contact with criminal justice agencies when experiencing a first episode of psychosis.
Aims:To investigate whether violence explains criminal justice pathways (CJPs) for psychosis in general, and ethnic vulnerability to CJPs. Library Services do not currently have access to this journal, but you can request a copy of the article online and we will try to get a copy to you: http://bit.ly/1Xyazai
People with psychosis face a life-restricting and life-shortening epidemic of obesity, diabetes and cardiovascular disease. This can be predicted by the associated antecedent risk factors evident from early in psychosis, yet remain largely ignored. Greater coordination between primary care, secondary care and public health to systematically prevent and intervene earlier for these physical illnesses offers a realistic solution to reduce this health inequality. Library Services do not currently have access to this journal, but you can request a copy of the article online and we will try to get a copy to you: http://bit.ly/1Xyazai
Open access. Social networks of patients with psychosis can provide social support, and improve health and social outcomes, including quality of life. However, patients with psychosis often live rather isolated with very limited social networks. Evidence for interventions targeting symptoms or social skills, are largely unsuccessful at improving social networks indirectly. As an alternative, interventions may directly focus on expanding networks. In this systematic review, we assessed what interventions have previously been tested for this and to what extent they have been effective.
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'This year, we've had encouraging news about integrated, comprehensive approaches for treating people with first episode psychosis, most recently from a major NIMH initiative, the Recovery After an Initial Schizophrenia Episode, or RAISE project. RAISE looked at coordinated specialty care for first episode psychosis.'
'The study is undoubtedly of value in furthering our understanding of the brain structure of people who experience abnormal perceptions. However, further research is needed to investigate whether this is a risk factor or a consequence of the condition. As such, at present it has no preventative or therapeutic implications.'
The authors compared the effectiveness of initiating treatment with either clozapine or a standard antipsychotic among adults with evidence of treatment-resistant schizophrenia in routine clinical practice. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
The question of whether there are significant changes in brain anatomy and function at illness onset and over the early course of schizophrenia is a crucial issue with broad implications for prognosis, patient care, and models of illness pathophysiology. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Although mortality related to psychotropic medications has received much attention in recent years, little is known about the relationship between risk of death and cumulative antipsychotic load, and even less about the relationship between mortality and cumulative exposure to antidepressants or benzodiazepines. The authors examined these relationships using nationwide databases. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
Auditory verbal hallucinations (AVHs) are core features of psychotic illness and remain significant in predicting poor outcome and risk. There has been a wide range of approaches to understanding these experiences.To read the full article, log in using your NHS OpenAthens details
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